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Anyone facing the prospect of illness in Karachi naturally wants the best for their loved ones and for most people including myself that would equate to the
AKUH. So naturally when my father slipped and broke his hip in the garden that was our first choice. We soon found out that this decision was to be the biggest mistake of our lives.
People recommended an orthopedic surgeon, Dr. Pervez Hashmi, who very happily took my father’s case and had him admitted to the hospital on Oct 31st, 2017.
I flew in from England on the morning of Nov 1st and was surprised to see why an insulin dependent diabetic was not put first on the operating list, which is the protocol world over for management of diabetics.
Around 5 pm, after numerous attempts to find out when the surgery would actually take place, we were informed there is no set time for Dr. Hashmi’s lists and they can run upto 2 am in the morning. I was quite surprised as to how that is even justified as safe operating.
My father was taken into theatre around 6 pm and the procedure was carried out under spinal anaesthesia. Even for a procedure under a general anaesthetic, a patient is starved only for 6 hours but here an insulin-dependent diabetic was starved for over 12 hours for a spinal anaesthetic.
The next day, my father developed chest congestion and difficulty swallowing, and stopped eating. Dr. Pervez Hashmi visited him with a used mask around his neck and was told about the chest congestion, and asked about antibiotics but he did not think chest congestion in an elderly patient is anything to worry about and he left without making sure he was on appropriate antibiotics or ordering any bloods to see if there was any infection brewing, as this was not AKUH protocol.
The swallowing discomfort and lack of eating continued over the next day. He was becoming dehydrated. Repeated requests were made to put up fluids and for an ENT consultation but neither happened. The residents informed us they were busy with other patients, and could not write up fluids. Is this why the AKUH charges lakhs of rupees, only to tell us they are busy with other patients?
My father started getting delusional, another sign of sepsis, but Pervez Hashmi’s resident ignored this and simply advised us to dim the lights and all will be fine. This was the most non-clinical explanation I had ever heard in my life. Eventually after 24 hours of dehydration and immense chasing, one bag of fluid was put up that evening.
On Day 3 an ENT consultation was arranged in the ENT department, but once we got there, Dr. Sohail Awan consultant ENT surgeon, refused to examine my father as he had come on a hospital bed instead of a chair. I informed him, how he’s struggling to swallow and is unable to eat, but Dr. Awan wasn’t interested and sent him back to the ward.
Had this been England, the staff would have tried to accommodate the patient and helped them shift, but it was easier to send a patient back to the ward than to try and help them and see why they are struggling to swallow.
My fathers’ condition started worsening and he developed coffee ground vomiting due to the high dose of NSAIDS he was being given by the Orthopaedic Team. (These drugs are normally contraindicated in such patients.) At this point in time, it became evident that things were getting out of hand, so very conveniently Dr. Pervez Hashmi sent his resident to inform us that his care will now be shifted to the medical team and the surgical team will visit him to make sure his wound is fine. Did we ever see anyone from Dr. Pervez Hashmi’s team again? No.
On the night of Nov 3rd, he was passed onto the medical team and shifted to the Special care Unit. Once there, the internal medicine resident, thought this may be hospital acquired pneumonia (HAP) but refused to start him on Tazocin, the first line therapy the world over for HAP and conveniently suggested to start him on medication for MRSA which would damage his kidneys. I told him my father isn’t MRSA positive, then why was he being suggested these medicines?
Because in the rest of the world MRSA patients are isolated. But in the AKUH, each Special Care Unit has one MRSA positive patient kept with the rest of the patients. Why don’t they isolate them and practice proper infection control? Because most people in Pakistan aren’t even aware of what MRSA is or that it should be isolated.
The next day, I was given a plastic bowl to use incase my father needed to spit. I wondered if this was one bowl per patient, but you can imagine my horror when I was told this was one bowl used amongst 5 other patients, one of which was an MRSA positive patient and only washed with water in between.
Is the AKUH a government hospital? Surely not. Do they provide us treatment for free? Of course not. Then why is it that they cannot provide basic infection control? Because its cheaper not to and the common man will not question them.
Later that day, a chest physician came to see my father who instead of explaining his condition, started asking me as to what I thought was the matter.
When asked if this was pneumonia, she said she didn’t know. When asked why doesn’t AKUH isolate MRSA her response was, ‘I’m a consultant, and you cannot ask me such questions and if you don’t leave right now, your father’s care will suffer.’ I stepped out, as I did not want any arguments to affect my father’s care.
She then came out and when asked again, what her treatment plan was, her response was, ’You are not his doctors, and I do not have to discuss this with you,’ and she walked off. The nurse then told me the name of this woman, Masooma Aqeel. How anyone can behave so unprofessionally and without any civilityis beyond me.
Over the next few hours, my father continued to deteriorate, numerous calls were made to the internal medicine resident to come, but no one came.
Later that evening, he became even more critical. My father was slipping out of our hands, and there was nothing we could do. But the AKUH nursing staff had plenty to do in the SCU. They wouldn’t allow more than one family member in at a time, but there were plenty of nurses in there who were laughing and joking loudly. When I asked one of them to be quiet, I was conveniently asked to leave.
The next morning my father passed away.
We were handed a bill of 7 lakhs and 60 thousand rupees and my father’s dead body. Before I left, I met Dr. Noreen Nasir, the internal medicine consultant who’s care he died under, and asked her if his care had been adequate and she said, ‘A lot should have been done for him, which wasn’t and that 90% of the times, the surgical team only involves us when things have gotten out of their hands.’
We took him home and I rode with him in the ambulance. That day we buried him, but not everyone buries their dead and forgets about the reasons that led to that death.
To lose a parent is the most painful thing one can imagine, but to lose them due to negligence is another chapter altogether. Had he been ill or suffering from a prolonged illness, I could have understood. But for an active man, who just went to AKUH to have surgery and then never come home again, except in an ambulance, shrouded in white, is unacceptable.
The chest congestion, which had started on the first day, was allowed to progress to become full-blown sepsis. Had proper antibiotics been given from the start, had proper bloods been done to check for infection, my father could have been alive. The residents, the other specialties, they all seemed to have one thing in common – total lack of regard for patient welfare. So what if the patient is dehydrated? So what if wrong medications are being given? So what if someone dies?
I lost my father due to the sheer negligence and recklessness of the doctors at AKUH and to avoid anyone going through what he had endured, I wrote to the entire management of AKUH, highlighted their lapses, and questioned why things were overlooked. Their response was unbelievable.
Complete and utter silence. Repeated emails, letters were sent, but again no reply at all.
After all, why bother? The main purpose of this organization is to make money, which they had. Pervez Hasmhi is a cash cow for them. He operates non-stop and charges lakhs per patient. His job as per their understanding is to operate and move on to the next patient, not patient care.
So what if the patient is deteriorating? They can always be passed on to the medical team where they will be kept with more ill patients, and hopefully contract something else which means more tests and more money for AKUH.
What is the government’s role in this? Is there no check and balance at what these private hospitals are doing? Who’s responsibility is it to make sure hospitals are held accountable? Why is there no value of human life in Pakistan? Why does medical negligence go unpunished?
People go to hospitals to get better, not be killed.
If this was anywhere else in the world, these doctors would have been struck off the medical registers, their licenses would have been cancelled and they would have been sent to jail. In Pakistan, it’s a different story altogether.
How many more people have to die before the powers that be wakeup and take action. Is this something, that will be looked into in our Naya Pakistan? I do not know, but by the time this article is published, the AKUH will have been served a legal notice because not everyone is as ignorant as they want them to be and some of us do not bury our loved ones and simply say this was God’s will. The negligence of the doctors at AKUH is not God’s Will; it is a crime for which they should held accountable.
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