KARACHI - Many years ago when Pakistan’s former hockey captain full-back Munawwar-uz-Zaman collapsed and died at the Pakistan Customs hockey ground due to cardiac arrest, a debate began advising the clubs and the players to get their players thoroughly examined to avert repeat of what had happened to the full back who led Pakistan to victory in 1980 Champions Trophy in Karachi.

However as the time passed and the death of Munawwar faded, the demand for stricter examination of the health of the players receded. Munawwar had some kind of heart problem when he was invited to play in a senior exhibition match. He put on his shoes and entered the field forgetting that extra physical stress that water filled astroturf demand could prove hazardous. But as the fate would have it Munawwar collapsed on the turf and breathe his last before some kind of medical aid could be given.

Former international athlete M Talib at that time was the lone voice who had written in an Urdu daily requesting the sports authorities to set some kind policy in which all the sportsmen across the board would be advised to undergo medical tests to determine their state of health.

There have been cases in Pakistan in boxing when a young boxer died in the ring of brain haemorrhage when the referee did not intervene in time as the youngster was getting punished by a superior opponent. There are many more examples including one of a cricket umpire and a cricketer breathing their last while playing in Karachi.

In Pakistan medical examination of players is non-existent. Even at international level there was no awareness of getting players medically examined thoroughly. However recent deaths of known footballers due to cardiac arrest while playing for their clubs in high profile competitions has forced the mangers of the game at international level to consider some kind of stricter mandatory medical examinations of players across the board before a championship, according to information available here.

Jiri Dvorak, FIFA’s chief medical officer was recently asked about the on-field collapse of Bolton Wanderers’ Fabrice Muamba in March and the death of Livorno’s Piermario Morosini in April, said that it was for the coaches to educate the players and for players to take responsibility for their health.

“It’s very important to have management on the field despite FIFA’s emphasis on prevention and pre-match examinations. We have to make a very clear and a very strong statement, work together with medics, paramedics, referees, coaches, and finally, the players.” Dvorak pointed to the steps taken by the world governing body in this regard, including mandatory medical examinations since 2007 for all players before FIFA competitions.

“We will now be studying heart attack cases again in players to learn what causes sudden collapses like in the case of Muamba. The project will be put forward at a medical conference, to be held on May 23-24 in Budapest. If a cardiac event occurs on the pitch, we need to make sure people are ready for emergency interventions. We have also invited all national team doctors to establish a worldwide database for cases of sudden heart attack.”

Dvorak, who is also chairman of the FIFA Medical Assessment and Research Centre (F–MARC), added that authorities ‘can do more’ in this regard. “For instance, we have recommended that national team players should have medical assessments before games. More member associations are following that advice. Also, at all FIFA competitions, we need to have an appropriate medical staff around the pitch and a defibrillator in the stadium. We want to educate all the member associations that having a defibrillator is important to help save lives.”

Dvorak admitted that though the well-being of a player ‘is an issue that no one in football can afford to take lightly’, it is impossible to prepare for every single potential on-field accident. “We have to make sure that team doctors examine and evaluate the footballer’s clinical history.” He also suggested banning footballers who feign injuries during matches because they cloud the judgment of referees, who then lose ‘precious moments’ in deciding on genuine injuries.

“We need to ban players faking injuries on the field, which seem to happen for tactical or different reasons. There might not be a contact and suddenly you find a player crawling on the pitch. In such cases, the referee cannot do anything.”