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Indian doctors help Pakistani patients

Safwan Sarfraz waved a toy gun menacingly at his younger brother as they squabbled over a bottle of soda, hardly surprising behavior for a 4-year-old. What’s more unusual was the pacemaker and rebuilt heart chamber beneath a large bandage on his small chest.

Safwan is alive thanks to rare cooperation between uneasy nuclear neighbors India and Pakistan that sees several hundred Pakistanis a year traveling to India on health visas, most for heart operations.

“He’s not quite ready to play cricket,” said his father, Sheraz Sarfraz, 30, a cellphone repairman. “But he’s growing stronger and more active every day.”

Decrepit government hospitals and inadequate funding have left healthcare in Pakistan, like much else in the country, in crisis. The situation is made worse by mounting violence against doctors, seen as wealthy, relatively soft targets, accelerating a medical brain drain to the United States, Europe and the Middle East.

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For Pakistanis with serious health problems, neighboring India offers high success rates. And although many Pakistanis arrive in India fearful — textbooks, officials and the media in both countries spread distrust — they come away from the experience with the realization that they have a lot more in common with Indians than they expected.

“I thought they’d be mean to us, think we were the enemy,” Sarfraz said. “But we met many nice people who even bought food for us. You don’t behave like that if you harbor hate in your heart.”

Friends and relatives back home can be even warier, sometimes expressing concern before a heart transplant that their loved ones will get an Indian heart.

“How ridiculous! A heart is a heart no matter where it comes from,” countered Nida Rashid, a British-educated journalist from Lahore whose aunt recently had a liver transplant. “But if you’re educated in Pakistani schools, taught to hate anything India in the textbooks, you have this sort of thinking. It’s high time people realize that India has a lot to offer and they should make use of it.”

Safwan’s parents first noticed a problem soon after his birth when his brown eyes turned bluish green in the bath. They spent months visiting government and private hospitals before getting a diagnosis: Safwan’s arteries were connected in reverse, causing pure and impure blood to mix in his heart’s left chamber.

More bad news followed: The parents say Pakistani hospitals told them they couldn’t fix the problem. And getting the surgery done in India would cost more than $6,000, including flights and hotels, equivalent to about 15 years’ salary for Sarfraz — money and time they didn’t have.

“We were distraught,” said Sofia, Safwan’s mother. “We did nothing but pray, felt hopeless and powerless.”

They were turned down by several charities before someone suggested that they approach a TV network. A Pakistani businessman saw the story and agreed to donate the money.

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On May 20 at New Delhi’s Fortis Hospital, Dr. Rajesh Sharma operated on Safwan for 11 hours, then three more hours a few days later, closing a hole in Safwan’s heart, expanding his right chamber and inserting artificial tubing and a pacemaker.

“Dr. Sharma has gifted hands, a blessed soul and he’s a very nice person,” Sarfraz said.

Congenital heart problems are relatively common in Pakistan, given frequent marriage between first cousins, contributing to birth defects, Sharma said a few weeks later in his small office at the hospital.

Sharma, who performs about 300 heart operations annually on Pakistanis in India, said he feels a special connection with these patients. His parents were born in what is now Pakistan before moving to India in 1947 as the wrenching partition divided the two countries.

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The cases also tend to be challenging, and therefore more interesting, he said, and Pakistani patients are generally very trusting.

“They have real faith, different from us,” he Said. “Maybe it’s because they’ve been knocked down so much, which makes it easier, and you can do a better job.”

He said bureaucrats occasionally cause delays. The Indian side was wary of one of his recent cases, a pregnant woman coming to deliver a baby with heart problems, amid questions of whether the baby would become an Indian citizen (it didn’t). But by and large the foreign ministries on both sides are supportive, Sharma said.

“Borders and citizenship are man-made problems,” he said. “Children don’t know; they just come into the world.”

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India did its first open-heart surgery in 1961 and its first heart operation on a Pakistani patient in 1978. When relations between the two countries deteriorate, bus and train service is often halted, making medical trips too expensive for some people and occasionally costing lives.

In 2003, a 6-month-old heart patient was forced to fly to Bangalore by way of Dubai, United Arab Emirates, and Mumbai because land routes were severed after a 2001 attack on the Indian Parliament. Soon after arriving at a Bangalore hospital, he died of pneumonia, which Sharma attributes to the air conditioning, stopovers and stress. “We were unable to save him,” he said.

Even when relations are relatively good, there can be a backlash. An Indian confidence-building program in 2004 that saw 25 Pakistani children with heart problems brought to Bangalore for free operations was discontinued after Indians groused that Pakistanis were treated better than they were.

The Sarfrazes say they want India and Pakistan to increase people-to-people exchanges like their son’s operation and eventually learn to trust each other.

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“The governments create suspicion that puts negative feelings in people’s hearts,” Sheraz Sarfraz said. “I just hope the two countries can drop that distrust. It’s hard to imagine their really getting along. But anything is possible these days, God willing.”

mark.magnier@latimes.com

Magnier recently was on assignment in Pakistan.


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