“Winter Pakistanis” can end up having very blasé trips back to the sohni dharti. This last stint promised to be no different than the usual visiting, shopping, weddings, restaurants and qawwalis. And then one morning spurred by the offer of Dow Medical College to give a guided tour to its alumni, I decided to return to that lovely place where I spent what was undoubtedly the happiest segment of my life. Took my bevy of beauties a.k.a. my three daughters with me so that they may see where their parents became what they are today.

Memories remain preserved as though in formalin. Not necessarily gilded, but untouched by the ravages of time. The storm that came to my mind and how I had to quickly harmonize what was, with what is now, gave my cerebral cortex quite the workout.

Dow Medical College has been separated from Civil Hospital by a high wall, the office has moved to another building, the library is snazzy in its upgrade and the dissection hall does not keel you over. I remember very distinctly that the dissection hall and the gynecology department were sensed by the olfactory epithelium well before one’s feet got us there.

In my time cadavers lay on the dissection tables in various stages and areas of dissection, but in this visit the tabletops were clean and there were only three bodies in a dry tub at the corners of the hall. Between many exclamations of disgust and outrage, my daughters took pictures. The Pathology museum was fascinating even to me, especially the conjoined twins that were preserved in large formalin containers.

Pakistan’s burgeoning population was really manifest that day at Civil Hospital. A large area in the compound of the hospital was particularly disconcerting for it appeared that this shed-like area was a waiting room of sorts for patients. I had done my house-job in Medical Unit II and took the girls for a tour of the place. Had my long-term memory faded so much that I did not remember that Medical Unit II looked like something out of Africa? The girls photographed the unit but the camera could have been better used on their facial expressions. Not remotely could one have imagined that this was a hospital ward, except for the fact that the beds were in lines against the walls and different manners of tubes emanated from various parts of the occupants of those beds.

On the way to and fro Civil Hospital the girls photographed and laughed at the multitude of signs and graffiti especially the “Homeo” stores for the resemblance to the word “gay” in America. The lens also captured the multicolored painted buses and the rickshaws and donkey carts on Bunder Road. By this time the girls were almost comfortable with the very many near misses that are a constant occurrence on the chaotic roads of Karachi. They had learned to not look or to look away in case they happened to be.

It was a great experience for them but there was this tacit sort of question that hung in the air: you came out of that? Civil Hospital was truly in a shambles and I began to wonder myself how we did graduate from a system such as that, even though that many moons ago the place was not that crowded.

When I complained later to my nephew, a third year DMC student, that the poverty visible in Civil was very sobering he suggested I visit SIUT, The Sindh Institute of Urology and Transplantation. They were having a dinner for Dow alumni and I agreed only because he promised to accompany me. That evening the car wound around Civil Hospital and in the smog of the Karachi night was a building about a block away. We entered from the rear ramp and the first token of technology was the newer model elevator, in which doctors discussed patients and operations in the Urdu-English colloquy so typical of Karachi.

It is only when one gets off at the fifth floor and is faced with the high-fangled auditorium that one is instantly transported to an American hospital. And you can rationalize the many desis ambling around with the valid argument that a significant number of Pakistanis inhabit America. I was very honored to have transplant surgeon Dr. Haider Mehdi take me for a tour of S.I.U.T.

In a previous article I had bemoaned the lack of philanthropy at a public level and I stood corrected looking at the awesome Rs. 80 million facility that was donated by the Deewan Mushtaq family. The entire area is called the Deewan Farooq Medical Complex.

It was 8 pm and the electron microscopist was still working. I was delighted to see that they did not just have this amazing instrument that can look at slides at ultra high magnification and make difficult diagnoses, it was in use and that gentle soul was totally conversant with it. Here was an electron microscope and I could not help but recall that as one of 450 students in Dow many years ago, getting up close and personal with even a regular microscope gushed gratitude from us.

I am forever indebted to my beloved Pakistan and Dow Medical College for making me a doctor for what was then the equivalent of $100 per year. Dow is recognized the world over for graduating quality physicians, and the credit is quadrupled for the resources that this is done with is minuscule.

The lithotripters were as much state of the art as the extensive laboratory and radiology departments, the last complete with a helical CT scanner as well as a Digital Subtraction Angiography suite. The sign “operation theatre” broke my reverie that I was at an American hospital for we use the word “operating room” in the United States. Also the gown, mask and cap were of cloth as opposed to the disposable paper stuff that America uses.

SIUT’s statistics compare just as well as the 21st century technology that it has. Not only have over 1200 kidney transplants been done here, the success rate at 92% compares very favorably with international data. Thousands have had their stones pulverized and even more have received dialysis. Training is provided to postdoctoral students as well as paramedical personnel, and the outpatient and emergency departments channel patients toward the requisite treatment. There is emphasis on research and SIUT has its own medical journal.

The philanthropy of a multitude of donors, as well as government grants show in the facility and the equipment. I about tripped and fell though, when Dr. Mehdi told me that not only is the treatment of all patients free of charge, transplant patients that need to be on immunesuppressive medications all their lives, receive lifelong follow-up and medication free as well. A kidney transplant can cost Rs. 1,200,000 but at SIUT it is free.

I was anxious to meet my professor and the architect of all this wonder. And there he was the recipient of the Hilal-e-Imtiaz, two Sitara-e-Imtiaz and the Asian counterpart of the Nobel the Ramon Magsaysay award: Dr. Adibul Hasan Rizvi. Must be some elixir that he’s on for he looked as though he had skipped the almost 20 years that had intervened. The same ready smile and the twinkly eyes. From a Urology ward at Civil Hospital this man has accomplished what is indeed a gem in the murkiness of inner city Karachi.

Familiar with the perpetual fund-raising that goes on even in wealthy Catholic institutions in America and how difficult it is, my mind whirred and I had a brief spell of anxiety just thinking about this venture and the money needed to run it, in a Third World poverty stricken land. Is there a way that we can donate from America I asked, just past my brief panic? There is SIUT North America for this purpose I was told by the house officer that brought me the printed material about SIUT, pointing towards the pamphlet that detailed this. Prof Adib Rizvi stood close by. Deftly he pulled at and rounded the bottom of his jacket and with the makeshift begging bowl said, “We accept donations in cash and kind!”

(Mahjabeen Islam is a physician practicing in Toledo Ohio. Her email address is mahjabeenislam@hotmail.com )