For Karachi’s poorest patients, this hospital makes high-quality care accessible


But first, when it comes to providing innovative
health care, Pakistan is not a country that usually comes to mind. But in Karachi, one public-private partnership
is trying to address some of Pakistanis’ most pressing medical needs. In cooperation with the “Associated Press”,
special correspondent Fred de Sam Lazaro has the latest in our series, “Agents for Change”. (BEGIN VIDEOTAPE) FRED DE SAM LAZARO, PBS NEWSHOUR SPECIAL CORRESPONDENT
(voice-over): On any given day at Karachi’s Jinnah Hospital, some 5,000 patients arrive,
many wheeled in on rusty, bare metal gurneys by family members who wait sometimes for days
in the outer corridors. Inside are long lines-for X-ray scans or appointments
with overwhelmed staffers. There are lots of exhausted children. Jinnah is one of the oldest, biggest public
health care facilities in Pakistan’s commercial capital, a city of 15 million and the hospital
hasn’t been immune to the violence and terrorism that has gripped this country, including this
bomb blast in 2010 in its own emergency department. DR. SEEMIN JAMALI, CEO, JINNAH HOSPITAL: We nearly
missed to die. I was standing right at the gate and very,
very injured. About 18 people lost their lives at that point. DE SAM LAZARO: Yet hospital CEO Seemin Jamali
notes that just 30 seconds after the blast, staff are back on their feet, tending to the
injured. She says it’s a metaphor for a hospital that
is transforming itself amid all the chaos, replacing its decrepit old buildings and bringing
some of medicine’s most modern equipment and care to Pakistan’s poorest patients who may
never otherwise have access. Six-year-old Noman Azim was brought in after
losing his sight when a growing brain tumor began to affect his optic nerve. SHEENA AZIM, MOTHER OF NOMAN (through translator):
He was scared of everything. He lost his eyesight for two months. He was completely blind. Thank God my son has a new life. He goes to school, he studies, he plays outside. DR. TARIQ MAHMOOD, RADIOLOGY CHIEF: This is pre-treatment
images. And this is post-treatment images. Look at this, that whiteness has almost completely
gone. DE SAM LAZARO: Radiology chief Dr. Tariq Mahmood
(ph) says Noman was treated with some of the most sophisticated technology anywhere. He was restored to sight with a $4 million
robot like device called a cyberknife. In the U.S., the price tag for such treatment
ranges between $50,000 and $90,000. Here it is free, true of all services in government
hospitals. Patients can chip in after their care but
it’s voluntary. On average, these donations defray about eight
percent of the hospital’s costs. All this equipment was donated to the hospital
by a non-profit group called the Patient’s Aid Foundation, private citizens who’ve provided
guidance and much of the funding for the hospital’s facelift. MAHMOOD: From 1984 to 1994, we were doing
200 scans in a year. Today, we are doing 300 scans, CT scans in
a day. DE SAM LAZARO: This public private partnership
began in 1992, when a group of business leaders were moved by the desperate conditions at
the hospital. Businessman Mushtaq Chhapra says it began
with pleas from the hospital to replace broken refrigerators in the blood bank and parts
for medical equipment. MUSHTAQ CHHAPRA, VICE CHAIRMAN, PATIENT’S
AID FOUNDATION: The government didn’t have the budget to do these repairs or renovation. And this is where my organization stepped
in and virtually, these were small things which were remedied within hours. DE SAM LAZARO: Those small things have added
up quickly; $35 million so far, in donations from prominent business families in Karachi,
for buildings, equipment and some staff at the hospital. Chhapra says at first they were skeptical
about partnering with a public sector notorious for inefficiency and corruption. He says they forged a clear understanding
of key roles each side would play. CHHAPRA: We have not let the government abdicate
their responsibility. The government has 3,000 people working in
this hospital, the government is paying salaries for those people, the government provides
the utilities, the medications. What we do is we bring the ideas, we bring
the systems and we bring the much-needed equipment. DR. TASNEEM BUTT, VOLUNTEER, PATIENT’S AID FOUNDATION:
Doctors, obviously everybody wants to work in a neat and clean environment. DE SAM LAZARO: Retired radiologist Tasneem
Butt volunteers as a patient advocate at the Jinnah Hospital. She says the upgrades have not only improved
patient care but also morale among providers. BUTT: We did not have any mammography machine. It took like 20 years for us and now as I
speak of, we have the latest technology of mammography machines. And this is probably the largest radiology
center in Asia. DE SAM LAZARO: It is large and state of the
art but ironically, it is perhaps the least busy section of a very busy hospital, even
though the incidence of cancer is growing in Pakistan, including the highest rate of
breast cancer in Asia. (on camera): A lot of the cancer that occurs
in Pakistan goes untreated. Patients in many cases can’t afford therapy,
if it’s available. And even in places where it is available,
doctors say the vast majority of patients come in in advanced stages, when it’s too
late for any effective treatment. (voice-over): That was the case with this
seven-year-old boy, brought here by his father from Peshawar, a city some 850 miles away
near the Afghan border. His brain tumor had progressed too far to
benefit from radiotherapy. Dr. Tariq Mahmood says only five percent of
the cancers seen here are in the early treatable phases. MAHMOOD: There is lack of the availability
of the proper equipment for the early diagnosis. And at the same time, there is lack of education. DE SAM LAZARO: Public education is a big challenge,
but Dr. Mahmood says the Jinnah Hospital offers a model for delivering high quality care to
the poor. A public private partnership is inherently
fragile amid Pakistan’s volatile politics but the foundation’s Chhapra says he’s not
deterred. CHHAPRA: We are pumping in millions and millions
of dollars into a hospital which is owned by the government. Tomorrow, they may turn around and say enough
is enough. Get out. We as a group have decided, come what may,
we are here to stay. DE SAM LAZARO: And despite the challenges,
the foundation has ambitious plans to expand. A state of the art, $25 million outpatient
department is slated to open early in 2018. For the PBS NEWSHOUR, I’m Fred De Sam Lazaro
in Karachi, Pakistan. (END VIDEOTAPE) WOODRUFF: Fred’s reporting is part of the
Under-Told Stories Project at University of St. Thomas in Minnesota.

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