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Quality healthcare in urban slums of Karachi

Pakistan and Gulf Economist approached the relevant authorities of SINA Health Education & Welfare Trust to get the first-hand knowledge about the healthcare facilities being provided by the trust. Following are the excerpts of the conversation:

With majority of the people working on daily wages, the average per day income of meagre 300 rupees, the urban slum communities in Karachi are ultra-poor and suffer from a total absence of affordable and accessible quality primary healthcare, making it a constant battle between choosing bread and butter versus obtaining treatment, and keeping them into an endless disease-poverty vicious cycle. SINA is actively changing this, and with support of generous donors plans to create an impact by establishing dedicated clinics to address the most important human need of people that prevents them from disease and death. Primary healthcare is a basic human right which should not be denied if vulnerable population cannot afford to pay. Millions of people in Pakistan are denied basic healthcare because of their inability to pay. SINA’s model removes this barrier between the community and the service, where Zakat eligible patients have to pay only PKR 20 (80-90% of the patients seen), and non-Zakat patients have to pay only PKR 50 (approx. 10-15%). This covers the cost of screening, immunization, doctor consultation, any of 130+ lab tests, ultrasound, treatment from 150+ range of medicines and referral service for tertiary care. Per visit actual cost of treatment is PKR 450+ inclusive of all services. SINA has developed a unique referral system whereby every patient who requires a specialist opinion or secondary and tertiary care gets the opportunity to have access to qualified consultants in Karachi either free or at highly subsidized rates.

Currently SINA has two referral clinics. Each year our Referral Clinic refers approx. 20,000 patients to partners for specialist consultation. SINA’s greatest asset is its quality management system. This system is unique as it has adapted quality healthcare protocols used in developed healthcare systems naturalized for application in local settings. We have 80 doctors at SINA clinics (55% male and 45% female). All are trained to use this protocol system, and are continuously evaluated by a medical team of auditors right from the hiring to the practice in clinic. Their performance is evaluated every month.

SINA is a not-for-profit organization dedicated towards providing affordable access to quality primary healthcare in urban slums of Karachi since 1998. We are 450+ people working together full time focused for one cause — to provide quality primary healthcare to the less privileged. Through our 30 clinic locations operating 08 hours a day, 06 days a week, round the year, in the heart of urban slums of all districts of Karachi, we treat 3000+ patients daily and 850,000 patients every year. 80% of the patients treated at SINA are Zakat eligible, majority being women and children. The communities where we are present have around 80-90% Zakat eligible population, which means they are the poorest of the poor. Every patient entering a SINA clinic receives a qualified doctor’s consultation, screening is done by a qualified nursing staff, we have around 100 qualified doctors and 250 nursing and paramedic staff, 130+ types of lab tests (ranging from CBC to PCR which is a specialized Hep C test), 150+ range of medicines (ranging from Panadol to Insulin), ultrasounds and referral system for complicated cases to hospitals.

 

SINA was born out of the belief that quality primary healthcare should be accessible to everyone in our society. It is as much a right of the under privileged communities, as those who have the access and means available. Currently through our 30 clinics, we are able to serve 850,000+ patients in a year, but the need is much more. SINA is one of the largest network of locally funded private clinics, which covers all the districts in Karachi. We are present within the heart of urban slums, where the need exist the most. In simple words, we are at their doorsteps, where they can reach easily and do not have to spend a lot on transport to reach. The ease in locations helps them in saving their bucks which they then use it on their food and other expenses. The other most important factor is the qualified doctor and nursing services.

All the doctors at SINA are qualified degree holders, who are trained further through continuous educational programs which helps them in staying up to date with the disease dynamics as well as the global trends.

The third pillar which is the most important part is the affordability. The people, whom we serve, cannot afford to get treated by private doctor who charge a lot for just consultation, and then prescribe medicines which are way out of the budget for the people. This results in non-compliance, people don’t buy medicines, therefore they get so sick that they end up in a hospital. SINA makes sure that these worries are taken care of at the grass root level, where the disease is born, and provide affordable preventive care so that the burden at tertiary care hospitals is reduced as much as possible. The main barrier is that normally in Pakistan people don’t understand the concept and difference between primary and tertiary health care units. If a disease can be diagnosed and treated in the primary health care stage, then a lot of money can be saved which is eventually spent on treatment in hospitals. Secondly, the people’s mindset is that they believe helping in treating a cancer or other severely diseased patient will give them better satisfaction, rather giving charity to a primary health care unit. We want to change this mindset.

SINA has been providing services to the deserving patients since 1998, starting from a single clinic in Baldia Town to now a network of 30 clinics. The quality of services provided are of international level, where a protocol based system is used to diagnose a patient. This system has been brought from international healthcare systems, but localized according to Pakistan dynamics. This system makes sure that the patient is treated as accurately as possible, with the correct history present from past records, current vitals taken, along with additional diagnostic test performed at the clinic. All these services under one roof gives a complete care to a patient, who doesn’t have to go to different places for doctor, tests and medicines. To validate that the services provided to the patients are of best quality, monthly audits are conducted of the doctors and nursing staff.

SINA started 21 years ago with one clinic, but as we discovered that the need was much more, we expanded our operations, we now have 30 clinics in operation. Karachi alone is so huge, that 30 clinics are not enough. So we would like your help in spreading the service about this cause and ask for the people support in terms of donations, because the work we do will not give you back in monetary return, but the ‘ajar’ is immense.

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