Shortage of ventilators posing risks to saving lives in hospitals across Islamabad

ISLAMABAD: While ventilators are considered the last resort to keep the patient alive and continue efforts for his recovery, the shortage of ventilators has emerged as a major hindrance in saving lives across the federal capital.

A ventilator is a medical device which helps a patient breathe by pumping air in and sucking it out of their lungs. It also monitors most of the body functions and keeps the patient alive. It is mostly used in intensive care units (ICUs).

Officials of both Pakistan Institute of Medical Sciences (Pims) and Polyclinic Hospital reported that nearly all of the ventilators at their medical facilities were occupied most of the time.

Pims Executive Director Dr Rana Imran Sikander told Dawn that along with financial constraints, there were “so many other factors” behind the ventilator shortage.

Dr Sikander said Pims had over 90 ventilators in different ICUs, including medical, surgical, pediatric, neonatal, cardiac and others, but almost 100pc of them remain occupied.

“Moreover, in some ICUs, including neurology and pulmonology, once a patient is placed on a ventilator, they remain there for around 20 days,” he said, adding that several patients require ventilators as the hospital had 1,400 beds.

“On the other hand, patients are referred from across the country and we have no refusal policy, so we even keep a patient on a stretcher but don’t send them to another hospital,” he added.

The Pims executive director elaborated that although ventilators were costly, ranging from Rs3 to 5 million, it was not only ventilators which put a financial burden on hospitals with a limited budget.

“In public sector hospitals, free treatment is provided to emergency patients and patients in ICUs are considered emergency patients. The expense of each ventilator in Pims is around Rs200,000 per day, but the hospital does not charge any amount from the patients even for medicines.

“Moreover, there is a severe issue of human resources, such as specialised and trained staff to run ventilators,” he explained.

He said that when Pims was established, the population of Islamabad was 500,000, which has increased to 5m.

“Although, on the intervention of Prime Minister Shehbaz Sharif and efforts of Health Minister Mustafa Kamal, a new block is being established in Pims and it will have 40 ventilators, but people need to change their lifestyle to decrease the burden on hospitals. They should go to parks and start physical activities because that is how they would remain healthy,” Dr Sikander suggested.

Polyclinic Hospital Spokesperson Dr Abdul Jabbar Bhutto, speaking to Dawn, said that there were 35 ventilators in different departments of the hospital.

“I have been working in ICUs for the last seven years. We have a limited number of ventilators and all of them remain occupied.”

However, he went on to say that even if his hospital got more ventilators, more staff would be required to run them as there was currently a “severe shortage” of human resources.

Replying to a question, Dr Bhutto said that even well-off people get their patients treated in private hospitals, but when those hospitals tell them that the patient has to be shifted on a ventilator, they approach public sector hospitals as private ones charge up to Rs300,000 per day for one patient.

The spokesperson added that people contact public sector hospitals claiming that they cannot afford treatment at a private medical centre and request to shift their patient on a ventilator in a public sector hospital. Due to this, a priority list is prepared, but unfortunately that list “never ends”.

Dr Bhutto said that planned periodic maintenance (PPM) was essential for machines, but sometimes it gets delayed as it seemed awkward to remove a patient from a ventilator and send it for PPM.

In a recent incident, journalist Abid Raza Kazmi died at Pims just because a ventilator was not available, his family said.

Asim Raza Kazmi, a relative of the deceased, told Dawn that the journalist was initially admitted to the emergency after suffering a stroke, then was shifted to the medical and finally to a surgical ward.

“On the last day, doctors suggested shifting Abid sahib on a ventilator, but it was not available. We used all possible resources due to which a doctor took us to the ICU. There were 12 ventilators but not a single one was vacant. We started arrangements to shift the patient to a private hospital, but he could not survive,” he recalled.

Abid was not the only patient who died due to the unavailability of a ventilator. Such incidents are reported frequently in government hospitals due to the unavailability of high-end ICU equipment.

Former science and technology minister Fawad Chaudhry contended that after he left office, efforts were not made to manufacture high-end ventilators.

“In Pakistan, the quality of engineers is not up to the mark, due to which they were not capable of making high-end ventilators,” he told Dawn.

“While I was the minister during Covid-19, I made efforts to manufacture ventilators in Pakistan and some simple ventilators were manufactured which could cater to up to 60pc of patients. However, then I left the ministry; no one took interest in that issue,” he claimed.

Chaudhry suggested that Chinese companies’ involvement should be sought in the manufacturing of ventilators under a joint venture.

In 2020, public sector hospitals in the federal capital faced a severe shortage of beds, especially ventilators for Covid-19 patients.