PKLI: from hope to despair

ISLAMABAD: “What has happened at PKLI should be a case study for why Pakistan could not succeed like some other countries such as Malaysia, Turkey, Korea, Japan and Germany, despite having some of the best minds in the world in all fields,” this is what Dr Aamir Yar Khan, Medical Director and Chief Operating Office, PKLI, wrote as his reason to quit.

“Small people sitting on big chairs -- the tragedy of Pakistan,” is how Dr Aamir was made to explain on his Facebook the state of affairs in Pakistan after the Pakistan Kidney & Liver Institute, oncethe great hope, has been turned into a despair initially by the suo motu notice of the former chief justice and later by the controversial actions of the Punjab government.

Dr Aamir is one of the several foreign qualified doctors who had come to Pakistan leaving their lucrative and well-paid jobs in the US, Europe and Middle East to join the PKLI as Dr Saeed Akhtar’s team to serve Pakistan with the mission of providing free kidney and liver treatment including transplant to the poor and needy besides attaining the objective of getting the country rid of Hepatitis B&C by 2030. But the treatment meted out to the globally acclaimed Dr Saeed and the consequent damage done to PKLI by the SC’s suo motu and Punjab government’s action, have frustrated these doctors to leave the institute and the country as well.

Dr Aamir, who was brought in by Dr Saeed, has served as Clinical Associate Professor of Medicine, University of South Dakota, Division of Health Sciences, School of Medicine, USA. He also worked as Director of Hospital Medicine at Saint Alexius Medical Center in Bismarck, North Dakota as well as BroMenn Regional Medical Center in Bloomington, Illinois, USA.

Others who too have left the PKLI include Dr Bashir Azher, a top notch Urologist trained in USA to do complex cancer surgeries; Ahmad Awab, critical care Specialist from USA, who was very disheartened by suo motu and rude behaviour of forensic auditor working on order from former CJP; Dr Shah Gul trained in USA and was director of PKLI’s pathology lab who put her heart and soul in building a state-of-the-art lab; Dr Mazhar Butt, child specialist who joined from Saudia; Dr Nauman Zafar, a top urologist and robotic and laparoscopic surgeon, who wanted to build and teach latest techniques in cancer surgeries went back to the UK; Dr Abdul Rauf Mazhar, a nephrologist trained in USA, who worked with a lot of passion and also was a good teacher also resigned.

While the future is uncertain about highly reputed Dr Saeed Akhtar, his wife Dr Masooma Saeed, will also leave if the PKLI is not revived to its original mission. Dr Masooma did her residency in anesthesia and pain management at Texas Tech University Health Sciences Center, Lubbock, Texas. Trained in all aspects of anesthesia with special interest in transplant anesthesia and anesthesia for major cancer surgeries, she has given anesthesia to more than 1,000 kidney transplants and cancer surgeries.

It is said that seven other doctors, who have requested not to disclose their names, are also planning to resign. According to a source, for the last 28 days no cheque has been signed because the PKLI has no Chief Executive Officer. “How can anyone leave a running hospital without CEO for a month, where active patient services including kidney and liver transplant are being offered? Mind boggling,” a PKLI source commented on the indifference of the Punjab government.

It is generally believed and said that the treatment meted out to Dr Saeed and PKLI, would serve very negatively in government efforts to allure top Pakistani minds serving in foreign countries to come and serve Pakistan.

Dr Aamir Yar Khan comprehensively explains what happened to PKLI and how the dream of making PKLI an institution of international repute became a nightmare.

Dr Aamir note reads as: “I had resigned from PKLI last month (letter attached) after, despite all efforts, the (Punjab) cabinet approved the PKLI Act 2019. This Act comprehensively takes away any autonomy we had which is a pre-requisite to run any facility in a modern and efficient way, let alone a future Harvard of Pakistan, which is what we had set out to make. I needed to put this post up to avoid the dozens of calls I’m getting and to help avoid confusion and rumours as well as saving me from explaining the same thing to multiple people.”

“The well-respected ad-hoc management committee placed by the SC convinced me to stay at least while they were functioning to which I had to defer my resignation in their respect, however, without any liability to stay after they had gone. The ad-hoc committee was disbanded along with ditching of the suo motu case against us by the new bench of the honourable SC.”

“What has happened at PKLI should be a case study for why Pakistan could not succeed like some other countries such as Malaysia, Turkey, Korea, Japan and Germany, despite having some of the best minds in the world in all fields. The PKLI Act 2019 practically gives complete control of the institution to a bloated government bureaucracy which has no clue how to run modern hospitals, while dumps responsibility on an executive which is not given the authority which would enable delivery. People who are professionals and motivated to deliver will never be able to accept such an appointment. Small people sitting on big chairs - the tragedy of Pakistan.”

“Another remarkable thing is that just 3 months into the partial inauguration of PKLI with rudimentary out-patient services only, a suo motu was taken by a biased CJP claiming that PKLI had wasted money and were ineffective in still not being able to conduct a liver transplant. He did not stop there, he humiliated and threatened us in the court and specifically told me by name that he would put me behind the bars! The ridiculousness of all this is incomprehensible. The icing on the cake was that after that every institution or segment of society jumped on board singing along with the ex-CJP making PKLI the child everyone desired to kick and shame! Not only the courts, but the media, the vile and lowly forensic auditor with questionable credentials, the anti-corruption establishment, the auditor general office, two individuals from the NAB, FIA, Punjab Health Care Commission, our own colleagues from local hospitals, you name it, every single person went after PKLI with a battering ram for 11 months. Sad part was no one spoke up for justice. Even more tragic was that those cognizant of this torture, chose to remain quiet.”

“I just salute each and every member of my team who despite all this, continued to toil and brought the facility to a level where just this month we have conducted three successful liver transplants. Despite all the filth spewed against PKLI and dragging us down in litigation, I take pride in saying that within the last six to eight months, we have developed the best ICU and dialysis services in the province, the only OPD in the public sector where consultants see and are held responsible for every patient and the only public sector facility where you can expect safe liver and kidney transplants. PKLI has also made HMIS, EMR, Infection Prevention and Control, Quality Assurance, Waste Management, hepatitis elimination, hepatitis bill etc buzz words, which are so essential to implement proper health care in Pakistan. This is no small achievement and kudos to the PKLI Family for all this and much, much more.”

“I had hoped that after the conclusion of the suo motu the new government (now relieved from the pressure of the ex-CJ) would reverse the draft PKLI Act of 2019. That has not been the case. They are “know it all” there. They are people who, for whatever reason, are so upset at the PKLI management that literally no one has ever even bothered to contact the PKLI management to even briefly discuss what we were about and how we planned to achieve what we had claimed. The contempt for PKLI has been obvious from not only their facial expressions but also from their complete lack of any meaningful communication with anyone of us.”

“While PKLI was independent I never got a single call from any corridor of power asking to treat, hire or promote someone. Just two weeks or less into the PKLI Act 2019 and the government takeover, I am inundated with requests, which I (now damaged with a year of government agencies’ unjust investigations) now cannot ignore without some stress of consequences. Is this the environment in which professionals can perform?”

“We are told by the government that PKLI will be an independent organisation like Shaukat Khanum. Let’s not take the Pakistani people for a ride again, like all previous governments have. Read the PKLI Act 2019 and please explain to me how anyone can possibly believe that!”

“PKLI has been a love and a passion for me. It has consumed me completely for more than 2 years. It has often come before my family and always before my health. It is so painful to leave that I will likely detox for the next 6 weeks. However, when there isn’t even a sliver of hope for achieving what I had signed up for, one has to take a stand on principles.”

“I wish from the depths of my heart that better sense prevails in future and PKLI blossoms. Ameen.”