Lack of surgeons: Gambat’s free kidney transplant centre needs doctors

GIMS has performed six successful organ transplants so far since April 14

HYDERABAD: In the upper Sindh region, people suffering from kidney ailments or those requiring the transplant may no longer have to travel to Karachi for their treatment. A medical facility in a small town of Chief Minister Qaim Ali Shah’s Khairpur district, Gambat, is offering free kidney care and transplant.

The Gambat Institute of Medical Sciences (Gims), formerly a taluka hospital elevated to the status of an institute in December 2006, began to offer free kidney transplant in April this year. However, one stunting factor continues to restrain Gims from operating to its full capacity.

“We can take up to four cases a month. But this can be increased twofold or more if we can complete the team of doctors and specialists,” Gims urologist and transplant surgeon Dr Muhammad Khan Babbur told The Express Tribune in Hyderabad. He lamented that “the experienced professionals required mainly for the transplantation cases have been avoiding coming here from the big cities and hospitals.”

Babbur, having worked for 22 years at Sindh Institute of Urology and Transplantation, is the only surgeon specialised and experienced in the field of kidney transplantation even though Gims has a total of four surgeons. The institute’s transplant unit still lacks a nephrologist, immunologist, anaesthetist and radiologist. Even the state-of-the-art laboratory, which Dr Babbur claims equals any top lab in the country, and the radiology equipment, could not attract any such specialists.

Gims, offering a package of more than Rs200,000 to these specialists who will be appointed as associate professors, has twice advertised the posts, received applications and taken interviews. However, the qualifying doctors turn away. “In their absence, it’s me who has to do the consultation work of the nephrologist and prepare reports for the CT and MRI scans. I also happen to be the social mobiliser and physician to consult during the post-operation phase.”

The samples for tissue typing, which pertains to the subject of immunology, are sent to the National Institute of Blood Disease in Karachi, which charges Rs56,000 - Rs28,000 for the kidney donor’s sample and as much for the recipient’s. Meanwhile, an anaesthetist, Dr Dilu Raja, of the Kidney Centre, Karachi, volunteers whenever a surgery is planned.

Since April 14, when the first free kidney transplant was done, six cases of the organ transplantation have been successfully carried through, with the last two of them on June 29 in one day.

According to Dr Babbur, the cost of the transplant, including the lab and radiology tests as well as consultation and medicines, is Rs150,000 for one patient. However, he said that it can be reduced if an immunologist joined his team.

“The big institutions [medical universities and colleges in the neighbouring districts] have also disappointed us,” he said. Talking about why doctors do not want to work at the centre, Dr Babbur said that with an experience like his, a doctor can earn around a million rupees in Karachi or Hyderabad. “Why would they be drawn to a small rural town offering hardly one-fifth of their income?” he said.

Making headway: Free liver transplant by August

Gims will soon be offering free liver transplants, becoming the only government hospital in the country with this facility, from August this year. According to Dr Babbur, 65 patients have been registered so far for the surgery. A team of seven surgeons, doctors and technicians from Germany will arrive in August and will train the doctors at Gims for the liver surgery for two years. The provincial government has set aside a budget of Rs300 million for the purpose.

The solution?: Forcible transfer of specialist

To fill the important vacancies at Gims, Dr Babbur thinks the government can forcibly transfer a professor or associate professor level specialist. But, he fears, such a move is quite unlikely to succeed as the appointed doctor may use political influence or even resign as a last resort if big income is her/his primary consideration.

Gambat is an underdeveloped rural town but its location is central to several districts of Sukkur and Larkana divisions. Dr Babbur believes the place can become a health centre in the future with the help of the institute’s medical college. “There is hope in the long run.”

Published in The Express Tribune, July 18^th, 2015.