• Sindh Institute of Urology and Transplantation. (SIUT)
  • Syeda Armeen Nasim

Sometimes there is such a clear picture in your head, complete with visuals and sound that if given a task to pen it down you wonder whether you will do justice with words. This is not just an assignment that I type, instead it is a piece of my heart. It is one of those journeys that I undertook unknowingly which was soon to transform me and shape my perspectives towards day to day life in an entirely different way, one that I never imagined.

It is one of those Saturdays when I excitedly wake up at 6am without an alarm clock. I leave my house in due time and it is worth mentioning that I am travelling for a good 40 minutes in a rickshaw alone with no hesitation whatsoever as it turns from the wide roads of main Saddar inside the narrow lanes of an area whose name I am still not sure of. In time we are nearing Civil Hospital when I ask the rickshaw wala to take the turn towards the building of Sindh Institute of Urology and Transplantation (SIUT). His curiosity gets ahead of them as he notices my white coat and judging by the look of an oversized starched coat that presumably not a doctor anyways, he asks me what am I doing here so early in the morning? In my hurry to get off I give a vague explanation of how I am working at the hospital during summers.

By the time I get down, the question is now burning in my head, ‘what exactly am I doing here?’ But this question must rest as I carefully tread my path across the Dewan Farooq Medical Complex DFMC (SIUT) and notice scores of people strewn about and yet more standing in lines waiting for their turn, yes it is an OPD today at SIUT and the numbers are uncountable, I try moving past without noticing too much but how can you walk down a street full of people who so strongly overrun all your senses as you try not to feel nauseous due to heat and the lingering smell of sweat, urine and perhaps blood too. The hollowing eyes seem to follow me all the way up to the doors of Hanifa Suleman Dawood Oncology Centre HSDOC (SIUT) as this is where I must report, and I cannot help but wonder how different this place is in perspective for these patients and me, for most of them it is one of the last hope they cling on to while being here is my choice, my idea of spending summers.

Do not get confused by the names of buildings that I mention, for they are nothing but what shapes SIUT. Benefactors have helped SIUT expand over the years from a 7 bed ward at Civil Hospital to one of the largest Transplantation centers in the South Asian regions and these names of various buildings simply reflect of their contributions. The recent installment is the majestic building of Suleman Dawood Transplantation Centre (SIUT) dedicated to transplantation and research in the field.

I take the lift to the 5th floor and I am truly excited to begin this week. Not many people have arrived by this time but I as Senior Captain Volunteer is expected to be there on time to welcome the newcomers. It is the typical beginning of another Volunteer Program Batch conducted by SIUT during both the summer and winter vacations. It is now that I wonder why I must come here year after year, season after season not bothered by waking up early during vacations and convincing my parents to let me travel alone to an area they are still skeptical about.

Soon enough I will have my answers, an answer that I first stumbled upon in the scorching heat of summers 2014 when I did my volunteering batch eager to get a certificate and Dr Adib Rizvi put forward his philosophy on the table:

“We cannot let them die just because they cannot afford to live.”

As the Summer Volunteer Batch begins once again this summer, I inhale deeply, I clearly recognize this hospital smell and know the reason why I am here once again. This is my attempt at contributing positively to the mission of SIUT. For once I do not bother about how insignificant it might be. In this moment, being here is all that matters.

As it is Saturday, Day 1 of the volunteer program, we are to go on a round to familiarize the newcomers with the hospital’s surrounding and vicinities.

It might be a round for aimed specifically at the first timers here, however the learning and surprises never stop. I am as eager to go on this round as anyone can be despite running around these buildings countless times now.

We start by going around the Oncology i.e. to do with cancer, dedicated building of HSDOC going about how Radiation Therapy works and having a quick look around the pharmacy of SIUT. SIUT does not have any cash counters and all services are provided here absolutely free of cost, this pharmacy supplies all the necessary medicines. We go through the oncology wards and it is advised not to interact much as these are cancer patients, sure most of the patients are under effect of strong medicines. Amidst this I notice this mother consoling his son who’d be no more than 10 years old, he is wearing the patient’s gown so I assume he is in pain and thus not paying heed to his mother, but what actually catches my eye is that the lady is communicating in sign language with her son who cannot help but simply wail out of pain. It is difficult when you actually start imagining, being a cancer patient and not being able to fully express your pain because you lack the ability of speech and hearing. I could feel the goosebumps on myself, a strange occasion to feel them. Slowly I retraced my steps back to the crowd. We still had a lot of places to cover.

We cross the bridge connecting HSDOC to DFMC and enter the main building of SIUT i.e. the Dewan Farooq Medical Complex which houses most of the facilities dedicated to Urology and Transplantation, it also has a nursing school at its top i.e. 6th floor and the volunteer session on basics of first aid and nursing is conducted by the nursing staff trained here. The 5th floor houses a large auditorium where we’ll have our end of the volunteer batch ceremony at the end of the week, the library complete with the collection of books you may wish to look for at SIUT and the Centre of Biomedical Ethics and Culture (CBEC) which is by far my favorite and one of its kind place here. The CBEC aims to educate about the ethical dilemmas faced daily in the medical sphere and we will have on of their sessions later in the week.

We go through the whole DFMC building floor by floor visiting the Lithotripsy unit and silently passing by operation theatres. We are now approaching the dialysis ward and I ask everyone if they are okay with seeing blood and perhaps a dense smell mixed of urine and blood which lingers in the ward, some people are already apprehensive but most of the brave souls agree upon going inside, SIUT is one of the cleanest hospitals you will visit in Karachi and the fact that it maintains the standards despite dealing with hundreds of patients coming from all parts of the country on daily basis, is commendable. We enter the dialysis ward, routine dialysis rounds are going on but as I turn around the corner to this specific bed I cannot help but feel teary. Just until last year i.e. 2016, Abdul Sattar Edhi had occupied this bed; I remember volunteers getting excited to meet him and I also remember him expressing regret that he failed in his mission. Edhi Sahab would tell every time that he failed in his mission to eradicate poverty and would hold our hands saying that we must continue this forward. The bed is now occupied by another patient who perhaps have no idea that Edhi Sahab was one of its occupants too.

We linger around in the dialysis ward for quite some time as there are patients who are eager to see us, many who regularly come here know that we are volunteers and are more than happy to talk with us. There are others who are in real pain as anyone who has heard about the dialysis procedure would know. There are instances of communication barrier where none of us know how to talk in Sindhi, Siraiki or Gujrati but then quite surprisingly there are people within our volunteer group who step up perhaps hesitantly or shyly as it is one of their first languages. The smiles warm your insides as the faces immediately brighten up having someone who understand. The most trivial of details are shared with enthusiasm as they narrate their journeys and why they are at SIUT, these stories are painful, heart wrenching but somehow the laughter and smiles never leave the room. I am forced to wonder, what makes SIUT such a happy place? The answer to this is what I discovered long ago; everyone here from the doctors, staff, workers, patients to us volunteers gel together like a family and this is what makes SIUT unique in its standing. It does not only live up to its motto of providing free health care with dignity, but also ensures that the core human values are practiced.

Right across the dialysis ward is the Pediatrics unit comprising of Peads, Nephrology, Peads. Urology and the ICU. This is the place we all look forward to, meeting these lively children but of course not all of them, we cannot ignore for a moment even that these children from mere 6 weeks to around 8 years old have seen and gone through more than we can imagine in a lifetime. But today is a different day, we can already hear the music before entering the wards. Zainab Baji is playing the songs on her keyboard and singing along. Zainab Baji, like us, is also a volunteer associated with SIUT for over a decade now. She might be blind in our normal definitions of blindness, but I am sure she has the ability to see with her heart or how else could these melodies flow from her bringing the whole place alive.

Time flies away sooner than you expect, few songs later, I realize there is still a lot to be seen and we must hurry. But somehow these children pull at the strings of your heart, they despite all their hardships go on smiling and filling the room with their giggles.

We are now heading towards the ground floor, sure we are pretty tired by now and this building is not centrally air conditioned, the heat is making it worse. But I assure the newbies that they are in for more surprises, the ground floor comprises of the outpatient department, waiting areas, the social welfare office and the office for organ donation. It is here when they come to know that SIUT does not only treat its patients but also supports them economically as many come from far flung area only for the treatment and have no support whatsoever in this region, the social welfare officers run a rehabilitation center which works closely with the patients to provide them monetary support through employment as well as the mental support through the psychology unit. Things such as our volunteer coats are stitched by people working in the rehabilitation center, it is truly marvelous how SIUT interweaves all spheres of living and provides its patient complete care be it tertiary health care or income and moral support.

The organ donation office is where you find Dr Wasim Khan, he is the favorite amongst with a knack to explain the most serious of issues with wit and humor. The Organ Donation office is crucial to SIUT’s mission, it campaigns for deceased organ donation which is that you donate your organs after death. SIUT is a flag bearer and advocate for this mission as organ donation can readily help save millions of lives across the land. It is here when we meet transplant patients, amongst them a girl who had her transplant recently, it was her father who donated a kidney to her. This girl’s story of resilience inspires me, she gave her O’ level examinations while on dialysis and then went through the surgery, her will to triumph against all odds leaves me in awe, but then, SIUT is home to many such stories.

However there are other stories to be heard, stories which we don’t wish to address. We met this young lady in her 20s who is on dialysis since years now and in the waiting list for transplantation. She cannot have a transplant from her direct relatives as the kidneys don’t match. The only way out is deceased organ donation, which is why SIUT campaigns for it. Edhi Sahab lived by his pledge and donated his corneas (eyes) after he died which were then transplanted to two different patients who were completely blind before.

We shall now head back to the 5th floor, in order to reflect upon the day and discuss our plan for the whole week.

I can sense the eagerness and spirited enthusiasm in the volunteers now. They cannot begin to start their volunteering duties for the rest of the week. SIUT is a world of its own and I can guarantee for each of these new volunteers that they will leave as transformed people at the end of this mere one week. Some like me might even get addicted, coming back every time they get a chance to.

Dr Adib Rizvi started SIUT from a 7 bed ward in the 1970s and today it stands as an example of human dedication and commitment. It is a place where communities come together for a single noteworthy goal, we may be divided by our linguistic and ethnic differences, yet somehow SIUT weaves them together as a fabric of an exemplary community. SIUT leads by example. It is an honor for me being able to visit it every time I feel like, I do not see it as community service anymore, it is far greater than that. Some experiences cannot be summed up in an array of words.

This is how I sum up my experience at SIUT: