KARACHI: Free ENT camps were organized by the International Medical Relief Agency (IMRA). These camps were installed at the Hashmani Hospital in Karachi and the Bhitai Medical Hospital in Mirpurkhas. The nine-member team conducted free ENT camps and operated on 37 complicated cases. The team comprised seven surgeons of Pakistani origin and two British trainees. The team was part of IMRA, a charitable organization from UK. The team was facilitated by Dr Shoukat Malik, a senior doctor at the Hashmani Hospital.
The UK-based surgeons’ team, led by Dr Junaid Hanif, shared their experience that cases of complicated ear were on the rise in Sindh. The treatment of ear infections required costly surgical intervention. Such treatment in the public sector was available only at two government-run hospitals in Karachi. The city had a handful of ear-nose-throat (ENT) surgeons. The government must intervene and improve the situation by training young ENT surgeons in this particular field.
“There is a real shortage of ENT surgeons in Karachi with a population of over 20 million. This means that the poor, most of whom report the disease belatedly, would suffer a lot when it comes to treatment,” said Dr Junaid Hanif.
Hanif added that to develop expertise in the public sector, the availability and maintenance of highly specialised equipment should be done. Though the lack of it for ear surgery was a major barrier in Karachi. He said, “The team has brought its own equipment, including microscopes and ear drilling machines from the UK, and will donate them to the hospital here.”
Dr Hanif explained that anyone could be infected. Surgeons could only save a life and fail to restore full hearing ability depending on the severity of the disease. The people in the developed world had the opportunity to immediately contact a specialist and start treatment. “In resource-constrained settings with low levels of education, the poor report the disease when it has spread, making chances of complete recovery challenging,” he said.
He underscored the need for government intervention and said development of surgical skills in this particular area was a lengthy process but possible only when basic surgery tools were made available.
Dr Shoukat Malik said ear surgeries were conducted only in Karachi (in the public sector) and the city received patients from across Sindh. He said, “I have a whole list of poor patients reporting from different areas of Sindh. Patients requiring immediate surgery are either treated in Mirpurkhas or Karachi at the two camps held free-of-cost annually.”
According to Dr Malik, the discharging ear not only damages tympanic membrane (eardrum) causing deafness but may spread to other areas, including brain, facial nerve and internal ear. He added, “This is usually due to cholesteatoma, a bone-eroding disease of the ear which may cause brain abscess, meningitis, facial paralysis and total deafness. In these cases early surgical intervention can save a life. In less severe diseases, if not taken seriously [it] will result in deafness and damaged eardrum, a constant source of repeated ear infections which again may lead to complications.”
Dr Malik admitted that two ear-surgery camps in a year were not sufficient to treat a growing number of patients and said: “You can imagine the severity of the situation that currently only two public sector hospitals, the Jinnah Postgraduate Medical Centre and the Civil Hospital Karachi, are offering ear surgeries. The Abbasi Shaheed Hospital has stopped doing it for two years for some reasons,” Dr Malik said.
Sharing his experience, Dr Waseem Ahmad, who was on maiden visit to Karachi, appreciated the fact that the medical staff here had “developed engineered solutions” to overcome shortages in resources. His colleagues, Dr Ketrina Mason and Dr Selda Boztepe also praised the Pakistani staff they worked with at the camps and described them as “committed, responsible and thorough professionals”.
Dr Boztepe said: “The cases were pretty complicated which I wouldn’t have the opportunity to see and operate in the UK. It was a great learning experience which helped us see how different systems work in two countries [the UK and Pakistan] in the public sector,” she said, while appreciating that the allied medical staff in Karachi was able to perform multiple tasks at a time.
According to experts, chronic ear infections were common in Pakistan. Its symptoms include foul smelling discharge and impaired hearing. They discouraged removing earwax as it provided protection from all kinds of germs. Also, mothers should feed their children in an upright position to prevent ear infection from milk.