Dr Sara Khurram – Ensuring health for the ‘hers’
A graduate of Dow Medical College and a proud mother of three-year-old Anayah, Dr Sara Khurram possesses an experience of three years in Gynecology, Medicine, Psychiatry and Radiology. She worked in a Micro Health Insurance Organization for more than 2 years before founding doctHERs™. Dr Sara is one of the three co-founders of doctHERs™ along with Dr Asher Hassan & Dr Iffat Zafar. She is is currently working as the COO of doctHERs™ as well as pursuing her Masters in Health Policy and Management from Agha Khan University, Karachi. Pakistan is actually desperately in need of female doctors like Sara, who choose to put their skills and knowledge to good use instead of just using the name of their degree as a medal to get ‘good rishtas’.
Lost in an abyss, Dr Sara was faced with the option of choosing between her career and her baby. It was not until she decided to stand against all socio-cultural constraints (expectations from a family, expectations that come along with being a mother and the balancing act between the two most important aspects of her life) that she was able to pave the way forward to being a working mother. She considers herself fortunate to be part of the 1 in 5 women who are still married to their profession even after becoming a wife and a mother. The feeling of despair during the earlier months made her feel the pain of peers who had to face similar issues.
‘It was on one of those rare occasions of standing at a crossroad of rebellion and despair that doctHERsTM came about.’
The idea made Dr Sara feel empowered and she realized that there was a massive market opportunity for female doctors to be re-integrated into the workforce in a way which would address the healthcare needs of millions.
doctHERs™ is a novel healthcare marketplace that connects thousands of qualified female doctHERs to millions of under served patients in real-time while leveraging technology. Circumventing gender and socio-cultural barriers that restrict women, doctHERs™ addresses two market failures: access to quality healthcare and employment for women.
‘Today, it is not only my passion but the very core of my existence that my work is helping fill in a healthcare gap in Pakistan that had left so many at the doors of misery. I have no doubt that taking the bold step of leaving my personal (lucrative) medical career behind to focus on this issue at a systemic level has been one of the best decisions of my life.’
According to the Pakistan Medical and Dental Association (PMDC), out of 150,645 licensed doctors in Pakistan till 25th October 2015, 69670 are women. Yet only 9000 are registered as specialist physicians (~13% of eligible female doctors). Simultaneously, the Human Development Index (HDI) states that 60.3% of Pakistan’s population lives on less than $2 a day and some 22.6% live under $1 a day.
‘Stuck in this ever growing crisis of poverty and gender inequality, millions of marginalized women face unnecessary high maternal-child mortality/morbidity and that too, sadly, in the presence of promising doctors.’
doctHERs™ is a socio- cultural initiative that connects female doctors to millions of underserved patients in real-time while leveraging online technology. This enables doctHERs™ to circumvent socio-cultural barriers that restrict women to their homes, while correcting two market failures: access to quality healthcare and inclusion in the professional workforce for unemployed, qualified health professionals. It also aids to access urban/rural patients through mobile and internet enabled technologies/video-conferencing. Home-based female doctors can remotely access patients via the cloud-based technology.
This e-health system constitutes a high-definition (HD) video-conferencing, online patient forms, online pharmacy inventories, online medical reports and referral systems and application of peripheral diagnostic tools such as Blood pressure sensors, e-oximeter, e-thermometer, e-ophthalmoscope and etc. Nurses, Community Health Workers (CHWs) and Community Midwives (CMWs) are trained to assist these home based doctors in the physical assessment of patients at the point-of-care using remote, diagnostic, cloud-based tools attached to a telemedicine (TM) system.
The success of doctHERsTM revolves around creating brick and mortar clinics in rural communities via community co-ownership. By engaging community elders, male and female residents through door-to-door mobilization, students in schools and colleges through workshops and by conducting quarterly analysis of the community’s needs and level of satisfaction, doctHERsTM is able to provide a one stop shop. The clinics not only provide online consultations with general physicians and specialists, but also house a pharmacy and a dispensary setup along with provision of a referral system with an ultrasound specialist, a physiotherapist, a tertiary care hospital and a phlebotomist. Moreover, health camps are conducted every month to create awareness to enable patients to prioritize and actively seek affordable, quality medical care.
Starting from a prototype on 100 patients in 2014, in just about a year, doctHERsTM now has 7 functional clinics under its brand.
‘We have been recognized by many national and international organizations in Pakistan and throughout the world for our innovation, dedication and hard work. Proud and humbled, we believe we have a responsibility to serve our nation and fulfill our promise.’
In a man’s world, Dr Sara’s team comprises 80% of females and that in itself has its fair share of challenges. A women-centric organization where every leading person is a woman – managers, clinic coordinators, doctors, nurses; the cultural ideologies and the limited understanding of technology, at times, creates problems in interacting with men in the target communities. It is difficult to reach out and interact with them; they don’t like women talking to them, raising their voices and explaining or answering their questions. The team’s struggles are not limited to making their voices heard to community leaders. In Pakistan, people are not fond of innovating, changing or collaborating with others.
‘When talking to many other stake holders, convincing them that females can take up the responsibility of bringing about a revolutionary change, treating patients or taking healthcare into underserved communities of Pakistan through video consultation, is a challenge.’
Another hurdle that Dr Sara and her team have to face is the difficulty that no doubt comes in making patients understand the concept of telemedicine and making them accept that their healthcare needs can also be a priority; showing that it is not a drama on a TV screen, rather a genuine, licensed, female physician has been made available for their well-being when they themselves do not believe that healthcare is their right.
‘Social risks are always a part of the overall dynamics; preaching to urban slum communities and bringing about a behavior change amongst people who have lived in the same manner for centuries, is no easy feat.’
Dr Sara believes herself to be an independent woman in a society where one has to prove oneself to be who one wishes to be. She is free to take her own decisions, travel alone, meet anyone she wants to and wear anything that she wants, but only up to a grey line defined by her cultural norms.
We live in a patriarchal society where majority of the decisions are taken by the heads of the family. Dr Sara grew up in the same culture but what differentiates her from the women of the older generation in her family, is that she is equipped with education and exposure to take her own decisions in life and be accountable for them. Yet, she does not think that she is completely independent. There are decisions in her life that are still influenced by others, choices where she has to put herself in the background and occasions when she has to compromise due to the demands and expectations of her loved ones. There are certain times when her personal beliefs are challenged and she has to bring about a change within her own personality.
‘Yet, I feel blessed that I am one of the lucky few who have a choice in their lives, as majority still don’t. My parents, my husband and my 3-year-old are my biggest support system. Being a mother of a 3-year-old and running a business in Pakistan is not easy and it is only my family’s support that makes me juggle it all.’
In contemporary times, Pakistan is a country full of surprises. A nation where people refuse to let anything bring them down, Pakistan breeds individuals whose only purpose in life is to transform the dynamics of Pakistan, making it a safe haven and a hub of innovation and change. doctHERsTM is just one example to showcase the strength and power that common Pakistani individuals can hold.
doctHERsTM has not only challenged the very core of the society by allowing women an equal standing, rather it has done so while keeping in mind the cultural barriers. Not all women have the power to stand up immediately but once provided with a solution to live a dream, nothing can stop THE change. doctHERs has provided female doctors with a platform where they are welcome to relive the moments of complete ecstasy by fulfilling their promise of putting their patient’s life before all. It has also allowed community women to take matters of healthcare into their own hands by not having to face resistance in visiting a healthcare facility. In short, doctHERs exists to shatter the stereotypes that are meant to be challenged and broken. Fear is our only enemy that can hinder our growth. Once defeated, there is nothing that can stop companies and the nation from achieving brilliance.
‘We are trying to show that Pakistan has what it takes to move in a forward direction now and not a backward direction. We plan on making history!’