LAHORE: As the country faces a threat of `chronic kidney disease epidemic`, the fact that Punjab has no rules and regulations for promotion of nephrologists highlights the apathy of the government.

According to the latest statistics, nearly 21 million people in Pakistan have either stage 3 or 4 Chronic Kidney Disease (CKD) and there are only 145 qualified nephrologists.

`Punjab being the largest province faces a gruesome situation as kidney failure incidents have assumed alarming proportions,` an official told Dawn.

He said a batch of nine qualified nephrologists, which was produced a few weeks ago for the first time by any public hospital of Punjab, was recruited (on a regular basis) as senior registrars. `They have become a rolling stone as the government has no rules for their promotion in higher grade.

Besides, there are few designated nephrology sections all over the province,` he said.

He said it was quite disturbing for highly-educated persons (nephrologists) who were forced to work without promotions in the public hospitals.

He said the health department recently conveyed to them to `bring rules and get promotions otherwise wait for an indefinite period.

When they pleaded their case, he said, the officials got annoyed and `directed` them to visit them next time with a copy of the rules.

Although they later tried to present Shaikh Zayed Hospital`s model of rules for promotion for the nephrologists, the health department was reluctant to adopt it in letter and spirit.

The official said the nephrology services were already facing a grim situation in Punjab as there were only six FCPS accredited public teaching institutions. They are Shaikh Zayed Hospital, Fatima Jinnah Medical College/Sir Ganga Ram Hospital, Lahore, Allama Iqbal Medical College/ Jinnah Hospital, King Edward Medical University Lahore, Punjab Medical College/Allied Hospital Faisalabad and Nishtar Medical College, Multan.

Similarly, he said, there were only six seats of consultant nephrologists at the district level hospitals of Punjab and four positions of assistant professors and one each of associate professor and professor at the teaching hospitals. `SZH is the only institution in Punjab which has been producing the nephrologists for the last 30 years,` he added.

Some nephrologists have managed to establish a new nephrology unit at Mayo Hospital with the help of a charity organisation. It is said to be the first designated nephrology unit ofthe health department which is training FCPS doctors.

Recently, it produced a batch of nine nephrologists which injected hope that the patients would continue to get trained practitioners of the neglected specialty.

The Punjab Public Service Commission (PPSC) advertised the nine posts ofsenior registrars and these nephrologists got recruited first time on a regular basis in various tertiary-care hospitals. Dr Muzzamil Riaz Malik and Dr Irfan Elahi were posted at Mayo Hospital, Dr Salman Tahir Shafi at Jinnah Hospital, Dr Aurangzaib Afzal at Lahore General Hospital, Dr Poonam at Banazir Bhutto Hospital Rawalpindi, Dr Samee and Dr Yousaf at Nishtar Medical College Multan, Dr Irfan Rasool at DHQ Hospital Faisalabad and Dr Bilal Chaudhry at Allied Hospital, Faisalabad.

They were happy to join their new job but soon realised that there was no mechanism for promotion. Dr Shahid Anwar has been working as assistant professor at FJMC/SGH on an ad hoc basis for the last hve years. Neither his service has been regularised nor has his post been sent to the PPSC for regular recruitment.

Similarly, Dr Zahid Rafique has been working as senior registrar for the last seven years as the post of assistant professor of nephrology does not exist due to absence of rules of promotion.

There is only one post of SR Nephrology in Jinnah Hospital Lahore which had been recently advertised via the PPSC. Dr Arslan Khalid is working there as an assistant professor on an ad hoc basis. At the Allama Iqbal Medical College, the post of an associate professor is vacant for the last many years and thereisno postof professor of nephrology. Dr Hafiz Ijaz, who is the professor of medicine, is heading the nephrology department.

At Mayo Hospital, Dr Muhammad Anees has been working as assistant professor of nephrology without designated unit for the last 11 years.

He has not been promoted as associate professor of nephrology on a regular basis.