MDAUK Hospital and Flood Relief Update 17 July 2010

Altaf worked around the clock to arrange an excellent function that raised £25,000.

Well done team!

MDAUK Update Visit by Mr Tariq – 16th June 2010

Our wonderful engineer, Mr Amin Tariq, MDAUK Civil Engineer in Chief, paid a visit to the site today to oversee the construction so far and ensure the quality of the build is according to his detailed specification.
Mr Tariq has given a lot of his time for the project on a charitable basis for which all of the team at the Midland Doctors Association UK are indebted.

His comments are below:

“It was basically to have an overview about the progress and to ensure that the plumbing services were understood by Rizwan to ensure implementation would run smoothly.  We discussed various items and told Rizwan that all plumbing pipes should be kept in sleeves so that later these can be replaced anytime for choking or malfunctioning.  I also checked the quality and fixing of protective bituminous sand coated membrane.

I discussed with Rizwan all his survey layout issues, resolved and ensured that room sizes are coming out as expected to drawings.

I also took Rizwan along to two other sites, so that he could understand the strictness required in the complicated work of the superstructure.

I plan to visit in a week or two once again”

Please see below the pictures taken earlier today.

Derby Event Update Event - 6th June 2010

The Derby Event held at Anoki on the A38 Eggington towards Burton, raised a huge £28,000 !

The charity is indebted to the support by key sponsors led by Naveed at Anoki restaurant. Anoki donated the food and provided donations and ongoing support for the project.

Other key sponsors of the event included McTurks, The Meat Centre, Day Night Pharmacy and Pak Foods

We would like to thank Anoki especially for leading on this event and supporting the effort.

Update Hospital Build - May 2010

Dear Supporter

With the concrete foundations laid, the structure is taking shape. The builders are working hard to construct the facility and the steel vertical columns are next on the list. This is a solid foundation designed to withstand the type of earthquake that previously devastated the country.

Trustees have been busy, as although the hospital is the paramount focus, the charity continues to be dedicated to providing Medical expertise to Pakistan as a whole.

As you know I was recently helping with Surgeries in Sind improving Maternal and Women's Health.

A clinic has been identified in Mirpur and is currently being furnished to provide medical care to the poor of outer Mirpur. although you may think of Mirpur as affluent there is still a need for charitable medical care in the region.

So what do we need this year in 2010, for the hospital ??....the target we have set ourselves is £300,000.

The following functions are planned and I would like to ask your help with each of these cities, to see if you can be involved to further the cause.

2 more functions planned in Canada this year:

6th  June 2010 Derby event (afternoon event)
19th June 2010 Luton event Dr Asrar to lead
10th July 2010 Nottingham event/Shafqat to lead
17th July 2010 Stoke event/Rahim to lead

Books are also being printed containing glossy slips that will be given out at £5 per slip. If you wish to dedicate parts of the hospital to loved ones or in the name of organisations, please drop me an email. Please help and volunteer, we need you!

Dr Iftikhar
Chair Midland Doctors Association UK and Consultant Surgeon

Progress - February 2010

The Muzaffarbad Charity hospital project, which has been backed by many in the UK, Kuwait, UAE, Dubai, India, Pakistan and recently Canada, is undergoing a critical stage. Funds are needed to help focus efforts so that the front of the hospital can be completed and treatment can be started by early 2011.

Medical experts from the UK National Health Service have pledged their time to help train doctors and pass on necessary skills that will benefit the medical community of Pakistan itself.

We ask for your help this year with fundraising. Please remember that donations made are eligible for UK Gift Aid and are also Zakaat compliant.

In the pictures below show the hospital shell being built. The team have progressed from the foundation stage and now the skeleton framework is being constructed. As soon as is possible, the focus of construction will be the front section of the hospital completed so that treatments can begin.

The price we have had to pay for running the project independent of anyone, is both delay and red tape. However, as you can see, we are now past that stage and importantly, we have saved thousands from undertaking and managing the construction stage ourselves.

Midland Doctors UK are committed to this project and are being given vital support from Nottingham, Derby, Birmingham, Luton, Stoke, Manchester as well as many other organisations. Please support our visits to your city, the dates are below:

12th June 2010 Derby event Ajaz to lead.
19th June 2010 Luton event Dr Asrar to lead
10th July 2010 Nottingham event Shafqat to lead
17th July 2010 Stoke event Rahim to lead

Thank you so much indeed
Dr Iftikhar, Consultant Surgeon Royal Derby Hospitals NHS Trust
Chair, MDAUK

Gynae camp for poor patients of Upper SINDH

Last March I was part of a team serving in Kandiaro and treating those women who can’t afford health care. We had worked with discarded catgut sutures and no diathermy. I had promised shershah that I will return and be part of the team again.

Therefore, I undertook the trip with Emirates Airlines, which is most convenient for me as it flies from Birmingham and is usually punctual. Travelling by plane has its advantages. One of them is tranquil time in the lounge and on the plane, especially if one uses ear plugs and is fortunate enough to be sitting next to an individual who does not indulge in too many tipples and keeps the oration to a minimum. It is one of those times when I have time to put pen to paper to reflect on my last six days of travelling.

I travelled on the 10th March 2010 from Birmingham airport. Unfortunately the start was inauspicious as the flight was delayed by 2 hours. Therefore, not surprisingly I missed the connecting flight from Dubai to Karachi. I eventually arrived at Karachi at 10 pm on 11th of March. I was advised by Syed Irfan (the Chief Executive of Kohi Got Hospital) to travel straight to Kandiaro. However, common sense prevailed and I slept for a few hours to commence the onward journey at 5 am in Shershah’s banger, driven by his driver Hasan. Shershah had already travelled at day time. We travelled on to Jacobabad and then 20 kilometres further into Baluchistan where work has already gone on in the Rural Health Centre at Dera Allah Yar.

I announced my arrival at Dera Allah Yar by taking a pic.

Break for a cuppa on the way.

Motorway services are the most effective tools to reduce detruser contractions.

Jacobabad is well known for being the hottest place on earth and is named after Charles Jacob, the Brigadier General in charge of that area in the 19th century. He and his horse are buried in the Christian cemetery in town centre. In his day, people use to travel safely at night and they did that to avoid intense heat at day time. However now, travelling even at day time is fraught with danger as kidnappers and bandits are rife in the area.

In front of Charles Jacobs grave.

I was pleasantly surprised to hear that Jacobabad is the only city in Pakistan with a HINDU majority. It boosts 135 local doctors with 100 of them belonging to the ethnic minority. It was heartening to observe this as conditions for ethnic groups in Pakistan are not conducive for healthy tension free life with progression as normal.

We arrived at Dera Allah Yar at 2.30 pm. Dera Allah Yar is a small town at the edge of Baluchistan and the health care facility is a Rural Basic Health Unit. Pakistan’s health care service is based on the advice given to the Government of Pakistan in early 1950’s by Harvard group specially commissioned to plan health care services.

Bottom of the pile is the Rural Health Centre, then the Basic Health Unit, thereafter, Talluka Health Unit, District Hospital and then Tertiary Referral Hospitals. The problem is that 90% of the health care budget is given to Tertiary Hospitals like Civil Hospital and only 10% goes to the rest of the health units. Those of you who have worked in Civil Hospital will appreciate the paucity of resource in RHC. The troublesome finding, was the absence of doctors from these Rural Health Centres. There are a large number of doctors employed by the Government to serve in these facilities but no one turns up as they work in the urban area. They pay a portion of their salary to maintain the status quo.

A petrol pump guard with very decorated rifle.

Shershah’s mission is to train hundreds of midwives and tutors. So that they can take over the Doctor’s place. Really, doctors are not needed to deliver routine obstetrics service. Moreover, he is pursuing training of rural doctors to be able to perform emergency Caesarean sections so that maternal mortality, pre natal deaths and occurrence of Vesico-Vaginal or Recto Vaginal fistulas are reduced. Furthermore, such patients who can’t afford to pay a bus fare, let alone pay for health care in Urban Hospital will receive a reasonable
standard care at home.

Sukkhar Guddu Barage still remains the most impressive structure although built during the British Raj.


We travelled on the 12th March in the evening to Thari Mirwa from Jacobabad via Sukkhar. It was a 4 hour trip and we arrived at night to be greeted by Dr Qurban Setho who is a local GP and MS of Thari Mirwa Rural Health Centre. We were served a very delicious meal and accommodation. We slept 7 to a floor and were tired enough to have uninterrupted sleep despite the ferocious attack by mosquitoes on Shershah’s army. We were grateful for the attached bathroom. It reminded me of the good training we had when one travelled for flood relief and drug campaigns. Qurban Setho has the distinction of performing the first caesarean section in Thari Mirwa. He has had training given by his mentor Shershah.

We had two anaesthetists, two scrub nurses, four junior doctors, two tables and four full instrument trays with sterilised gowns and towels with anaesthetic drugs and about 8 kilograms of sutures and good quality surgical gloves which I had taken with me from UK.

Sutures which brought Shershah into 21st century.

We were ready at 7 am but work did not start till 9 am because of difficulty in getting a theatre running which normally remains dormant. Once we got going, the progress remained steady and by 7.30 in the evening Shershah and I had done 23 hysterectomies. The light kept on failing and even the generator failed to work at times. Therefore, a number of times a procedure had to be completed in torch light or mobile phone illumination. Completion of the day indeed was not a mean feat for a professor of Psychiatry and a GI surgeon.

Those of you who are not aware I must put the record straight. When Shershah left  Nawabshah Medical College, he was offered a job at the Qatar Hospital Orangi where the only vacant post was that of a Psychiatrist. He was offered the post which he duly filled and went on to become the president of The Society of Gynae and Obs, Pakistan. You must have thought that you had heard and seen everything, but this one will take some beating… The down side is that Qatar Hospital cannot have a psychiatrist till Professor Sahib vacates the post. I have Shershah’s permission to divulge with this information.

The evening culminated with an open ceremony with honourable citizens attending a gathering where every citizen of Thari Mirwa gave a speech and the entertainment was snake dancing, fortunately performed by snakes themselves. Important feature of the speeches were the immense reverence of Shershah. One day he will be called a saint or a Sufi. I bet they would love to have his grave in Thari Mirwa or Kandiaro.

We travelled to Kandiaro and met up with the team lead by Shaheen (Shershah’s sister). They had arrived that evening to operate next day. We, therefore, travelled back the same night to Karachi and arrived at 5 am on the 14th March. While Shershah went to start the Annual Marathon race starting at PMA Karchi I headed home for a kip. He could do that as he had slept throughout the journey, while I had the task to keep the driver amused and awake. I took a day out to meet my relatives and travelled to Muzzafarabad at 7am on the 15th.

The time was spent seeing a couple of gastric cancer patients and visiting the construction
site. Following the recent heavy rains work has started again. I returned at 2 am on the 16th March and worked with Shershah at Qatar Hospital on the 16th. An interactive meeting with surgeons was very productive. We all learnt a lot and were better for it.

Shahida Memon hosted lunch at the Chinese restaurant “Dynasty” at the Avary Towers. Before you guys start thinking of me as lucky and get envious, the dampener is that Qazi Wasiq and Shershah were the two other guests. It was lovely to remise. I met Najam at PMA house. He has remained the principle organiser of the PMA Annual Marathon and is keenly involved with Journal of Pakistan Medical Association who are celebrating their 60th birthday.

One was supposed to meet Idrees at dinner but his cousin’s cardiac event kept him busy at the NICVD. We wish him well.

I met up with an old friend Mabel in the evening and then had dinner with Shabbir and Shershah. In a nut shell, one had a fantastic time and a very fruitful one as well. I just wish that as torch light showed us the way during our operating at Thari Mirwa, someone could show such guiding light to the people at the helm of affairs in the Pakistan health care provision. It is good to contribute, but in a country which is a nuclear power and boasts an army of 600,000, complete absence of electricity in hospitals and total absence of basic health care is lamentable.

We all remember the conversation between Prime Minister Zulfiqar Bhutto and American Foreign secretary Henry Kissinger.

“The desire that we will have a bomb even if we have to eat grass was strong but the prophecy that one may not have any grass left to eat is not far away from being true”

Dr Zahid’s Visit to the Hospital Site

Dear Supporter

Consultant Anaesthetist Dr Zahid from Derby, MDAUK treasurer visited the Midland Doctors Association site.

Below are pictures from the visit and you can see the project progressing.

Nurse Joy has been busy collecting various hospital furniture that has completed it's life in the NHS but has still value for the Muzaffarabad Charity hospital.

Najeeb and sons have kindly agreed, through the wonderful Mr Ajaz to collect the material and store for future shipment.

We need your continuing support for the project.

Thank you

Dr Asrar

Hospital Update by Dr Asrar - 28th January 2010

Dear Supporter

Running a charity on a shoe string, i.e. at 0% costs allows funds to be used on where they are required. In this instance,  in Pakistan on the development of the hospital.

However, such level of commitment requires the good will of many. This week I would particularly like to thank the team on PHDU for their kind support in raising money this last Christmas. Thanks to Pat for maintaining the poster board at the PDHU and coordinating with Joy and the Stores to secure donations of equipment that was being decommissioned from the NHS.

Nurse Joy has been wonderful in her co-ordination and boxing of equipment for Pakistan.

Next I would like to thank Richard from Najib and Sons for donating his time today to collect trolleys and a couch for the hospital project. Ajaz of Najib and Sons had donated his staff, and van so that the equipment could be collected from Nottingham today. Ajaz, further at his own expense, has provided a container to house the equipment until the container can be shipped to Pakistan.

As I said, we are indebted to all for their goodwill and support. With kindest regards to you all.

Dr Asrar
MDAUK Secretary and Consultant Paediatric Intensivist

Visit to Pakistan by Ifti in January 2010

Weather in Derby was as usual for this time of the year. Cold and trees devoid of any leaves.

8 am on the road, and the contrast between sunny Karachi and a gloomy winter morning in Derby, was so wide.

I had visited Pakistan in December 2009 and had planned to return and attend the Surgical Society of Pakistan’s meeting (SURGICON 09) at Karachi from 11th January until the 16th January 2010, and therefore, duly arrived in Karachi on Sunday 10th January and made a hurriedly organised day trip to Muzaffarabad.

I took an early morning flight to Islamabad from Karachi. Khwaja Arshad picked me from the airport at 9 am. He took me to his house where I was offered a sumptuous breakfast. He took me to Muzaffarabad via Murree and Kohala (3 ½ hour drive).

I spent all afternoon negotiating and cajoling Raja Sajjad who agreed not to interfere anymore; provided we bought construction material from him and relinquish the services of the Panjabi workforce (we moan about racism by whites).

Therefore, rather than agree to such scandalous demands I gave the contract for the work force at Rs350 per square foot with all the material being provided by us to another contractor.

I was grateful to Mr Bashir who helped me in my endeavours on that day. I returned to Islamabad same evening and took a flight back to Karachi. I arrived in Karachi at 1 am on the 12th January and was at the Civil Hospital, Karachi at 9 am to conduct a surgical workshop.

Amir Khan, Aijaz Jabbar and I were the foreign faculty members on the workshop course organised by surgical society of Pakistan. The workshop was held in the dow78 thetare complex and its linked lecture theatre with video links.

We worked every day all day long from the 11th January to the 15th.  It was the most enjoyable time of our professional life as we performed a number of advanced laparoscopic procedures. It was received well by the audience and I believe they learnt a number of perioperative, operative and post operative techniques from us.

We capped it all by delivering lectures at the meeting on Saturday the 16th January at the meeting held at the Ramada Hotel. Amir gave a lecture on morbid obesity and measures for its control. The session was very well attended and immensely interactive. He held his own and educated seniors and juniors alike in his inimitable brummy (Birmingham/black country) accent. Aijaz Jabbar gave a talk on laparoscopic colorectal surgery and I expressed my views on oesophageal cancer; its current treatment and future.

It was a bit tiring but every bit of it was worthwhile. We were entertained exceptionally well by friends at Karachi. We were hosted by Abbas Zafar on the very first evening and were treated with Bihari Kabab. I visited Dr Shamim (ret surgeon from Abbasi Shahid hospital and ex VC Hamdard University). His son Dr Shahid Shamim had worked with me in the past and is currently Asst Prof in surgery at the Civil Hospital Karachi.

Update by Asrar - 18th January 2010

Dear All

Dr Iftikhar visited Muzaffarabad again this week. It was only three weeks ago that the Chairman of the Charity, Dr Iftikhar visited Muzaffarabad to check on progress at the hospital site and to ensure that the project is on track. Dr Iftikhar arrived back in Derby only last night after a hectic few days.

You can see below how the foundation for the hospital has taken shape and the rapidity with which the structure is beginning to taking place. Despite the cold weather, the workers are dedicated to continuing work through the harsh winter period. Fortunately, weather has not hindered progress.

Dr Iftikhar was also invited on TV when he arrived back in the south of the country, to talk about what must be done to improve health-care across Pakistan.

On behalf of MDAUK our thoughts are with the people of Haiti who are currently suffering from a natural disaster, the likes of which hit Pakistan and we understand only too well the problems when you put pressure
on an infrastructure that is not ideal.

The Midland Doctors Association dedicated to providing a NHS level facility in the South Asian region of Pakistan administered Kashmir.

With Kindest Regards

Dr Asrar Rashid
Secretary MDAUK

Water Pipes

Dear Supporter

Recent pictures from the ground are below. The water pipes are being laid so that water can be brought to the site for construction.

We will update you as more information filters through. Dr Iftikhar is travelling to the region in the very near future and we will be able to report on further progress in due course.

We wish him a safe journey and continued thanks to all our supporters.

Dr Asrar Rashid
MDAUK and Paediatric Consultant

Muzaffarabad Charity Hospital Update

Dear Supporter

Despite the harsh winter conditions, the construction of the hospital continues.

I would like to thank everyone for their continuing support.  I was handed a donation of £50 today from my Children's Dependency Nurses who raised the money by not sending out Christmas cards this year - very kind indeed. Dr Iftikhar also informs me that £500 was raised in a similar manner through the local donors.  Many thanks again.

Below is a short email from the team on the ground with pictures attached of the work in progress.

Kindest regards
Dr Asrar Rashid

“Tomorrow we start compacting granular fill of back portion and labour start levelling with granular fill to front portion.

1. Granular fill for the front portion of the hospital has been ordered.
2. We also need local crush and sand for lean concrete. I prefer local crush because it is lean concrete”