Where health is a birthright

By Zubeida Mustafa
Source: Dawn

WHILE validating the Transplantation of Human Organs and Tissues Ordinance 2007 in the form of a bill, the National Assembly paid rich tributes to Prof Adibul Hasan Rizvi and the Sindh Institute of Urology and Transplantation (SIUT), Karachi.

They deserved the recognition they received — belatedly though — from our lawmakers.

What has been achieved through the transplantation law, that had to be validated under a Supreme Court judgment, is something momentous. It was the good name of the country and the medical profession that was at stake.

If the law is implemented transparently and due vigilance is exercised Pakistan should be able to shed the stigma it had acquired as the kidney bazaar of the world. We had earned the reputation of being the spot where a foreigner with end-stage kidney failure could buy an organ from the poorest of the poor and have it transplanted by hiring the services of a local urologist who had sold his conscience to the devil. This was demeaning beyond belief.

No argument to support the practice — it did have its advocates after all — had any moral justification. The monetary transaction involving hundreds of thousands benefited a handful of individuals whose bank accounts grew fabulously.

The donor, whose poverty was used as an excuse to vindicate his decision to sell his kidney, received peanuts that did not help him repay his debts while he ended up with new health problems caused by poor post-operative care.

The recipient who was supposed to be the main beneficiary found himself suffering from the after-effects of surgery done hastily and clandestinely.

The new law will therefore be welcomed because it provides the legal framework to curb this shameful practice. The impact of the ordinance promulgated two years ago had already begun to be felt. It is Dr Rizvi`s success in getting this law enacted that is the news of the day. The law had many enemies. It had been in the works for 15 years. Its adoption now signifies the victory of an idealist against big money.

Our experience tells us that where entrenched vested financial interests making illegal profits are involved in Pakistan, it is nigh impossible to dislodge them. The system works in their favour.

Then how could one frail-looking man with a shock of white hair take on the organ traffickers? It became apparent that he had a will of steel. There were risks involved and one of the profiteers even claimed before the court that the factor at work in the case was “business rivalry”.

The simple truth is that for Prof Rizvi practising medicine is not a business. He gave up his private practice in 2000 and the SIUT does not charge a penny from its patients.

A man of moral convictions, Dr Rizvi practises what he preaches. He has not forgotten his Hippocratic Oath or the leftist leanings he imbibed during his student days, notwithstanding the sweeping advent of the market in this age of capitalism. Hence social justice continues to be close to his heart and is the lynchpin of his professional and personal life.

A sceptic may ask, so what? That is what they all claim. But pay a visit to the SIUT and see for yourself. Prof Rizvi welcomes visitors any time — that is how I discovered the place when I was investigating some health facilities that were raising donations through public walks.

Those were pre-SIUT days when Dr Rizvi`s kingdom was the urology ward of the Civil Hospital, Karachi. It was in March 1991 that the Sindh Assembly adopted an act that created SIUT as an autonomous institute. This gave SIUT the space it needed. By then even the parent hospital had imposed service and bed charges on its patients.

It is not just the impeccably clean environment of the place, the skill and expertise of the doctors and the staff that impresses one. It is the compassion and humanity in the operation of the institute that attracts well-wishers and there is no dearth of them.

The decisive factor that has turned the tide in favour of SIUT is that in a country where only the rich are entitled to healthcare, the institute has proved that the poor can also be given the gift of health with dignity and compassion. Dr Rizvi never tires of saying, health is the birthright of every citizen and it is a deplorable system under which the rich get health cover and the poor are left to die.

That is why at SIUT all are equal before the cashier. All services provided to any one who enters its portals are free of cost — be it antibiotics for renal infection or the expensive transplantation surgery and the anti-rejection drugs one has to take for life.

True, there are a few other health centres in the country working for the poor who are provided free treatment. But they restrict their intake of patients. Some require the ill to get an appointment. Others shut their doors when the magic number of patients has been registered.

At SIUT the flood of patients keeps rising. In 2009 (until Nov) 650,000 patients received treatment for which the institute spent Rs1.2bn. Since 1985 2,740 patients have received kidney transplants. But most importantly no questions are asked about one`s economic status. One doesn`t have to prove one`s poverty to be entitled to free treatment. According to Dr Rizvi, a person`s self-esteem should never be offended.

It is therefore not surprising that even our MNAs who adopted the bill in a bipartisan spirit had to acknowledge the greatness of the cause Dr Rizvi espouses. The public is constantly paying him a tribute by making donations that account for double the budgetary allocations SIUT receives from the government, although it is a public-sector utility.

Unlike many others, Dr Rizvi`s brand of medical ethics does not allow him to collect funds from the public to run SIUT and then slap high charges on his patients as many are doing in the name of philanthropy.