Hospital From Concept to Reality:

The Earthquake : On the morning of 8th October 2005 a catastrophic earthquake measuring 7.6 on the Richter scale struck the unsuspecting people of Northern Pakistan. For six terrifying, agonising minutes the earth shook and when it stopped, over 87,000 people had lost there lives, tens of thousands were severely injured and over three million were made homeless.

One of the many groups to respond was a group of doctors from Nottingham and Derby Hospitals.

Working in tents in Balakot, they treated over a thousand patients, including 134 major surgeries, in less than a week.

The Hospital : On return to the UK, the doctors realised that there was a huge unmet need for medical care in the region. The team had the vision of building a hospital in Tandali village, some 20 kilometers from Muzaffarabad, capital city of Pakistan administered Kashmir, and in the heart of the area devastated by the earthquake.

With incredible amounts of goodwill from architects, equipment suppliers, the local population, donors and many medical professionals, Midland Doctors were able to start construction of the earthquake resistant hospital and progress to inauguration in 2013. Between 2013 and 2019 the hospital treated some 250,000 patients, all free of charge, in the NHS model, and to NHS standards. Doctors volunteer their time and travel from the UK (paying for their own flights) to perform operations, assessments and procedures at the hospital.

But let us go back to the beginning on the hospital construction project, and see how the building took shape and how, once operational, treatment and training began and expanded….

2006-2012 :  Initial fundraising allowed provided the funds to purchase  4 acres of land outside Muzzafarabad on the main road to Srinagar at a cost of £96,000. In parallel, detailed design work was undertaken by supportive architects and civil engineers, in collaboration with the MDA medical team, to put together a set of plans that would provide an earthquake-proof building, with the space and facilities to undertake medical procedures and care to the same standards as patients are used to in the NHS in the UK.

Initial quotes for construction contractors were around 2 to 4 million pounds, which the trustees felt were too high, so the decision was taken to hire a small team of a project director, engineer, supervisor, accounts manager, driver, cook and a labour manager to construct the hospital by hiring builders and equipment  as required. Site surveying was undertaken and foundations started to be laid.

Over time, with the concrete foundations laid, the structure began to take shape. First the walls and then roofing and plumbing. All carefully managed to ensure that the resuling building would be a fit place to perform high quality healthcare and medical procedures. By 2012 the internal rooms, including operating theatres, x-ray room, wards and labs were in progress of construction.

2013 : The Midland Doctors Board of Trustees are proud to announce the Inauguration of our NHS inspired Hospital in Muzaffarabad on Thursday 21st March 2013. The ceremony marks many years of hard work and dedication from our team, and more importantly our supporters, who have made a dream come true for our trustees.

2014 : Midland Doctors operating room used for the first time on the 1st January 2014 with a number of patients being treated for eye problems, including children who had been unable to attend school due to eyesight issues.

The Edhi foundation charity ambulance service is now frequenting the hospital facility to bring in the sick and inform to the facility. “There is no facility for miles and this is such a vital resource” said one patient to our team.

Fluoroscopy equipment is being installed, this allows allow real-time imaging necessary for certain surgical procedures.

The Hospital houses 16 wards, operation theatres, a laboratory, an X-ray plant, a physiotherapy section and a lecture hall. To this point, about 2.5 million pounds had so far been spent on the project and the facility is receiving over 150 patients daily.

 

Plants have been planted around the hospital to beautify the area for the benefit of the patients. The plants were chosen specifically as they do not have any asthma inducing properties; they do not produce allergens and do not have blossom.

2015 : By January, the hospital had treated a total of 32,000 patients in its first year and a half in operation.

PACS (picture archiving and communication system) was installed and will allow images to be stored electronically and assessed by volunteer radiographers back in the UK and the resulting guidance fed back to staff at the hospital.

In August, the operating theatres became operational. In the first day 55 operations were undertaken and some 650 people were treated.

Installation of central heating began and a two day  ‘orthopaedic fracture and plaster course’ was hosted.

Staff additions included three medical officers, a consultant gynaecologist, and a pharmacist.

2016 : This year saw the installation of a new X-ray machine and the total number of people who had been treated at the hospital since its opening reach 68,000.

In March, a Canadians for Global Care team provided training in CPR and in the area of contraception. Later in the year, Dr Yasmin Majeed, President of Canadian Global Care Society became MDA’s first honorary executive, and took on the assignment of organising a dedicated area for a paediatrics department within the MDMI,

March was also the month in which the first major operations were performed, with Dr Iftikar undertaking some 17 operations in three days, all successful.

An eye camp in April treated 135 patients in 1 day, including 24 operations.

2017 : The medical team at the hospital now operates a childrens growth and nutrition clinic where the doctors and one nurse have been trained on height and weight assessments using the Manchester STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics). STAMP is a validated nutrition screening tool for use in hospitalised children aged 2-16 years.  It is a simple 5-step tool that was developed in the UK. MDMI is believed to be the only hospital in Pakistan using STAMP.

During the month of July and August approximately 600 children were referred to the clinic where 10% were diagnosed as malnourished.  These children are now being treated with dietary and nutritional supplements.

A mother counselling session was also held to discuss the important topics of  breastfeeding and weaning.

Digital  patient systems took another step forward with the introduction of software that allowed doctors to prescribe medicine and nurses to record  patient information electronically

2018 : Remarkable story from the MDMI surgical team who operated on a 2 yr old to resolve a life threatening renal problem. The surgery would have cost some Rs900,000, a sum which the parent had no hope of paying. Fortunately the MDMI was on hand to provide treatment at no cost to the family, and with the surgeons flying out at their own cost and without payment .

The STAMP initiative had now screened some  1600 children for malnutrition (The map shows how far patients some of the screened children have come from) . We hope once we have analysed the data in more detail, we can then implement work on the ground to modify the pattern for preventing the risk of children developing malnutrition. If successful we hope this programme can be implemented across North Pakistan.

2019 : February saw the installation of a Blood Gas Analyzer system at MDMI. This equipment increases the capability of the hospital to analyze blood samples quickly and respond as appropriate. This is extremely important in certain situations such as when patients are extremely unwell and need very close monitoring. Such situations occur mainly in high dependency areas such as intensive care units and intensive care situations.

Project Updates