Medical report again bars Nawaz from travelling home

Former prime minister Nawaz Sharif’s counsel on Tuesday submitted a medical report in the Lahore High Court (LHC) that restrained him from travelling to Pakistan without undergoing “definitive medical treatment”.

A three-page report, authored by Dr Fayaz Shawal, read: "If he [Nawaz] returns to Pakistan without undergoing a definitive treatment in London, the stress of living again in a solitary confinement as well as loss of a partner can further compromise his cardiac status before definitive treatment can be rendered."

The report also recommended Nawaz to continue "routine walks in open fields as well as stress-free physical activity”. It added that the former minister needed to stay close to the medical facilities he had been receiving his treatment from until he underwent “coronary angiography”. It also barred him from going to crowded spaces because of the Covid-19 pandemic.

"His co-morbidities make him a ‘high risk’ candidate for health, respiratory failure, etc. should he contract Covid-19 infection," it added. The report recommended that Nawaz should remain on medical treatment in London under the care of doctors with multiple specialties.

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"Moreover, these facilities have provided him the best of care so far without further acute coronary syndromes which he had sustained before his arrival to London, given his complex health issues.”
According to the report, Nawaz's extensive examination in London confirmed significant ischemia – the heart not receiving enough blood – in the distribution of his left circumflex artery.

"As I mentioned in my previous evaluation that he should undergo coronary angiography to assess his coronary anatomy so that appropriate therapeutic modality could be recommended before he returns back to Pakistan," the doctor wrote. In addition, pending his angiographic findings, he may “need either complex coronary intervention or redo CABC [Coronary Artery Bypass Graft]. But due to the Covid-19 pandemic, this procedure has been on hold..."

According to the doctor, in addition to medical therapy, the former premier was placed on lifestyle changes to aid his recovery and was advised to have healthy diet and exercise regularly. Similarly, he was "strongly advised to manage his stress to the maximum extent to avoid what happened during his imprisonment (had two episodes of NSTEMI [a type of heart attack] due to stress),” the doctor added.

The report read that solitary confinement for a prolonged period would have a negative effect on Nawaz's health, adding that the ex-prime minister was under close medical surveillance during his stay in London.

"Once Covid-19 is over, he should then proceed with his coronary angiography and possible angioplasty or redo CABGS if intervention is not feasible.” In August last year, the doctors treating the former prime minister had restrained him from travelling and visiting public places and advised him to stay very close to the healthcare facilities where he had been receiving his treatment.

That was the gist of a three-page medical report – signed by David Lawrence, consultant cardiothoracic surgeon in London – which the counsel for Nawaz had submitted to the LHC. In November 2019, Nawaz had left the country after he signed a court-approved undertaking, saying that he would return to the country within four weeks. Shehbaz too had signed an undertaking, which stated he would "ensure return" of his brother "within four weeks or on certification by doctors that he has regained his health and is fit to return back to Pakistan".

Nawaz was allowed to leave the country for a period of four weeks, extendable on the basis of medical reports. Back then, the government had agreed to allow Nawaz to travel abroad, with the condition that indemnity bonds amounting to Rs7-7.5 billion be furnished.

The PML-N had rejected the condition and had taken the matter to the LHC, which ordered the federal government to remove Nawaz’s name from the Exit Control List without any conditions. He left for London after he was released on bail from a seven-year sentence for corruption.

Later on, upon his failure to appear before different courts, he was declared a proclaimed offender.
Now, the government believes that Nawaz is staying in London despite being healthy and, therefore, he should be brought back.