The Paediatrics Cardiology department at the All India Institute of Medical Science gave ailing one-year-old Muhammad Ayaan Asad Khan in Pakistan an appointment for March 23, 2018 but his agonized parents Asad Ikram and Hadia Izhar who sent in their Indian visa applications on March 1, 2018, are still waiting.

Ayaan’s deteriorating condition makes them increasingly frantic. Ikram, a sales and marketing executive with a trade company, said he has visited the Indian High Commission in Islamabad three times with the necessary documents, twice taking little Ayaan with him.

“His growth has halted since the past three months. We are desperate to take him for the surgery,” he told The News over the phone from his home in Rawalpindi, stressing the urgency of the situation. “He turns blue because of lack of oxygen in his body.”

Ayaan, who celebrated his first birthday in February, still weights just 8.2 kg, which is on the lower side for his age. “He is very cranky at night because of sleeplessness, but we are far more worried about the fact that he doesn’t walk or crawl. He started to stand on his feet with balance but hasn’t even been doing that for the past few days,” says Hadia.


An only child, Ayaan was six months old when his primary care doctor Dr Zaheer Ahmed told the parents that his congenital heart ailment requires urgent surgery.

The condition is Tetralogy of Fallot (TOF), which means there are four hindrances to the flow of blood to his heart: a hole between the heart’s ventricles, the thickening of a muscle surrounding the lower right chamber, blood from both ventricles entering a displaced aorta (the largest artery) and an obstruction in the flow of blood between the heart and lungs.

In Pakistan, children with such ailments are usually treated after they are at least a year old.

kram and Hadia also consulted paediatric cardiologists at the National Institute of CardoVascular Diseases (NICVD) and Aga Khan University Hospital (AKUH), who seconded Dr Ahmed’s advice for surgery at the earliest. They suggested hospitals in India that could more efficiently handle the case.

Ayaan’s mother, a clinical pharmacist who previously worked at Shifa International Hospital, Islamabad, reached out to a cousin in New Delhi, who obtained the doctor’s appointment.

Post-op issues

Meanwhile, with the child’s condition worsening, on March 10, they brought him to Karachi, hoping to find a doctor to perform the life-saving surgery. But all the doctors they consulted said the same thing: even though the surgery is possible in Pakistan, the post-operative care is not adequate – a catch 22 as the parents want the surgery and their child to survive after it too.

“We were running around different hospitals for checkups, including AKUH, Liaquat National Hospital, Tabba and NICVD,” said Ikram, listing the medical facilities his family went to in Karachi.

They also went to Lahore on March 17 to examine options there but found the same story. The operation would be risky because of inadequate post-care.


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