Dearth of paediatric heart surgeons, facilities plagues country

The scarcity of specialised medical personnel, particularly paediatric heart surgeons, has amplified the challenge of congenital heart defects (CHDs), across Pakistan.

With only a handful of surgeons serving the entire country, timely interventions remain elusive for countless children. According to the Centers for Disease Control and Prevention (CDC), the national public health agency of the United States, CHDs are the most common type of birth defect and can affect the structure of a baby’s heart and the way it works. Although the CDC recognises that as medical care and treatment have advanced, infants with CHDs are living longer and healthier lives; in Pakistan’s context financial constraints exacerbate the issue, with families often unable to afford the costly treatments available in private hospitals.

Meanwhile, public hospitals struggle to meet the overwhelming demand, leading to long waiting times and inadequate resources for treatment.In this regard, Professor Dr Sohail Khan Bangash, who heads the paediatric surgery unit at the National Institute of Cardiovascular Diseases (NICVD), shed light on the challenges faced by affected families. "We have a dire shortage of paediatric heart specialists nationwide," Dr Bangash lamented, “with only 100 physicians and a mere 25 specialised surgeons across the country, timely intervention remains a distant dream for many."Dr Hamidullah Malik, a cardiac physician, echoed these sentiments and emphasised the need for heightened public awareness and specialised paediatric heart hospitals across Pakistan.

"The prevalence of CHDs is alarming, with over 70,000 affected children born annually in the country, 60 per cent of whom succumb to poor diagnosis and management,” informed Dr Malik. Dr Bangash and Dr Malik’s assertions, while startling, are a reality for many. Murad, a small farmer from South Punjab, who was visiting the Children’s Hospital in Lahore, shared his anguish as he waited for treatment for his child's CHD.

"We have been coming here for over a year, hoping for an operation but all we receive are medications. We simply cannot afford private healthcare,” an upset Murad informed. Likewise, Imran Bhatti, a resident of the Shahdara area of Lahore, recounted his son's experience in getting treated for a CHD, while talking to the Express Tribune.

“Although my son received life-saving treatment at a public hospital free of cost, it was only possible after requests from influential people. Many families do not have such an option and thus continue to suffer due to inadequate resources and facilities."Ikram Khan, a resident of Peshawar, is one such individual. Sat outside the Out Patient Department (OPD) of the Peshawar Institute of Cardiology (PIC), Khan told the Express Tribune that his 4-year-old daughter had holes in her heart but since he was a poor daily wage earner, who neither had money nor access to anyone influential, he was at the mercy of the doctors at the public hospital. While Dr Mujeeb Khan, a paediatric cardiac surgeon at the PIC, is aware of the plight of families like that of Khan’s, he stressed about the critical role of prenatal care in preventing such ailments. "The lack of prenatal care and the prevalence of self-medication during pregnancy contribute significantly to these heart conditions," Dr Khan noted.

"Nevertheless, we also urgently need more paediatric cardiac specialists and improved antenatal care to combat this growing crisis,” conceded Dr Khan. Agreeing with Dr Khan, Dr Farqad Alamgir, Chairman of the Punjab Institute of Cardiology, emphasised the urgent need for expanding the country’s healthcare infrastructure. “There is a dire need of building more hospitals dedicated to paediatric heart diseases to alleviate the burden on existing facilities. However, the road to improvement remains long, as Pakistan lags behind global standards in healthcare by a significant margin,” regretted Dr Alamgir while talking to the Express Tribune.