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September 25, 2020

Lone transplant surgery centre in KP’s public sector closed


September 25, 2020

PESHAWAR: The only transplant surgery centre of the public sector in Khyber Pakhtunkhwa was closed down and transplant procedures stopped after the retirement of transplant surgeon Prof Asif Malik at the Institute of Kidney Diseases (IKD).

The professor after his retirement had offered his services free-of-cost for undertaking transplant procedures and even a patient was readied but some faculty members in IKD stopped him from the surgery. “There are multiple serious issues in IKD having a direct impact on patient care. The biggest loss is the retirement of Prof Asif Malik and lack of transplant surgeons in the centre to continue this highly sensitive procedure,” said a senior faculty member of IKD.

He said they had prepared a patient and completed all his investigations and Prof Asif Malik had agreed to perform a transplant but a few people in IKD raised issues and stopped him from the surgery.

“Interestingly, those who stopped Prof Asif Malik are holding key positions and one of them is on the post of professor of urologist and transplant surgeon but could not do a single procedure in his life. The ultimate sufferers are the poor patients and they would continue to pay the price of mismanagement if the chief minister and health minister didn’t intervene,” said the faculty member.

He said transplant procedures were carried out free-of-cost in IKD, except investigations and kidney matching, for which the patients had to pay.

After the transplant procedure, the patients are required to use life-long medications and all medicines, approximately Rs25,000 per month, are given free of cost in IKD.

Pleading anonymity, the faculty member said that Prof Asif Malik had offered to come to IKD after his retirement and do transplant surgeries free-of-cost and also train young surgeons. Prof Attaur Rahman was the pioneer of transplant surgery in KP and had first started procedures in IKD. After his retirement a couple of years ago, Prof Asif Malik remained the only transplant surgeon in IKD and in the public sector hospitals of the province. According to officials, around 200 transplant surgeries had been conducted since the start of the procedures in IKD.

Also, he said they had registered 20 more patients for transplant surgery but since the procedures ceased in IKD, the patients could go to private hospitals if they could afford the cost. There are two units of the Urology Department and only Prof Asif Malik’s unit used to do transplant procedures.

He was the founding director of IKD and had matchless contributions to developing services in IKD. During his service, Prof Asif Malik trained dozens of young doctors in urology, and some of the fellows, including Dr Akhtar Nawaz and Dr Riaz Ahmad Khan, were members of his transplant team.

“Both of them are assistant professors and very competent surgeons but can’t do transplant procedures independently. If the government didn’t intervene, then their skills will get wasted and patents would need to pay a heavy amount for transplant surgery in the private sector,” said a faculty member. It costs around Rs1 million in the private set-up.

The transplant procedures were earlier stopped for two months due to multi-drug resistant infection in IKD in February this year.

The procedures were again stopped for six months due to the Covid-19 pandemic. It was recently re-started and only one transplant procedure was undertaken when Prof Asif Malik retired from service. The IKD was established in 2007, with the aim of offering advanced services in nephrology, urology and renal transplantation in KP, but it didn’t get due attention of the people at the helm of affairs.

In IKD, renal transplant procedures were started in 2008-09. At that time, the government had set up two units and appointed two urologists - Prof Attaur Rahman and Prof Nasir Orakzai. Prof Attaur Rahman was supposed to do renal transplant while Prof Nasir Orakzai was assigned to handle the urology cases.

The government would need to pay attention towards IKD and its issues and the best way is to appoint a separate Board of Governors (BoG) for it and appoint Prof Asif Malik as its chairman. It needs funds as well as staff as since its establishment in 2007, it recorded a 700 per cent rise in patients. It had 35 beds with accommodation of 266 patients, coming from all over the province and its adjoining tribal areas when it was set up.

The Awami National Party - Pakistan People’s Party coalition government had increased its bed capacity from 35 to 100 beds owing to an unprecedented rise in the numbers of patients.

It was started from the ground floor and still using the same floor, though the second floor along with four operation theatres are ready and needed to be utilised. The patient flow can be imagined from distant dates given to patients for normal procedures.

The patients coming to IKD for kidney stones are presently given dates of 2022, apparently due to the unprecedented rise in patients suffering from renal complications.

Efforts were made for bringing the issue into the knowledge of Health Minister Taimur Saleem Jhagra and seeking his comments but his cell phone was found switched off.