Former prime minister Mian Nawaz Sharif (MNS) has been under treatment in London for the past 20 months. He had gone there in a precarious condition as, it was then claimed, his treatment was not possible in the country – not even at the well-equipped medical facilities set up by the Sharifs. 

The medical report of MNS submitted to the Lahore High Court a few days ago is still depressing. His doctor has advised him not to travel, an excuse the former prime minister will use for not returning to Pakistan in the foreseeable future. 

In other words, barring some miracle he will not be in a position to campaign for the party even if, hypothetically speaking, elections are held in the near future. 

General elections are scheduled for 2023, although the Pakistan Democratic Movement, of which the PML-N is a major constituent, calls for immediate polls to solve the country’s multiple problems.  

The three-page report, prepared and signed by Mr Sharif’s consultant cardiothoracic surgeon David Lawrance says: “Nawaz Sharif, undoubtedly, has complex and complicated medical issues which need to be treated holistically. Great care needs to be exercised in dealing with each of the diseases and comorbidities he is suffering in order to maintain the right balance. He has been looked after by an experienced hematology team led by a senior hematologist at the Guy’s and St. Thomas Hospital and the cardiologists at the Royal Brompton and Hare field Hospital, London. Prior to this latest referral Mr Nawaz had been getting treatment here in London for many years.” 

The doctor said: “There is also the appearance of the transient ischemic dilatation suggesting significant ischemic burden that amounts approximately 22 per cent of the myocardium. This is indicative of significantly reduced blood supply to the heart in the circumflex territory and impaired functionality. Mr Nawaz is advised cardiac catheterisation and subsequent management given the significant risk of worsening of his heart disease but once his comorbidities (ITP, hypertension, diabetes and chronic kidney disease) were stabilised by a multidisciplinary approach.” 

“He developed ITP during his incarceration and his response to the first and second line therapies was unsatisfactory, a stable platelet count within the medically prescribed range, was paramount to ensure the safety of diagnostics and treatment. In addition to the recent finding of him having developed carotid artery’s stenosis, he was assessed to have had an exacerbation of his coronary artery disease and deterioration of renal functions. The intention was indeed to proceed with the management of his cardiac and carotid diseases once he was given clearance from haematology and nephrology specialties.” 

Surgeon Lawrance further said: “Nawaz Sharif told me that he was kept in solitary confinement for a prolonged period of time during his imprisonment in Pakistan. If this were true, I share his concern that this could have contributed negatively towards his health, both physically and psychologically. During the Covid crisis he was managed medically and was under surveillance and follow up for his persistent symptoms. He should now proceed with his coronary angiography and possible angioplasty,” Lawrance said, adding that it was his opinion regarding Mr Nawaz’s travel to Pakistan and its implications on his health remained the same as reiterated in my earlier medical reports. 

“He should by all means avoid travelling and visiting public places like airports. He should only stay in close proximity to the healthcare facilities where he has been getting his treatment until the Covid-19 threat is over and his health problems are adequately addressed,” Lawrance said and added the facilities in the UK provided the best of care as is important to address his complex health issues. 

“Mr Nawaz needs to take serious precaution being a clinically extremely vulnerable person.” 

It may be recalled that it was in November 2019 when Mr Sharif left Pakistan in an air ambulance to receive medical treatment in London. 

The former prime minister was suffering from an auto-immune blood disorder, high blood pressure and deteriorating kidney function. His platelets had gone down, a situation that moved the hearts of government doctors.  

His doctor said he was “fighting for his life”. 

Despite a disappointing report on Mr Sharif’s health, Maryam Nawaz Sharif’s son Junaid Safdar is scheduled to marry former Ehtesab Bureau chairman Saifur Rehman’s daughter Ayesha in London after 10 days on August 22. 

Since Maryam and her husband Capt (Retd) Sadfar are on the exit control list, they cannot participate in the ceremony. 

This has provided Maryam an opportunity to get public sympathies.  

She says she would not approach the government to seek permission for participation in the event. 

She recalled that she was in jail even when her mother had died. 

The PML-N vice president must know that it is not mandatory for the family to perform the wedding in London.  

She can participate if the ceremony is performed in Lahore, the city of the Sharifs. 

The members of the Sharifs family, staying in London for years, should come to Pakistan together and participate in the ceremony.  

The change of venue from London to Lahore will also make it possible for a large number of party leaders and workers to share the joys. 

Final decision will, however, rest with Maryam and her father.