The News International (Pakistan) : Babar Sattar

February 12, 2011

We are mostly prisoners of our individual experiences, and this makes our presumptions of truth largely relative. The tale that follows is a personal one and my version of the truth. My father used to remind me often that human nature comprises both angelical and daemonic characteristics. It is one’s acquired and nurtured values, socio-economic circumstances and conscience that determine which of these characteristics emerge more prominently to define one’s life and character.

We have been in India since Jan 5, to seek treatment and transplant surgery for my mother who had been suffering from end-stage liver disease. She has been under the treatment of Dr Subash Gupta and his 15-member liver-transplant team at the Apollo Hospital in New Delhi and we have been extremely blessed to encounter only angelic professionals and hosts in this country that we in Pakistan love to hate.

My mother has suffered from Hepatitis C for over a decade. Doctors suspect that she might have acquired it from the Armed Forces Institute of Cardiology in Rawalpindi when she went in for an angiography in 1998. Bad as we are in documenting statistics, we don’t know the exact number of Pakistanis who have acquired hepatitis. What we do know is that millions in Pakistan suffer from this ailment, and most are not even lucky enough to be able to afford the expensive Interferon treatment that has a 60-70-per-cent success rate in curing Hepatitis C. If left untreated, or if there is a relapse after treatment, Hepatitis C can lead to liver cirrhosis (a condition where the liver begins to fail) in around 10-15 years. It is hard to predict a cirrhotic patient’s life expectancy, but the quality of life is fairly grim. The only medical treatment that can cure cirrhosis is a liver transplant. According to one estimate, liver failure claims over 10,000 lives in Pakistan every year.

With the rapid proliferation of hepatitis in Pakistan the lives we lose to cirrhosis will grow exponentially in the years to come. And yet there isn’t one credible liver transplant facility that can offer the gift of life to citizens with liver disease in this nuclear-weapon state with the seventh-largest standing army in the world. Also extremely disappointing is the quality of medical advice afforded to patients in Pakistan, which seems to be caused not by doctors’ lack of medical expertise but poor professional ethos and a complete absence of accountability. For example, my mother was given Interferon treatment for a third time when cirrhosis had already set in, without the doctor advising us that this was extremely aggressive strategy that could even accelerate liver failure (de-compensation of liver in medical-speak), instead of slowing down cirrhosis. That is exactly what happened.

On the advice of another friend and consultant at Shifa, we also consulted Dr Najam-ul-Hasan (who is leading the effort to establish a transplant centre at Shifa, together with Dr Faisal Dar, another very professional and helpful surgeon who has given up his job at Kings Transplant Centre in London to return to Pakistan). He was the only doctor who sat us down and explained in detail cirrhotic patients’ need and eligibility for liver transplant, various transplant options, and the fact that we should actively consider transplant. He advised that the UK, China and India had transplant centres that patients from Pakistan generally opted for. At the time India didn’t jump out as the preferred destination. Having nurtured the bias of the West’s superiority in most things, including healthcare, the US and the UK were the destinations of choice.

We ended up with Apollo Hospital in Delhi through a process of exclusion. And it turned out that the universe was conspiring to get us to the best medical treatment and care that we could aspire for.

(The views expressed above are the personal views of the author)