I was determined to live — and live normally

By Zubeida Mustafa

Dr Rukhsana Parveen is a Senior House Officer in the Nawabshah Civil Hospital. Her job in the 73- bed medical ward is considerably demanding entailing as it does six hours of morning duty every day and four emergency duties a week — twice in the afternoon and twice at night.

For 27-year-old Rukhsana, her work as a physician is most satisfying. She speaks enthusiastically about her profession, narrating animatedly her experiences with her patients. She is proud of her achievements: in the last few weeks she has cured six patients suffering, from the deadly disease Hepatitis-B.

But Rukhsana’s most outstanding achievement has been her own relentess fight for survival. She has won. Only three years ago when she was in her Fourth Year at the Nawabshah Medical College, Rukhsana came down with Nephritis, an inflammation of the kidneys, which leads to renal failure.

“I felt really ill and miserable. Nausea and vomiting put me off food altogether, even my favourite dishes,” she recalls. The only hope for her lay in dialysis followed by a kidney transplant. “I was determined to live and live normally,” she says.

She came over to Karachi for her. treatment. Her family who live in Kotri rented a house in the city to enable Rukhsana to be close to, Civil Hospital. Dialysis brought relief but it restricted her life: she could not return to Nawabshah. For eight months she was required to visit the Civil Hospital twice a week for a three-hour session on the dialysis machine. There was also a setback when she came down with a lung infection.

Then came the crucial day of her kidney transplant operation. “My younger sister, now in her Intermediate, donated a kidney. I was not really worried for I have great trust in God. Besides, I had met other patients who had had a transplant and they seemed to be doing well,” says Rukhsana.

“Fifteen days in the ICU and another fortnight in the ward. Then I was home with my family. Oh it felt so nice to be normal again. No more dialysis sessions. No more restrictions on my fluid intake.”

She was back in Nawabshah five months after her transplant operation, “studying day and night”, to use her words, for her MBBS exams. Rukhsana was exempted attendance from lectures but was required to take her clinical postings. She did not breathe a word about her health condition to any of her examiners.

“Not that there was anything to hide. Only that I did notwant to win their sympathy. They would have marked me leniently. Would that have been of any help in my professional life?” Rukhsana asks.

Two years after her kidney transplant, Rukhsana does not feel disadvantaged or handicapped in any way. She lives in the hostel and eats in the doctors’ mess where a lowsalt diet is specially prepared for her. Her drinking water is boiled. She copes remarkably well with the strenuous nature of her job. Over and above that she travels once a month by bus from Nawabshah to Karachi for her check-up at the Civil Hospital’s Urology Department.

Rukhsana was CHK’s ninth transplant case. There have been 56 altogether. They come from all walks of life. There is Ramazan the farmer from Ranipur who has gone back to ploughing and tilling his land. Mohammad Rasheed Khan, the first transplant case, teaches in a Nai Roshni school. Others are Dost Mohammad the malakra champion from Sadiqabad, Haroon the Karachi salesman, Naeema the banker, Saeed Mirza the B.Sc student from Lahore, Akhtar Kamal Abbasi who works in his brother’s law firm and many more. Each of them is living on one kidney donated by a close relative. They have all been rehabilitated in terms of health, family life and profession, many of them having returned to their homes in remote rural areas.

A major concern of the transplant surgeons when they launched their programme in Karachi was whether the patients on immunosuppressants would be able to resist infections to which medical science finds them particularly vulnerable. Kidney transplant patients have to take drugs to suppress their immunity, so that they do not reject the grafted kidney. Environmental pollution, insanitary surroundings, contaminated food and water and the low level of health education posed a serious threat to the success of this highly sophisticated form of surgery.

But the patients who are, as a matter of course, briefed thoroughly about the rules of hygiene have fared immensely well. In fact not all of them have been mindful of the doctors’ instructions. A team of cameramen sent incognito to film some of the transplant patients in their natural surroundings found one of them submerged till the waist in water bathing his buffalo. Another was photographed sitting on a garbage dump eating corn as he watched a snake charmer.

“We are learning anew,” observes one of the urologists. “Some of our observations from practical life are quite contrary to what we were taught from dur textbooks written in the West. Now we know that our patients can develop considerable natural resistance to diseases and their will to survive is phenomenal.”

Source: Dawn 10 March 1989