April 11, 2012
Honorable Mr. Justice Iftikhar Muhammad Chaudhry
Chief Justice of Pakistan
Supreme Court of Pakistan
Constitution Avenue, Islamabad
Telephone: 051-9220581-9220600
Fax: 051-9213452
Email : mail@supremecourt.gov.pk
Dear Sir,
We, the members of Karachi Bioethics Group, wish to bring to your notice an issue of major financial repercussions to the public health care delivery sector of Pakistan.
With severely constrained national resources, every rupee matters. We are concerned that without appropriate assessment of the needs and demands of the health sector of this country, a machine called the “da Vinci Robot” worth Rs. 10 crores, and for which approximately Rs. 30 crores were paid, has been installed in a public sector hospital, the Qatar hospital in Karachi. It is even more troubling to us that no consideration was given to the fact that for every surgical procedure performed with this machine, additional materials worth 2 lacs will be required. And yet another two similar machines are in the pipeline for other public sector hospitals in Karachi.
Today, public sector hospitals lack not only basic equipment for routine surgery and life saving drugs, but even beds, bed linen, and staff. The health policy of Pakistan (on paper) is stated to focus on primary care and prevention of diseases, and yet this expensive robotic equipment will be at best applicable to a handful of patients, and will be of no use for routine and emergency surgical procedures that are needed to address the main burden of surgical diseases in Pakistan. Within this scenario purchase of such equipment is unethical and constitutes gross mal-utilization of public funds. Every responsible citizen of Pakistan has the right to both, question the decision to buy this machine as well as the non-transparent process employed to arrive at it.
As healthcare related professionals of Pakistan, we are aware of several scientific publications that are debating the usefulness of such machines over standard surgical procedures, questioning their cost effectiveness, and challenging the financial monopoly and tactics of companies involved in their manufacture. In our opinion companies are directly influencing governments to buy these machines, as has been the case in Pakistan, with handsome kickbacks raising the cost even further.
In your recognized role as a defender of the rights and interests of the common citizen, and an advocate of equity and social justice in this land, we request that you do the needful to stop yet another scheme that will line the pockets of a few at the cost of the needs of many in this country. We request your help in the institution of transparent processes for need assessment with involvement of appropriate experts and stakeholders before any more robotic machines of this nature are installed in public sector hospitals.
Sincere regards,
Prof. Farhat Moazam
Dr. Shahid Shamim
MBBS, Diplomat American Board, MA Bioethics, PhD, MBBS, FCPS, FRCS, PGD-Bioethics
Dr. Nida Wahid
MBBS, FCPS, FRCS, PGD Bioethics
Correspondence:
Dr. Shahid Shamim
77/2, Khiyaban-e-Roomi, Phase 8
Defense Housing Authority, Karachi
Phone: 0300-8239763
Email: doctsaab@gmail.com
List of members of KBG (http://karachibioethicsgroup.org/index.html)
- Aasim Ahmad MBBS, FCPS, MA Bioethics
- Aamir Jafarey MBBS, FCPS, FRCS, MA Bioethics
- Arshi Farooqui MBBS, FCPS, FRCS, MA Bioethics
- Bushra Shirazi MBBS, FCPS, PGD Bioethics, MA Bioethics
- Farhat Moazam MBBS, Diplomat American Board, MA Bioethics, PhD
- Imtiaz Jehan
- Kausar S Khan
- Khawar Mehdi
- Maqbool Jafary MBBS
- Mazhar Nizam MBBS, FRCS
- Moin Siddiqui MBBS
- Mumtaz Lakhani
- Murad Khan MBBS, MRCPsych
- Naila Rahman
- Naima Zameer MBBS, FCPS, PGD Bioethics
- Nausheen Saeed MBBS, FCPS, FRCS, PGD Bioethics, MA Bioethics
- Nida Wahid Bashir MBBS, FCPS, FRCS, PGD Bioethics
- Salahuddin
- Samrina Hashmi MBBS, MRCOG
- Shahid Shamim MBBS, FCPS, FRCS, PGD Bioethics
- Shaukat Ali Jawaid
- Riffat Moazam Zaman
- Rehana Kamal
- Rozina Karmaliani
- Rubina Naqvi MBBS, FCPS, PGD Bioethics
- Seema Mumtaz
- Shifa Naeem
- Tayyaba Abbas MBBS, FCPS, PGD Bioethics
- Tufail Bawa MBBS, FRCS
- Yasmin Wajahat MBBS, FCPS, PGD Bioethics
