Anaesthesia means loss of sensation. In medical practice, the word refers to patients undergoing surgeries while temporarily losing sensation. The News on Sunday sat down with Dr Mirza Ali Azhar to understand the basics and some of the current issues in its practice.

The News on Sunday (TNS): What is the role of anaesthesia in surgery?

Dr Mirza Ali Azhar (MAA): The role of anaesthesia is most vital. No significant surgical procedure can be carried out without the assistance and support of an anaesthesiologist. An anaesthesiologists must be present at the operation table to facilitate the surgeon by giving general anaesthesia or a regional block. They are responsible for keeping the patient pain-free and monitoring their vitals throughout the procedure.

TNS: What progress has anaesthesia made globally and in Pakistan during the last 30 years?

MAA: Anaesthesia practice has been revolutionised during the last 30 years. Since the world is now a global village, the fruits of recent developments and new inventions are disseminated throughout the world in no time. If we compare medical practices from the past, we are living in an entirely different world.

The discovery of some excellent drugs, extremely sensitive and accurate monitoring and availability of modern intensive care units have reduced the risk for patients undergoing difficult surgeries. Today, anaesthesia is safe, free of complications and dependable. Whatever advancements we observe today in the field of surgery are because of advancements in the field of anaesthesia. In yesteryears, many patients were declared unfit for surgery because of the non-availability of safe anaesthesia and ICU facilities. Today nobody is unfit for anaesthesia. Today we can safely carry out operations on newborns and very old people. Thankfully, we are living in a very safe world as far as anaesthesia is concerned.

TNS: Do you agree that anaesthesiologists are under great stress during surgery due to their high work load and low budgets for healthcare in Pakistan?

MAA: This question has two parts that need to be addressed separately. First, the question of stress: yes, anaesthesia practice is stressful. Because anaesthetists deal with the life of patients who are sometimes critically ill, a little mistake or lack of concentration can have serious consequences. The stress level also depends upon the circumstances in which an anaesthesiologist works. There are many categories of healthcare facilities in our country. This makes the working environment at some places different from others. For example, working in a well-equipped private sector hospital with properly trained staff, and the other hospital in a poor residential area with minimal resources and facilities will obviously make a huge difference in the level of stress. Also, an anesthesiologist has to keep himself available. He may receive an emergency call at any moment. A poor law and order situation is also a considerable stress factor.

The role of anaesthesia is most vital. No significant surgical procedure can be carried out without the assistance and support of an anaesthesiologist.

As for budget allocations, in my opinion, anaesthesia services have not suffered because of funding constraints. Of course, if there is no anaesthesia, there are no surgeries. Once the surgeries are stopped, there is no revenue. So the hospital managements cannot cut the anaesthesia budget.

TNS: What proportion of public funds should be allocated for healthcare?

MAA: According to the WHO recommendations, at least six percent of the GDP should be allocated for health. However, health and education have never been the top priorities for our governments. We have never had enough resources for the health sector in our history. It has always been less than two percent of the GDP. The meagre budget includes administrative expenses. At the end of the day, very little remains to be utilised in healthcare.

Another issue is that we have to take care of people from other cities, particularly in Karachi. Karachi provides medical services, not only for the people from the whole country but also to patients from neighbouring countries like Afghanistan. That burdens our healthcare system, which is already under financial constraints. It is good to have an extensive public-private partnership to share the patients’ burden.

TNS: Why are Pakistani doctors going abroad?

MAA: It is not just the doctors. People from other professions, too, are moving out of the country. The reasons are many. First of all, this phenomenon is not new. People have been migrating for a long time. But now the trend is stronger. The first and most important factor in this is the law and order situation. Fear for life is the biggest factor. Second, many people have lost faith in the future of this country. In a country where you don’t find equal opportunities, jobs, quality healthcare and education, life security, political and economic stability, and there is lawlessness, extremism and intolerance, mass migration should not come as a shock. Another significant issue is the high population growth. We are rapidly running short of natural resources like water, food and energy. These are the real issues.

The interviewer is a journalist and peace activist. He writes on health, heritage and environmental issues. He can be reached at shahidhusain01@gmail.com