APRIL 8-14 2012
APRIL 8-14 2012
Cover Story 20 The Skinny on Surgical Weight Loss Those who have lost the battle of the bulge are increasingly opting for the scalpel instead of the treadmill 30 Crazy Diets Eat some air, chew on some tapeworms and staple your ears. Who ever said getting thin was easy?
Feature 34 Born Too Soon All expectant parents look forward to the birth of their child...but what happens when the baby comes too soon? 37 Madam Butterfly Larvae, lifecycles and a lifelong mission
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Regulars 6 People & Parties: Out and about with Pakistan’s beautiful people 44 Reviews: This week we look at films based on true stories 46 End Of The Line: Topi Man Returns!
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Magazine Editor: Zarrar Khuhro, Senior Sub-Editor: Batool Zehra, Sub-Editors: Ameer Hamza and Dilaira Mondegarian. Creative Team: Amna Iqbal, Jamal Khurshid, Essa Malik, Maha Haider, Faizan Dawood, Sanober Ahmed and S Asif Ali. Publisher: Bilal A Lakhani. Executive Editor: Muhammad Ziauddin. Editor: Kamal Siddiqi. For feedback and submissions: magazine@tribune.com.pk Printed by:
PEOPLE & PARTIES
Nickie and Nina
Mehreen Syed
Sabina Pasha
Sara and Fatima Fazli
Maria and Jania Sara Shahid
Hassan Sheheryar Yasin
6 APRIL 8-14 2012
Cybil
Aasma Mumtaz and Maheen Kardar Ali
PHOTOS COURTESY LOTUS
Hassan Sheheryar Yasin holds a preview for The World of HSY Prints 2012 in Lahore
7 APRIL 8-14 2012
PEOPLE & PARTIES
Pomme and Gohar
British Council holds a fashion exhibit featuring British designers in Karachi Maheen Khan
Amir Adnan with a guest
Falak
Khursheed Hyder and Tammy Haq
8 APRIL 8-14 2012
Andaleeb Rana
Imaan, Sofia & Mishaal
PHOTOS COURTESY PHENOMENA
Miran and Ayaan
9 APRIL 8-14 2012
PEOPLE & PARTIES
L’Oréal Paris launches a series of interactive mall animations in Karachi
Ujala Zia
PHOTOS COURTESY LOTUS
Sumeha Khalid
Aaminah Sheikh
Nabiha Zeeshan
Meesha Shafi
Dr Khilji and Ahmad Saadat
10 APRIL 8-14 2012
Mehreen Syed
Nubain Ali
11 APRIL 8-14 2012
PEOPLE & PARTIES
Dawood Global Foundation holds the 4th LADIESFUND Women’s Awards in Karachi
Humaira Saleem and Tara Uzra Dawood
Lubna Lakhani
12 APRIL 8-14 2012
Angie Maliha Bhimjee
Pomme Gohar
Tabinda Chinoy and Nadia Hussain
Dr Marilyn Wyatt and Bill Martin
Samiah Hamdani
PHOTOS COURTESY THE ART OF ... PUBLIC RELATIONS
Fatima Suraiya Bajia and Adeel Mansur
13 APRIL 8-14 2012
PEOPLE & PARTIES
Nazia Malik and Gia Ali
PHOTOS COURTESY TAKE II & M FAROOQ
Rizwan Beyg exhibits his 2012 lawn collection in Karachi
Munaf, Rosy and Sabeen
Asad Tareen, Rizwan Beyg and Fauzia
ir Lakhani
Hira, Zeenat and Saadia
14 APRIL 8-14 2012
Muneera and Am
15 APRIL 8-14 2012
PEOPLE & PARTIES
hip with s r e n t r a p el in heir Club Caramlaxy Series launch t e a r Samsung Gng Deewana in Laho latest so n
a and Shiree
Amna, Fatim
PHOTOS COURTESY IRFAN ALI
Taha Sadaqat and Sophiya Anjam
Mahrukh Agha
Maria B
Meher Tareen and Samina Khan
16 APRIL 8-14 2012
Kamiar Rokni, Kiran Chaudhry and Adnan Sarwar
Bilal Mukhtar
Jamal Rahman
Imtisal Zafar
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APRIL 8-14 2012
APRIL 8-14 2012
COVER STORY
Weight loss surgery is very much on the can’t seem to lose the extra pounds throu BY BATOOL ZEHRA
20 APRIL 8-14 2012
A number of white sheets cover the woman on the bed, leaving only the vast expanse of her doughy tummy exposed. Her legs splay out beyond the bed, propped up on stools, allowing Dr Mumtaz Maher absolute access to her abdomen. The lights are dim, the curtains are drawn, Jagjeet Singh’s dulcet notes fill
the room.
I am standing inside an operation theatre at Karachi’s luxurious South City
Hospital. Above the smooth white dome of the woman’s tummy — bloated
partly from obesity, partly from the carbon dioxide pumped inside her —
hangs a high definition monitor showing her viscera in intimate detail. The stomach wrapped protectively in layers of yellow fat, the liver resting chummily on top of the stomach, the spleen down below, a discoloured purple — all throbbing rhythmically.
menu for those who ugh diet and exercise.
Machines beep and buzz and hum. The anaesthesia unit exhales periodi-
cally. A wide screen TV mounted on the wall behind the doctor displays the woman’s vitals in reassuring detail. There are nearly half a dozen doctors in the room.
Then, the cutting starts.
Through one-inch incisions in the woman’s tummy, long, rigid laparoscop-
ic instruments with fine, specialised heads are introduced in the abdomen. One of these, a Harmonic Scalpel, shaped like a pair of pliers, firmly grips the
jelly-like fat adhering to the stomach and clips it off. With each clip, the fat falls away and a hiss of vapour rises from the scalpel. Soon the greater curvature of the tummy is free of fat and the rosy pink organ comes in full view.
>>Laparoscopic surgery or keyhole surgery is a modern surgical technique in which operations in the abdomen are performed through small incisions as opposed to a large incision through the abdominal wall to gain access into the abdominal cavity. It makes use of images displayed on TV monitors to magnify the surgical elements. (Source: Wikipedia)<<
Then a laparoscopic stapling instrument loaded with a stapling cartridge
is introduced in the body cavity. I watch in fascination as the instrument starts scissoring through the stomach, cutting off most of it so that only a thin strip — or ‘sleeve’ — remains. As it cleaves, it also seals, leaving behind
three rows of staples on both edges so that the stomach remains closed at all times. Cut off from its blood supply, the bisected portion of the tummy
starts turning a sickly purple. The surgeon pushes it to one side and starts suturing the layer of fat removed earlier on the now much smaller tummy that remains. Finally, the bisected portion of the tummy is teased out of the
body through an incision in the abdomen and then the incisions themselves are stitched up.
The woman on the operating table does not have cancer, nor does she suf-
fer from peptic ulcers. What has prompted her to get most of her stomach
removed is, in fact, nothing more than obesity. Piling on weight after her APRIL 8-14 2012
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COVER STORY
New Stomach Pouch
Stomach that is removed
Gastric band
Gastric sleeve
pregnancy, the 40-year-old is now morbidly obese. And when
iatric surgeries taking place every month in Karachi alone.
ple, but a medical term based on a coldly objective, scientific
drastic decision of getting one’s stomach cut out, or alterna-
ing the weight in kilograms of a person by the square of his
surgeons, you would think that obesity is the biggest blight
I say morbid, it is not an expression of my distaste for fat peobenchmark, the Body Mass Index, a number obtained by dividheight in metres.
When I had gone to see Dr Maher earlier, the first thing he
Still, I ask myself, does being overweight really justify the
tively, one’s bowels rearranged? To listen to some bariatric yet to scourge mankind.
“What is wrong with being fat?” asks Dr Maher but as soon
did was take my BMI. A BMI of 25-30 indicates that the person
as I open my mouth to respond, I realise that this is merely
35 means that the person is morbidly obese. My BMI is 20.
games, and are made fun of at school. Then in your teens, you
is overweight, over 30, one is obese and a BMI greater than
Clearly, I am no candidate for a sleeve gastrectomy, the weight
loss surgery that South City Hospital enthusiastically promulgates, a banner at the entrance advertising this sure-shot way to banish those extra pounds.
In the urban centres of Pakistan, surgical weight loss has
experienced a surge in popularity. Dr Maher, whose cli-
ents include celebrities who shall remain unnamed, has done 200 gastric sleeve surgeries over a period of three years. A team of bariatric surgeons
at the National Medical Centre (NMC) offer
get married because they’re fat. After getting married, you
cannot conceive because of polycystic ovaries. Employment becomes an issue. One girl wanted to be part of hotel man-
agement but was refused training because she was considered too obese to be attending to clients.”
I look up from my furious scribbling to check if Dr Maher
is entirely serious, but there isn’t a trace of irony in his tone. And he isn’t finished yet: being fat gets worse.
“Then there are medical reasons. The skeleton is built for a
certain weight, if you add 40 kg more, the joints have to take
gastric balloon (See Box: Weighing
hardening of the arteries, deposition of cholesterol, and in-
In). Doctors estimate that 20 bar-
APRIL 8-14 2012
have psychological and social problems. Girls are unable to
a more extensive menu: gastric bypass,
banding and even the insertion of a
22
a rhetorical question. “In childhood you cannot compete in
a lot of pressure, the heart has to work harder, the fat causes sulin resistance. And then diseases get established: arthritis,
Before Surgery
After Surgery
Stomach
Stomach (bypassed) Pouch
Jejunum
Duodenum jejunum
Small Intentine
Duodenum (bypass)
Weighing In: Each surgery comes with its own set of risks and benefits and the patient’s profile determines what will work best for him/her. In a gastric banding procedure, a band is placed around the top portion of the stomach which decreases the amount of food that can be consumed at a time. A person can lose over 50% of his excess weight this way. Though it is the least invasive option, it has its set of disadvantages. The band can always migrate up or down, or even erode through the wall of the stomach over time. A gastric sleeve is a more drastic procedure in which a portion of the stomach is cut away entirely thus reducing the hunger receptors as well as restricting intake by reducing the size of the pouch. Up to 80% of excess weight can be lost with a gastric sleeve, and though follow ups with a dietician are routinely advised, many patients never see their surgeon again – except in the rare case when a leak develops, which then entails a hospital stay of a week to a month. In a gastric bypass, the stomach is divided into an upper and lower pouch and the small intestine is re-arranged to connect to both. This restricts the amount of food that can be eaten and the amount absorbed. While this helps in weight reduction, in some cases, it can also result in nutritional deficiencies.
Gastric bypass heart failure. Fat, from childhood to middle age and old age,
pressed for a long time on account of her weight. At 130 kg,
Most of the people who opt for surgical weight loss claim
plish even simple everyday tasks. Since surgery, she has lost
is a problem.”
that they were galvanised by existing or potential health issues. Among the list of ailments that weight loss surgery corrects are diabetes, hypertension, arthritis, and sleep apnea.
“We make it very clear that we’re not here to create Marilyn
Monroes. We’re here to make sure that their medical prob-
moving was cumbersome and it was difficult for her to accom-
47 kg and, apart from all the medical benefits, she says she feels fabulous. “I can wear jeans now,” she says. “I’ve posted
an album on Facebook titled ‘The New Me’ with photos of my new, thinner self.”
Weight loss surgery is distinct from aesthetic procedures,
lems get sorted out,” says Dr Amir Khan, who visits from the
such as an abdominoplasty or ‘tummy tuck’ but doctors find
NMC.
ing in terms of cosmetic quick-fixes. “I’ve gotten patients with
UK every few months to perform gastric bypass surgery at the But what is also clear is that self esteem and body image
issues play a big role.
At a BMI of 47, Aisha*, opted for a gastric bypass surgery
because she had constant back pain, but the 44-year-old says
that being thinner and looking younger was part of the lure. “Obviously, that makes a difference,” she says, rolling her
eyes. “How you look is important and being fat takes away your confidence.”
that a lack of awareness results in prospective patients thinka BMI of over 50 who don’t realise what a dangerous disease
they’re carrying. They come to me asking for a liposuction, a
mere cosmetic procedure,” says Dr Shahid Rasul, a bariatric
surgeon at the NMC. “When I tell them that lipo is for a per-
son closer to their normal weight, they claim that once I take
this 7 kg off their tummy, they’ll try to go on a diet to achieve their normal weight.”
While the goal of a thinner self with fewer medical prob-
Suraiya*, 49, was teased for being fat through her childhood
lems is certainly commendable, is surgery the only way to
jected several times on account of her weight. “People would
disdainfully rattle off a list of the diets and cures, the herbal
and when the time came for her to get married, she was recome to see me, then say things like ‘Beta, join a gym.’”
She got gastric bypass surgery in April 2011, after being de-
achieve this? Those who have resorted to surgical weight loss
water and miracle pills, the dieticians and trainers that they (Continued on page 28)
APRIL 8-14 2012
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COVER STORY
The ‘eat less and exercise more’ credo of weight loss experts has turned out to be specious. New research shows that exercise, while it promotes fitness, plays a minimal role in weight loss. Early this year, an NYT article, ‘The Fat Trap’, caused uproar when it claimed that the metabolic changes induced by weight loss make the bodies of dieters act as if they are starving and thus work even harder to regain pounds.
tried before making the momentous decision.
“I joined three slimming centres, did yoga, aerobics, electri-
cal body toning, sauna and other exercises,” says Suraiya. “I tried every single diet. I would lose weight rapidly — 5 pounds every week. But I’d always gain it back.”
Every single person I interviewed had more or less the same
tale. If you know someone who has lost weight, you know
someone who has gained most of it back. Things have never looked so bleak for those who want to not just lose weight but
keep it off. The ‘eat less and exercise more’ credo of weight loss
experts has turned out to be specious. New research shows that exercise, while it promotes fitness, plays a minimal role in weight loss. Early this year, an NYT article, ‘The Fat Trap’,
caused uproar when it claimed that the metabolic changes in-
duced by weight loss make the bodies of dieters act as if they are starving and thus work even harder to regain pounds.
“The curse is hunger,” says Dr Maher. “Any operation which
will reduce hunger, reduce the capacity of the stomach, will succeed in weight loss.”
All three options — banding, sleeve and bypass — limit ca-
pacity and so control hunger. For the most part, the science behind these procedures is clear yet, for the patients, the decision is fraught with uncertainty: is it better to go for a high-
risk bypass surgery that leads to a huge reduction in weight?
Or should one go for a minimally invasive band, an almost half-hearted measure for someone who wants to shed a lot of weight?
It is interesting to see how the decision-making process
develops at one consultation at the NMC. In theory, this is a combined decision, taken by both the doctor and the patient.
In reality, there is a great disparity in the levels of knowledge of the doctor and patient.
At 5’2” and a weight of 130 kg, 40-year-old Sohail Ahmed*
has a BMI of 53kg/m2. Two weeks ago, he came to Dr Shahid
Rasul specifically requesting a band, and was told to research other options and talk to people who have had bariatric surgery. Now, as he rests his chin on his pudgy fingers, Dr Amir
Khan gives him a basic science lesson, making clear sketches
of all three procedures with deft, practised strokes: a band, a sleeve, a bypass.
“A sleeve operation will cut away part of the stomach that
produces hunger hormones so you will not feel hungry. With a bypass, there’ll be less space for you to fill and the food that
you do eat will not all be absorbed. The bypass is more invasive, the sleeve is irreversible.”
Ahmed shifts uneasily. “Bypass seems like a major decision.
I had only considered the band when I spoke to Dr Shahid earlier.”
“The band will not work on its own, you can easily beat it if
28
you don’t diet and exercise,” says Dr Khan. “But if you feel that APRIL 8-14 2012
it’s something you can work with, go for the band. With a BMI of 53 though, you’re better off with the bypass or a sleeve.”
“The reason I’m going for this in the first place is because I
haven’t been able to lose weight through exercise and diet. If I still have to do all of that after surgery — well, I won’t find the time for it.”
At this point, Dr Rasul steps in: “I advised him to go for the
sleeve because he wasn’t willing to go far enough for a bypass. He needs a bigger weight loss than the band can give.”
As the doctors concur that the sleeve should be okay for
overweight in time. “I used to eat late and go to sleep, I knew this was the easiest way to lose weight, so I went for it.”
Doctors are quick to point out that surgery is merely a tool
him, Ahmed nods.
to lose weight and is far from the easy option. The danger of
tients should undergo a supervised weight loss programme,
eration that is supposed to enhance the quality of life, even a
Medical guidelines say that before considering surgery, pa-
failing which they are candidates for bariatric surgery.
“Unfortunately,” says Dr Rasul, “these people are eating
away until one fine day they come to me and ask for surgery. I guess we don’t have many supervised weight loss programmes either, so I can’t really send them away and tell them to come in a month’s time.”
Before the surgery, a patient is put on a two-week diet
dying on the table is always present and with an elective op-
1% mortality rate is hard to accept. Often, this is not because of the surgery, but the diseases that the patients already had.
Malpractice is an issue in this field since bariatric surgery requires specialised equipment, large tables to lift up heavy patients, roomier chairs in the doctor’s office and a different anaesthetic technique.
And not everyone who is obese qualifies as a candidate
which ‘fixes’ his liver which is often heavy and lying on top
for weight loss surgery. “I’ve rejected a few patients on the
the patient that he can actually eat less, so that the extremely
you find their life is food, don’t mess with them.”
of the stomach. The other, more significant reason is to teach small portion sizes that they are able to ingest after surgery
grounds that their life was all about eating,” says Dr Rasul. “If
Patients sometimes face psychological problems indepen-
aren’t a trauma for them.
dent of weight and post-surgery the absence of comfort eat-
more than just overweight to be eligible for these procedures.
points out, is higher in bariatric patients.
So are these surgeries the solution to obesity? One has to be
Anyone with a BMI over 40 can get surgery to reduce weight,
ing can end up exacerbating them. The suicide rate, Dr Rasul
Like any major surgery, weight loss surgery comes with
but for a person with a lower BMI, it is justified only if that
its own set of challenges. Suraiya found herself battling not
It is then something of a surprise that Dr Raheel is a healthy,
plump body craved food but her now much smaller stomach
person has serious medical problems.
active 29-year-old who had a BMI of only 32 when he got the
sleeve gastrectomy in November 2011. “People wouldn’t believe that I was 103 kg, because I’m tall,” said the doctor. He did not attempt any sort of diet or exercise regimen to lose weight and was working till the day before his surgery.
just depression after her surgery but also weakness. Her still
could ingest only tiny portions. She was losing weight drasti-
cally and her body was rapidly adjusting to changes. For three months she battled depression and then things settled down. Today, she says, she couldn’t be happier with the decision.
“Some people feel extremely upset in the first month after
“This wasn’t a big deal for me since I’ve seen Dr Maher do it
surgery,” says a dietician who counsels gastric sleeve patients.
Planning to go to the US for his residency, he knew he
quantities.”
so many times,” he says, shrugging his shoulders.
wouldn’t have the time to exercise and with his family history of obesity, hypertension and diabetes, he was likely to get
“We make it very clear that we’re not here to create Marilyn Monroes. We’re here to make sure that their medical problems get sorted out,” says Dr Amir Khan
“But in the long run, no one regrets not being able to eat large
“I’m really happy about my divorce with food,” says Anam*,
38, who got a gastric sleeve six months ago and has come down to 83 kg from 107 kg. “It’s not just weight lifted off your
body — it’s weight lifted off your mind. I can only eat a quarter of a doughnut now,” she says gleefully.
And if there is one person who is convinced about the work
he is doing, it’s Dr Maher. If he were to make the human body all over again, no prizes for guessing which organ he’d change.
“If I could, I would give everyone a smaller stomach,” he says with conviction.t
29
*Names have been changed to protect privacy. APRIL 8-14 2012
CONTEXT
crazy diets If you think cutting your stomach in half is extreme, you should check out these crazy diets from across the world. Who needs surgery when you can eat tapeworms, air and cotton balls to help you lose all that excess weight.
Master Cleanse
Tapeworm Diet Developed by Stanley Burroughs in 1941, the Master Cleanse is a ten-day detoxification programme.
In the period of these ten days, nothing is consumed except for lemon juice, maple syrup and cayenne pepper. It is believed that through this
diet the body will get rid of all harmful toxins, lose weight and also cure a variety of diseases. Howev-
er, there are definite risks involved. The diet lacks many of the important vitamins and nutrients that are necessary for the body. Short-term side-effects include fa-
tigue, nausea, dizziness, and dehydration, while long term harm includes loss of muscle mass.
Sleeping Beauty Diet This diet advocates sleeping 24/7 for weight loss. Elvis Presley apparently was a devotee of this diet fad back in the 1970s. The diet advo-
cates sedating yourself for several days, so you can lose weight while sleeping. Unfortunately, our body is a pretty efficient machine. The hu-
man body will shut down to a minimal level of
energy consumption when asleep or extremely inactive. Even being awake and reading quietly will burn a fair amount more energy, as brain activity consumes a decent amount of calories.
30 APRIL 8-14 2012
The diet emerged in the 1920s and was based on the false notion that ingesting tapeworms was an appropriate way to shed
pounds. The idea behind this diet option is that these parasites secrete protein in our intestinal tracts that make our digestive processes less efficient. Since the tapeworms are already doing the work of digesting for you, you can actually lose pounds by
this method because in essence, you can eat whatever you want. The tapeworm is
already breaking down the food for you for its own growth. Fortunately, the FDA has
banned this diet â&#x20AC;&#x153;optionâ&#x20AC;?. It is both dangerous and downright gross.
Ear Stapling
Air Diet Now you can eat whatever you want at the same time eating nothing! In the Air Diet,
dieters sit down at the table, use a fork
and knife, and bring real food up to their mouth, but don’t actually eat it. By mimicking the act of eating, they claim to feel satisfied. Followers of the Air Diet are only
allowed to eat water “soup”. Thankfully,
it’s easy to make (the only ingredients are water and salt).
Baby Food Diet This Hollywood diet fad works by substitutThis diet involves having surgical staples
placed in the inner cartilage of the ear. The staples are believed to stimulate pressure
points that control your appetite, similar to acupuncture. However, this method can cause infections, nerve damage, extreme pain and as the body gets used to them, they
ing baby food for two, possibly three, adult meals a day. Though the argument can be
made that eating from small, nutrient-
packed pots is healthier than snacking on junk food, it’s not appropriate in terms of
adult nutrition. Once you start eating like an adult again, the pounds will return.
become ineffective as a weight-loss tool.
Cotton Ball Diet
Vision Diet For this diet, you eat cotton balls before
meals. According to some, it was believed
that eating cotton balls could suppress your
appetite, since apparently they are low in calories, but high in fibre. Sadly as exciting
as this sounds, cotton balls have no nutritional value and could damage your digestive tract.
Tongue Patches The tongue patch is a postage stamp-sized bit
of metal mesh that is surgically attached to the centre of your tongue, making eating a ex-
tremely painful endeavour. Patients are then reduced to a liquid only diet.
If it doesn’t look appealing, will you leave it on your plate? The vision diet involves wear-
ing blue-tinted glasses so that everything you plan to eat looks disgusting. The most
likely outcome: You’ll still eat whatever you want and you could hurt your eyes from wearing the tinted specs for too long. T
31 APRIL 8-14 2012
FEATURE
born too soon BY SADAF KHALID
Most expectant moms can’t wait for the baby to arrive. Every day past the due date is an agony of waiting, as the heavily pregnant mother copes with jitters and discomfort and looks forward to the day her little bundle of joy will arrive squalling into the world. But with some, it is the other way around — the baby surprises you with an appearance much earlier than expected or desired. This was certainly the case with me. Despite a delivery date in June, my twin boys were born in March — a whole 13 weeks before the expected date. They were tiny and weak, and when I saw them I shuddered with fear and guilt. I had been on near complete bed rest throughout the later stages of the pregnancy but a day before the babies came, I had gone out to a restaurant. ‘Was it my fault?’ I asked myself as I saw my silent newborns being carted off to the Neonatal Intensive Care Unit (NICU). “The next 24 hours will be crucial,” said the doctor as he took my babies away. All I could do was to wait, watch and pray. Weighing a mere 1.2 kg and 1.3
kg respectively, the tiny babies clung to life against all odds. I longed to cud-
dle them, to stroke their hair and fondle their tiny feet but, I was forbidden to touch them and was only allowed to see them 24 hours after the birth. I ILLUSTRATION BY JAMAL KHURSHID
stared at the veins showing through their thin skin and gazed at their fragile
bodies which were trapped in incubators and connected with tubes. For a new mother, it was terrifying.
But doctors warned me that this was only the beginning of the challenges
my babies and I would face. Initially on ventilator support, the babies were only able to breathe on their own after nearly three months of continuous ef-
forts on the part of the paediatrician and the staff. Now, the main target was
34 APRIL 8-14 2012
to increase their weight and I was told that feeding the babies expressed breast milk — a mentally and physically taxing task — was the only way to keep infections away.
When we left the safety and constant care of the hospital and
took the babies home, I remember just how vulnerable they
looked. Relatives who came to see them didn’t know whether to congratulate us or look mournful. Some people couldn’t help exclaiming out loud, “How will these bundles of bones survive?”
Their fears were not completely unfounded. The chances of
survival for extremely premature babies are very low. According
to leading paediatricians, less than 10% survive when born at week 22 and the odds only improve to a 50-50 chance of survival
by week 25. Additionally, they are at a higher risk of other health
problems such as delayed developmental milestones, affected hearing or vision, and weak motor skills.
My goal was to see my children become as normal as any full
term child and constant observation was required around the
clock until they achieved their target weight. Even the instinctive act of breathing did not come naturally to them as their
brain was too underdeveloped to even realise that breathing was
required to stay alive. Sleep apnea and the constant fear of crib
death was a major problem with one of my babies: he would stop breathing for a few seconds during deep sleep, and would have
Shehnaz, whose twin girls were born in the 30th week of preg-
nancy, says she feared that her babies — so tiny they could be
cupped in her two hands — would not be able to make it home. While one baby was weaned off from ventilator support on the 18th day of her life, the other one had to have surgery on her oesophagus — a process that required repeated operations over the
course of a few days. As the child was taken into the operating theatre, the mother prepared herself for the worst.
It was touch and go, and during the initial surgery, the baby’s
heart stopped beating for a few minutes. Then, on the third day of surgery, there was a brain haemorrhage that could have resulted in brain damage, but thankfully no permanent damage was done. Now, the baby girl is 18 months old and while she still needs treatment, she has won the struggle for survival.
Yasmeen, who had pre-term triplets at 30 weeks, also has a sto-
ry to tell. “One baby had a serious lung collapse and went home to be woken so that he would resume breathing. Neither of them
could be fed in the normal way. Instead, a tube was inserted directly into their stomachs through the mouth. Continuous eye exams and hearing check-ups were also required.
But the babies fought for their lives with incredible tenacity.
The problems did not vanish but they started tapering off gradu-
with an oxygen cylinder attached to a ventilator, while another
had a third grade brain haemorrhage. The third baby suffered from intestinal issues, which required multiple surgeries. Today, though,” say Yasmeen as she beams with pride, “the 5-year-
old boys are at home and it is incredible to see them all fine and healthy.”
That these stories have happy endings is largely thanks to the
ally. Today, when I see my two boys playing, talking, jumping
miracles of modern medicine. In the ’50s and ’60s half of prema-
Other parents of premature babies have similar tales to tell.
percent of them survive and lead full, healthy lives.
around and even fighting with each other, I am filled with pride.
ture babies would die from these multiple issues, but today 90 APRIL 8-14 2012
35
FEATURE For the parents, having a premature baby can be enormously
traumatic. It is an emotional rollercoaster ride swinging from shock, denial and anger to hope and back again down the slip-
pery slope. While dealing with this situation can be an absolute nightmare, the parents’ patience and determination give their children the best chance of survival and a healthy life. With the added support of skilled and dedicated physicians and nurses,
even extremely premature babies can lead perfectly normal lives.
But all that is easier said than done. Shazia, who gave birth to a pre-term baby, experienced intense guilt and could not accept
the fact that it was not her fault. At the same time, she also re-
fused to accept her child: “I will never take him home,” she said. Parents may feel disappointed to see the tiny baby: a wrinkly
little bundle of thin bones, surrounded with tubes in the incubator only able to breathe with the aid of a ventilator. They may
For the parents, having a premature baby can be enormously traumatic. It is an emotional rollercoaster ride swinging from shock, denial and anger to hope and back again down the slippery slope
become angry and blame each other, which is the worst thing they can do. The key to dealing with the situation is for both the
parents to support and encourage each other. Parents who are
Studies suggest that preterm infants who are fed breast milk
their child a fighting chance.
development parameters. The very first drops of breast milk (co-
strong and endure the challenges with fortitude can help give The most crucial support for parents and babies often comes
from the nurses. While the child specialist is only around for a
short time, nurses work round the clock and are always on their
toes to provide the baby all it needs. They educate the parents
lostrum) is the best food for a sick, tiny, early baby. Parents can also help such children through spending as much skin-to-skin time as possible.
With judicious care, the developmental problems of a prema-
about the baby’s condition and needs, help the frightened moth-
ture baby go away with time and the child ends up performing all
physicians and give him information about each baby. The best
crawling to walking, sitting up and taking his first shaky steps.
er develop a bond with the child, as well as collaborate with the in the profession understand that having a premature baby is exhausting and strenuous. “We try to provide emotional and spiritual support to the parents, by giving them hope,” says the head
activities that a normal or a full-term baby is supposed to — from
Very few people can understand the joy parents of premature babies experience then.
A few years ago, I met a couple who seemed very resilient, de-
nurse at a leading hospital in Karachi. “The smallest achieve-
spite their child being born 25 weeks pre-term. Despite all the
ventilator support or increasing the baby’s feed puts a smile on
the end. Now their son is a smart kid studying in a school with
ment, such as weaning off the oxygen cylinder or tapering off the parents’ face. This is our true moment of success. When I see
babies who were once under critical care in the NICU grow into smart young children, I realise miracles do happen!”
Once the baby leaves the NICU, extra care must be taken. Not
difficulties the child faced, the parents made it right through to
a competitive environment, as sharp as any other child who was
born full-term. Stories like this teach other parents to be strong and not let unhealthy remarks from others discourage them.
The importance of peer support cannot be overstated. “It is al-
only are premature babies more prone to the ailments that can
ways a source of relief for the parents to see the other pre-term
ing their temperature every few hours to being on the lookout
mother assuming the responsibility of a fragile baby to know
affect all newborn infants, they also need extra care, from takfor alarming symptoms and limiting visitors to avoid infections.
They are at a higher risk of eye problems and commonly have re-
survivals enjoying a happy healthy life. It is important for a that she is not alone,” says one parent of a premature baby.
In a country like Pakistan, where quality healthcare and
spiratory tract issues. Dr Tanveer A. Chaudry, an eye specialist
awareness are scant, parents need to be extra strong to fight
says, “All premature babies born before 32 weeks and/or weigh-
which may be associated with them due to their premature birth
and surgeon for children who practices at the Aga Khan hospital, ing less than 1500gms should be screened for retinopathy of prematurity. This disease affects a minority but, if untreated, can lead to permanent blindness.”
36
grow up with higher intelligence scores, and better neurological
One way to help the baby is to exclusively breastfeed him: this
builds immunity and reduces risk of other health problems. APRIL 8-14 2012
the ignorance and shield their children from any social stigma
and potentially delayed milestones. All babies are gifts from God and as such deserve all the help that can give them a chance at a healthy life. A baby is a blessing, and no matter how sick it may
be, the parents should focus on their child’s health, rather than worrying and fretting.
FEATURE
madam
butterf ly When Shereen Abdullah discovered that the butterflies were disappearing, she took matters in her own hands.
BY RAHAT KAMAL
At first glance, the neatly lined bottles seem to be just a mundane collection of jam jars, but on closer inspection, one discovers that they are filled with twigs, leaves and life. These thirty or so bottles serve an extraordinary purpose; they are nurseries for caterpillars till they metamorphose into beautiful butterflies. Shereen Abdullah, a housewife and a mother of three, has been playing host to these caterpillars, nurturing them like they were her own children, for the past eight years now. When Shereenâ&#x20AC;&#x2122;s eldest son showed an interest in nature and insects, she
37
wanted to show him the four stages of the development of the butterfly in
APRIL 8-14 2012
real life, and not just pictures in a book. But after an extensive
project to teach my eldest child the development stages of a but-
the butterflies had somehow disappeared. She visited nurseries
insects,” she says. “It is hard work raising butterflies, but see-
search of her garden and nearby nurseries, she realised that all and questioned the gardeners there but they didn’t seem to know
or care where the butterflies had gone. Her sleuthing finally bore fruit when she was able to identify the prime culprit behind the decline of butter-
flies in the city: pesticides. To her horror, she found that plants in all the nurser-
ies and home gardens were being sprayed with pesticides fortnightly, thereby killing
all the caterpillars, butterflies and other garden insects that are crucial in maintaining a healthy ecosystem.
Shereen asked around for people who
could help her in increasing the dwindling
number of butterflies, but didn’t find any-
one even remotely interested in the task. “I didn’t want my children to grow up and
say ‘There once used be a beautiful, colourful insect that used to fly around in our gardens.’ So I thought I’d do something about it myself,” says a determined Shereen.
Breeding and raising butterflies came
naturally to her. When she was young,
ing a caterpillar that you have personally raised come out of its chrysalis is one of the greatest joys in the world.”
“What had started off as a simple project to teach my eldest child the development stages of a butterfly, turned into a life long association with these remarkable insects,” says Shereen.
her father used to do the same thing, not
Caring for these to-be butterflies is just
like caring for young children. Shereen has
to keep a constant eye on the insects, keeping them well fed, away from ants and in
the right temperature. At times, she has to cut leaves in the middle of the night to feed them. Additionally, she also has to
ensure that her garden is well stocked with
specific plants which the caterpillars feed on. “My work has grown a lot over the years
but I always manage to squeeze in some time for them,” she says. On a typical day Shereen inspects her bottles right after she
wakes up at dawn. If she finds that a butterfly has come out of the cocoon, she re-
leases it then and there, or gives it to one of her children so they can release it with their class at school.
After the children leave she rushes to
tend to the bottles once again. This involves carefully taking out the leaves and
for preservation purposes, but to show his children the many
insects from each bottle, cleaning the frass (the caterpillar’s fae-
transforms into the majestic butterfly. Thanks to this upbring-
back in the bottle. This process takes her up to one hour and she
transformations the unimpressive larva goes through till it
ing, she already knew how to raise them from larva to butterfly
38
terfly, turned into a lifelong association with these remarkable
and with research and experience she learnt many other tricks to
best care for her new charges. “What had started off as a simple APRIL 8-14 2012
ces), putting in new leaves and finally putting the caterpillars has to repeat it in the evening.
Apart from her own garden, Shereen also rescues larvae from a
particular nursery. Out of the several nurseries she approached,
A butterfly puddle is a visually appealing way to attract butterflies — all you need is a shallow ceramic plate and a few big stones or pebbles she was only able to convince one to cooperate with her. Though
on citrus plants and mostly fosters butterflies that have wide
he cooperates with her by waiting till she has collected all the
and the African Monarch. She recounts that as a child she was
she couldn’t get the gardener to stop using pesticides altogether, larvae and pupae till he sprays.
Shereen says that the only way one can attract butterflies to
their garden is by not using pesticides and planting bright coloured flowers and host plants, i.e. the plants the butterfly lays
wing spans. Up till now she has grown Swallowtails, Mormons used to seeing a type of Mormon called the Red Rose Mormon
which is now totally extinct in Karachi, a fact that saddens her deeply.
In her quest to spread her message, Shereen also conducts ses-
its eggs on and the caterpillar feeds on, like the lemon tree. An-
sions at schools for young children as she feels they are most re-
more often is to make butterfly feeders. This can be done sim-
call me ‘the butterfly lady’,” she says with a proud smile. Not con-
other step that will make the butterflies frequent your garden
ply by putting rotting fruits like oranges and bananas in a plate and placing them a bit above the ground so that the butterflies
can drink the juice from the fruits. Another visually appealing step to attract butterflies is to make a butterfly puddle. In hot
summer afternoons, the puddle acts as an oasis for the tired but-
ceptive to her message of conservation. “The students and staff
tent to rest on her laurels, Shireen aims to put together a society for the conservation of butterflies that can work in tandem with
the various horticultural societies in the city, in order to increase interest in conserving these beautiful insects.
Shereen believes that if everyone who cares even a little for
terfly. “The puddles are easy to make, all you need is a shallow
the preservation of our beautiful world pitches in to help protect
in the plate and then place the stones in a way that they are half
tion of these insects. Perhaps then our children can learn about
ceramic plate and a few big stones or pebbles. Put some water submerged in the water,” explains Shereen.
At the moment, Shereen only works with butterflies that feed
these butterflies, they will make a major impact on the preservathem firsthand and not just through some pictures in a book.
Shereen Abdullah can be contacted at thebutterflylady786@yahoo.com APRIL 8-14 2012
39
REVIEW
the science of winning BY NOMAN ANSARI
Director Bennett Miller’s biographical sports drama, Moneyball, rolls with soul. Nominated for six Academy Awards including Best Actor and Best Picture, it makes an absorbing and moving film out of two dull subjects, baseball and baseball statistics, thanks to a fine script, and some even finer performances, especially from its lead, Brad Pitt. Playing the role of Oakland Athletics general manager Billy Beane, Brad Pitt is visually captivating in his fantastic performance as the lonely and excessively driven GM, who is unable to let go of his own failure as a highly promising athlete. The film is based around the Major League Baseball season in 2002, where after a bad start, the most poorly financed team, Oakland Athletics, eventually won 20 games in a row and set an all-time record. Though as the film shows, this achievement didn’t come easily. When the season begins, we learn that the Oakland Athletics have lost their major stars, and don’t have the resources to replace them. At a meeting with his staff, Billy Beane urges his scouts to come up with the impossible and when he travels to trade athletes with the Cleveland Indians, Beane almost leaves empty-handed. There he meets Peter Brand (Jonah Hill), a graduate of economics fresh out of Yale, who impresses Beane with his revolutionary ideas. Brand believes that baseball scouts
a whale of a tale BY NOMAN ANSARI
Loosely inspired by the actual 1988 international effort to rescue three gray whales trapped in pack ice in Alaska, director Ken Kwapis’ Big Miracle is a warm family movie with a big heart. The film works in no small part due to the simple charming appeal of its two main leads: veteran actors Drew Barrymore (Never Been Kissed) and John Krasinski (US TV Series: The Office). The movie begins with small time TV reporter Adam Carlson (Krasinski) who, having exhausted everything newsworthy, hopes to catch a big story and move away from North Alaska. While filming some silly antics of the local Inuit natives, Carlson, to his wide eyed amazement, discovers three beautiful whales, including a baby he affectionately names ‘Bam Bam’, caught in the freezing Alaskan nothingness. His account on the plight of the majestic sea creatures draws international attention, bringing to town journalists from all over the world, including his TV crush, Jill Jerard (Kristen Bell), a reporter who desperately wants to be noticed for more than her looks. Also in town is Carlson’s ex-girlfriend Rachel Kramer (Barrymore), a passionate Green Peace environmentalist. Rachel soon butts heads with oil tycoon J W 44 McGraw (Ted Danson), a business man looking to drill for laskan oil, and APRIL 8-14 2012
put more stock in superficial qualities rather than actual performance. This philosophy appeals to Beane, who bitterly believes the system let him down in his own playing days, and he hires Brand as the Oakland Athletics assistant general manager. The duo start building their new team based purely on the moneyball theory, putting together unwanted players and forming a team of misfits. When the season begins, and the theory initially fails to bear fruit, Beane finds hostile opposition from the fans as well as members of the staff, including Athletics manager Art Howe (Philip Seymour Hoffman), with whom his relationship grows extremely tense. After Art refuses to include all the players in the playing team whom Beane needs to make his theory click, Beane puts his job at risk by trading out perfectly good players who are favored by the Athletics’ manager. What makes Moneyball a real prized catch is the character of Billy Beane, who by changing the system which let him down, seeks catharsis. There are many dimensions to Beane, which make him, like this film, stand out from the crowd.
with the local Inuit leaders’ council who want to kill the whales for food. The whale of a tale really gets serious when it catches the attention of the world superpowers USSR, and the United States, two nations that share an icy relationship. Respective leaders Mikhail Gorbachev and Ronald Reagan cooperate on a rescue operation, using the event to briefly defrost the cold war. Eventually, like the world leaders, all those involved put aside their differences, while aided by Carlson and local entrepreneurs, to come together on a common cause, even though they have varying political and personal motives. Some may argue that Big Miracle, with its one dimensional characters and feel good clichés, too readily glosses over the actual facts of the international rescue event, taking an overly simplistic view, purely for entertainment value. However, Big Miracle isn’t a documentary, and works as a spirited movie that can easily bait and hook audiences with its absorbing and humorous narrative. And while it avoids diving to great depths, Big Miracle is still a fairly big catch.
http://www.facebook.com/secretachaarsociety
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Are you capable of drawing a straight line? Do you have a comic or doodle that you think will have us rolling on the floor with laughter? If youâ&#x20AC;&#x2122;ve answered yes to all those questions then send in your creations to magazine@tribune.com.pk APRIL 8-14 2012