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Video Message for KLWT

KLWT IDPs Relief
   
NEED ASSESMENT REPORT ON VISIT TO DHQ HOSPITAL RAWALPINDI FOR PARAPLEGIC EARTHQUKE VICTIMS 
 

Monday October 31st, 2005

Following an informal meeting held on 30th October 2005 to decide on future KLWT plans and based on Mr. Mahboob Elahi’s first hand information, it was considered necessary to investigate further what role, help and contribution could be made by KLWT to alleviate the suffering of paraplegic earthquake victims admitted at District Headquarter (DHQ) Hospital, Rawalpindi.   
11.0pt">DHQ Hospital is a tertiary referral hospital where many of the earthquake survivors with neurological damage were evacuated. A visit was arranged to DHQ Hospital Rawalpindi under the guidance of Dr Shoaib Shafi (Prof. Of Surgery, Rawalpindi Medical College).  Other than Dr Shoaib Shafi, discussions were held with Dr Iram, Dr Shehzad Manzoor, Dr Arif Malik, Dr Nadeem Akhtar and the MS DHQ Hospital Rawalpindi. 
There are currently a total of 80 paraplegic patients at DHQ Hospital who require long term (minimum of 6 months) intensive nursing, physiotherapy and rehabilitation treatment.  18 of these patients are being transferred to a specialised rehabilitation centre in Lahore.  Of the remaining 62 patients, 38 are men and 24 are women.  The average age of these patients lies between 28-30 years. 

HOSPITAL NEEDS 

DHQ Hospital Rawalpindi is the only tertiary hospital in Rawalpindi with a neurosurgery department (i.e there is no formal neurosurgery department in RGH and Holy Family Hospital)

NEUROSURGERY OPERATION THEATRE AND ICU:

The Neurosurgery department requires the following equipment for their Operation Theatre and ICU:

  1. Image intensifier (C-Arm)   (estimated cost is Rs. 4.0 million)
  2. Pneumatic Surgical Drills  (estimated cost is Rs. 1.5 million)
  3. Spinal Surgery Instruments and supplements  (estimated cost is Rs. 1.0 million)
  4. Ventilator x 2  (estimated cost per unit is Rs. 0.5 million)
  5. Blood Gas Analyser (estimated cost is Rs. 1.5 million)
  6. Personnel O.T assistant
    • O.T nurse
    • Ward nurse
    • Physiotherapy assistant/ aid  (Rs. 5000-7000/ month per personnel)
PARAPLEGIC PATIENTS WARD
As there have not been such a large numbers of paraplegic patients simultaneously admitted in the hospital before, there is limited provision in DHQ Hospital to effectively treat these patients in such numbers. Hence the TBC Ward (Tuberculoisis and Chest Diseases Ward) has been converted in to the ward housing the Paraplegic patients. The existing Tuberculosis patients have been either discharged or transferred to Sanghli TB Sanatorium near Murree. The following items are required immediately for the establishment of proper ward for the spinal injury and paraplegic patients:
  1. Hospital beds
  2. Air mattresses
  3. Special beds for spinal injury patients
  4. Wheel chairs (not required immediately but required in 2 months time)
  5. Training of paramedics and nursing staff in rehabilitation medicine
  6. 2-3 weeks on job consultancy and staff training by an experienced doctor having specialised in rehabilitation medicine.
  7. Installation of TV screens and TV network for admitted patients.
  8. Funds to employ additional doctors, nursing staff, paramedics, physiotherapists and cleaning staff to have the requisite number of staff members to run the ward in a proper professional manner.

REHABILITATION CENTRE

A complete list of equipment, training aids and physiotherapy equipment will be required to establish a basic rehabilitation centre for the already admitted paraplegic earthquake victims.  The list of items required was not available with the doctors interviewed as they lacked the specialised knowledge on rehabilitation medicine.  They are however in consultation with a doctor colleague in Lahore who will advise them of the items and equipment required along with the trained and specialised personnel to run an effective rehabilitation centre. In addition to the traditionally perceived requirements of a rehabilitation centre, clinical psychiatrists and psychotherapists will also be required for the rehabilitation purposes.  Artificial limbs are another important aspect to be considered for a rehabilitation centre, although most orthopaedic or amputation cases were dealt with in the other Hospitals of Rawalpindi. 
The above summary is the initial finding based on the interviews conducted with the doctors concerned.  It would be appropriate to mention that the staff at DHQ Hospital, in particular Dr Shoaib Shafi, Dr Iram, Dr Shehzad Manzoor and Dr Arif Malik are a dedicated team of doctors whose efforts and enthusiasm is inspiring and needs to be not only acknowledged but also supported.
Any and all equipment donated to DHQ Hospital will be formally entered into the inventory register of the hospital.  Through this, the donations given will then become property of the government and the government will then be responsible for the maintenance and repair of the donated equipment. 

DONATION OF FUNDS

It is recommended that the funds required to hire various staff and purchase miscellaneous items should be given directly to the doctors managing the wards.  The concerned doctors would then utilise the funds in accordance to their needs and at their own discretion. The credibility of Dr Shoaib Shafi and Dr Iram is unquestionable. 
Dr Arif Malik (Neurosurgeon) had been offered two image intensifiers (C-Arm) by a Dr Zafar fromUSA.  However, the donation was withheld on grounds that the power input (50 Hz, 110v) was not compatible with the mains voltage supply in Pakistan.  It has been explained to Dr Arif Malik that a power supply/transformer is available in the local market (and promised to be donated by KLWT) to fulfil the necessary electrical conversion requirements.  For the appropriate power supply/transformer, the current rating of the image intensifier is required.
Dr Neelam Khan & Dr Ayaz Khan
Dated: Monday 31st Oct 2005.
 
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