KARACHI, Oct 3: Women requiring urgent medical attention during pregnancy and labour are being turned away by the Civil Hospital Karachi (CHK) because the elective operation theatre suspended services three weeks ago owing to conditions rendering surgical procedures dangerous, such as sewage dripping on to the operation table, non-functional lights and falling plaster.

Furthermore, all gynaecological, obstetrical and emergency labour services have remained suspended since September 24 because doctors refuse to work in the emergency operation theatre or the labour room until their concerns are addressed. The out-patient department alone remains functional but the hospital is taking no admissions.

The CHK Gynaecology and Obstetric Department is one of the few places where emergency departments operate round the clock, but doctors have stopped working in protest against what they call the administration’s “persistent apathy towards the dangerous conditions prevailing in the elective OT.”

Meanwhile, over 30 patients a day, including emergency cases, are being referred to other hospitals at the time of delivery. As a doctor pointed out, “in the struggle between the doctors and the administration, the direct victims are the patients.” Patients visiting the facility have urged the authorities to provide a 24-hour emergency service until the dispute is settled.

Dangerous conditions

Nevertheless, the complaints appear justified. Giving journalists a tour of the elective OT for both major and minor surgeries, Professor Dr Ghufrana Umar Memon pointed out the sewage from upper storey bathrooms leaking into the theatre and dripping on to the lights and the operation table. “This dirty water and plaster has fallen on patients and surgeons in an environment that is supposed to be sterile,” she informed. “It causes a very high incidence of infection and increased morbidity in all the post-operative patients but the administration, which has been aware of the issue since 2004, has shown no concern.”

Dr Memon said that one of the overhead lights malfunctions frequently, forcing the postponement of major surgeries. In the minor operation theatre, the operating tables and lights do not function properly and there is only one anaesthesia machine. “The autoclave in the theatre is small and rusted, so we cannot sterilise all the equipment,” she stated.

“We boil the rest but that doesn’t kill all the germs. The power supply is erratic and the theatre does not even have a supply of water.” She also complained that all surgical specialities had been shifted to the new OT complex except those of the gynaecology/obstetric department.

Doctors say that they have repeatedly informed the management about the elective OT’s deplorable state and other issues such as staff shortages and inadequate emergency services, but have received no positive response. As a last resort, they discontinued all gynaecological, obstetrical and emergency labour services.

Injustice to the poor

Although Dr Memon claimed that only cases requiring surgery were sent to the Jinnah Postgraduate Medical Complex and Sobhraj Hospital, other doctors at the department said that no case had been attended to since September 24.

“All three departmental units are closed,” said one of the doctors. “Yesterday, a woman arrived with a ruptured uterus but was referred elsewhere. Yes, the elective OT is in shambles but the emergency operation theatre and the labour room are state-of-the-art. Doctors have been very insensitive in stopping these services as well.” Her views are endorsed by the patients, one of whom termed it “a grave injustice to the poor.” Upon being contacted by Dawn, the chairman of the Board of Governors of the CHK and the Lyari General Hospital, retired bureaucrat Abu Shamim Arif promised that repairs had been initiated at the elective OT and the matter will be resolved by the end of the week. “However, the protesting doctors should realise that having a project approved by the government requires time,” he said. “In the June to September quarter, the hospital has not received a single penny from the government for repairs.”

In terms of shifting the elective OT to the new OT complex, Mr Arif said that there was no vacancy in which the ward could be transferred. He added that doctors should remember that the new complex was funded not by the CHK but by the Dowites, an association of former Dow Medical College students.

Editorial

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