MEDICINE

Triumph of the heart

A six-year-old Pakistani girl receives a new lease of life after a complex surgery at the Madras Medical Mission in Chennai.

ASHA KRISHNAKUMAR
in Chennai

NOTHING perhaps unites people more than personal tragedy. A medical crisis, for instance, makes people reach out to help one another regardless of their social, economic and political differences. An event in a Chennai hospital on June 28 reiterated this seemingly incongruous aspect of human behaviour.

As India and Pakistan fought a bitter battle in the Kargil-Dras-Batalik sector, hundreds of miles away, a team of doctors led by Dr.K.M. Cherian at the Madras Medical Mission (MMM) fought to save the life of Sadia, a six-year-old Pakistani girl who suffe red from a congenital heart problem. After a four-and-a-half-hour surgical procedure which involved complex medical interventions, including the fixing a homograft conduit that comprised a heart valve and an artery from the cadaver of an Indian, Sadia g ot a fresh lease of life.

Sadia's mother, Uzma Asif, said: "The Pakistan-India war is not something new. It has been going on for 50 years. But the people of the two countries are constantly reaching out to each other." Although they were apprehensive about coming to Chennai, Uzm a and her husband Mohammed Asif, both 32, had few other options. Doctors in Karachi had given their daughter four months to live. Today, Asif and Uzma are happy that they made the trip.

Asif, a Mammon, and Uzma, a Pathan, got married in 1992 against the wishes of their parents. But the families were reconciled when Sadia was born in 1993. However, their joy was short-lived as Sadia was a blue baby. She suffered from constant colds and c oughs and also had frequent epileptic attacks. She was diagnosed as having complex congenital medical problems, including a hole in the heart. When she was seven months old, a hospital in Karachi inserted a shunt in Sadia's heart to improve the blood flo w.

Within five years, Sadia's problems recurred and she required a complex and quick intervention. No hospital in Karachi had either the technology or the expertise to treat her condition. Dr. Mehnaz Atik of the Agha Khan Hospital in Karachi tried hard but could not locate a facility in Pakistan to treat Sadia. She suggested that Asif and Uzma approach the MMM, which specialised in paediatric heart problems and was the only facility doing homografts in the subcontinent.

T.A. HAFEEZ
Sadia with parents Asif and Uzma at the Madras Medical Mission in Chennai a fortnight after the heart surgery.

In early May, Asif got in touch with Dr. Cherian, who suggested that Sadia be brought to Chennai at the earliest. Asif, who works in an export-import company for a salary of 4,000 (Pakistan) rupees, was not sure if he could put together the money require d for the travel and the treatment. As Sadia's life was at stake, the couple decided to take a chance. Uzma said: "Dr. Cherian's assurance and his clear and positive explanations gave us confidence."

Although friends, relatives and colleagues helped them with the money, obtaining a visa became difficult as hostilities heightened in Kargil. After numerous trips to the Indian Consulate in Karachi with the supporting evidence provided by Dr. Cherian, th ey received their visas in June. Sadia, her parents and her 10-month-old brother reached Chennai via Mumbai on June 21.

According to Dr. Cherian, Sadia suffered from complex congenital problems, which included the transposition of the great arteries, ventricular septal defect (hole in the heart), pulmonary atresia and sub-aortic conus (a shelf of muscle growth below the p ulmonary artery, which carries blood to the lungs). These caused inadequate blood flow from the heart to the lungs. The shunt inside her heart improved the blood flow and gave her respite but did not solve the problem.

Dr. Cherian and his team interrupted the shunt, closed the hole with a cortex tube graft so that the aorta emerged from the left ventricle (instead of from the right as before), divided the pulmonary artery, and used a homograft to connect the right vent ricle and the pulmonary artery. The MMM's homograft bank, the first of its kind in the country, harvested the homograft from a cadaver.

T.A. HAFEEZ
Dr. K.M. Cherian, who led the surgery team.

The surgery alone would usually cost Rs.1.4 lakhs, but considering the family's economic background and as a gesture of friendship the MMM decided to give Sadia a concession. According to Dr. Cherian, the total hospital charges, including the surgery, wo uld not exceed Rs.1.5 lakhs".

Asif, overwhelmed by the warmth shown to him and his family during the course of their stay in Chennai, said: "Once we crossed the border, all our fears were allayed. We felt more at home in Chennai than even in Karachi."

Sadia flew back to Karachi on July 18.