Daily Times

While the Pakistan broadcast media insanely screams the end of the world, metaphorically speaking, and given Corona, with some good reason too, and the recent arrest of Mir Shakilur Rehman

there’s also plenty good happening in Pakistan, especially where the dynamism of the private sector partners with the public sector.

Recently I visited the National Institute of Child Health (NICH), a government run 500 bedded Child Health Care facility in Karachi, Sind.

Walking into the huge OPD area, I expected to see an ocean of teeming humanity, distraught mothers, wailing children, but surprisingly we were met by a most unexpected and eerie silence. Empty halls, dark wards, silent chairs, gloomy corridors. No patients, doctors, para medics, nurses ward boys. Nothing! Even the day care surgery unit, brightly flashing the names of its benefactor, a leading business tycoon and his wife, was empty and deserted. Where’s everybody? The OPD closes at 1 pm and they stop giving out tokens at 11:30 to clear out patients by 1 pm, said my host. That’s government health care, he said, sadly. So where do sick kids go? ERs or private doctors, many of them the same who work here.

But follow me and let me show what we’ve done, he said as we walked into this adjacent building which was the “Emergency” facility of the NICH. Also government owned but with one difference. It was managed by the Child Life Foundation, a not for profit brainchild of Dr.Naseeruddin Mahmood, run by its indefatigable CEO, Ahson Rabbani. This was a state of the art facility, completely refurbished, professionally staffed, fully equipped, brightly lit, air conditioned, very clean and busy, very very busy. It had an air of calm professionalism only seen where professionalism is the number one value! Nurses and doctors were unfazed, polite, patient, professional and fully engaged. The queuing system displaying ticket numbers. I mischievously punched out a number and looked at my ticket number. 2116 The screen displayed, 2108. Just 8 to go. Very impressive.

It’s a shame that a party which rode on a platform to help the poor has still not been able to make use of such amazing selfless and dedicated institutions and people

Their TRIAGE system which determined the level of emergency and hence patient wait time, displayed visibly in bright colors, was as good if not better then what one finds in a first world health care facility. Everything was automated with upto date patient data. And the Pharmacy? 100% free. Fully stocked, temperature controlled, prominently sign posted with robust processes to check any wrong prescriptions. A 100% accurate prescription rate.

What was it like previously before you guys took over? Well the pharmacy hardly had any medicines and two private pharmacies outside did a roaring business as patients were forced to buy medicines from them. They closed down after we took over! About 9000 children emergency cases happen daily in Karachi. Today, thanks to this partnership, every child in Karachi is now within 30 minutes of one of 5 children emergency facilities, across Karachi.

The Sind government wants them to manage all centers across Sind. The Balochistan government requested the same and their first facility in Quetta was opened recently. So how does it work. I asked. Well the Sind Government gives us their operating budget, and any shortfall is met through our own funds which we raise from donations. For example, for this facility, we spent Rs.5 crores to completely refurbish and reequip and we spend another Rs.15 crore annually, on operational expenses, primarily medicines and staff salaries. This is our 7th year running and it’s open 24/7. But the general perception is that the Sindh government is very corrupt, so did you have to bribe or give kickbacks to get the funding?

Not a single paisa. Nor have we appointed anybody on anyone’s recommendation. In fact, when we terminated one employee, a resident of a very notorious area of Karachi rife with drugs and gangs, we received serious pressure from everybody. Government, politicians, even our own “law enforcement” agencies. But we refused and that was the last time anyone pressurised us on any issue.

Who is the driving force behind this from the Government side? My answer will surprise you, he said, knowing your political views, but Bilawal and CM Murad Ali Shah have played the key role in making sure that our work is unhindered. Both monitor our progress and ensure bureaucratic hurdles are promptly removed. For example when the CM Balochistan asked me what were our key success factors in Sindh, I responded, without hesitation. Complete support from the provincial government, zero interference and timely release of funds.

The results?

The number of patients coming to ER have more than doubled, the survival rate of critically ill children has quadrupled, and the patient satisfaction rates are higher than international standards. I couldn’t help but wonder why such things couldn’t be replicated across Pakistan

But why can’t you take over and run the main NICH Children’s hospital, we saw earlier, in the same manner?

We want to focus on the Children’s ER as this is where we can reduce 50% of under-five mortality. We hope that other nonprofits will step forward to work with the government to improve remaining areas of the hospital. However, their is also very serious resistance from the status quo and entrenched mafias. For example, PM Imran’s idea in Punjab to form independent boards for each hospital with complete financial and administrative independence is an outstanding plan, as this is the only way to reform our national health care system. But look at the push back from the doctors, including those from his own party. It’s a mafia and they won’t give up easily.

It’s a tough battle. People in Pakistan have no idea how we serve our country, putting our lives and that of our families at stake every day we come to work to fight the corrupt and deeply entrenched status quo of our society, he said, with a steely determination which only people like him can muster. And why don’t you do this for hospitals in Punjab and KP and Islamabad?

He smiled.

6 months after we approached PIMS to let us run their children facility in Islamabad, we received their response, asking us to get an “NOC” from the Ministry of Interior, if we wanted to “work” in the Federal Territory. It was my turn to smile and shake my head in disbelief! And what about Punjab and their health minister Dr. Yasmin Rashid. She’s a doctor. She would understand? Do they know what you folks have achieved? Mehdi sahib, I only wish, hope and pray, that PM Imran can spare some time, at the earliest, to come and visit us in Karachi and see for himself and with his own eyes, what we’ve achieved and how we’ve changed and impacted the lives of the children of our poorest and most deprived segments of our society.

I hope he does, I said, a trifle cynically.

As we departed, I couldn’t help but think of what he’d shared about Bilawal and CM Murad Ali Shah.

To both of you gentlemen, despite my views on dynastic politics. Thank you! PM Imran and Dr. Yasmin Rashid, hope you read this. It’s a shame that a party which rode on a platform to help the poor has still not been able to make use of such amazing selfless and dedicated institutions and people. All it takes to make a huge impact is to have competent people of integrity, effective operational processes, great technology, proper funding and leadership support.

CM Murad Ali Shah and Bilawal, in this particular case, got it right. One hopes PM Imran will also eventually get it right for the country and somehow save himself and the country from the hordes of sycophants and cronies surrounding him, several, consciously of his own choosing! There are many “Little pieces of Heaven in Pakistan”! And hopefully the Corona driven crashing oil prices, gives our government fiscal space to add more pieces of heaven.

All it takes is for open eyes to see, clean ears to hear, a humble mind to understand, competent people of integrity around you, and very importantly, to walk the talk and go beyond the rhetoric of container sermons, long-winded lectures and unscripted endless motivational talks.

The writer is a Geo political commentator / blogger on National and International affairs. Formerly a media anchor, corporate leader, management consultant