Viral hepatitis is the main cause of liver infection worldwide. In Pakistan outbreaks are frequent, and 7.4 percent of the population is infected with Hepatitis A and E. Many live in rural regions where there is no clean water and sanitation. In 2014, the Umrana Mumtaz Healthcare Trust decided it was time to tackle the issue, and this is a good news for the most disadvantaged!
A woman’s dream
One night in 2003, Mrs Umrana Mumtaz had a dream. She was dying from cancer, and yet, she dreamed of opening a small healthcare facility in rural Pakistan. She told her dream to her husband Ali. And since they had some money left despite her medical treatment, he swore to have her dream come true.
At the time, Mumtaz was working for the Ministry of Commerce and he had no experience in healthcare. But he is a man of action and he had been doing some social work for a long time. He decided to build a two-story hospital in the rural outskirts of Mardan in Northwest Pakistan. In the region, there were only two public hospitals, and they were located in the urban district. Most patients had to walk several hours to get treatment, whose quality was very poor. As a result, the local maternal mortality rate was high.
Telemedicine
Soon the UM Healthcare Hospital would welcome a hundred patients a day. For the doctors, it was overwhelming, as they had to treat an incredible variety of diseases. However well qualified they were, they did not have the required knowledge to treat them all.
Mumtaz thought ICTs could solve this issue. So he turned to his son Atif, who at the time had already started a few high-tech companies. With Stanford University, Atif developed Jaroka Tele-healthcare, the first telemedicine solution in Pakistan. Whenever the doctors faced a complex case, they could seek for advice from qualified specialists all around the world. They would email them the patient’s electronic medical record as well as the relevant photos and videos. This would allow the specialist to assess the situation and advise on the best procedures. For the patients, it meant they would get the best possible care, and the cost was minimal.
Sociocultural barriers
Jaroka also allowed the doctors to circumvent the local conservative culture. In the region of Madran it is considered shameful for a woman to see a male doctor. Well aware of the situation, Ali Mumtaz had hired a female physician, but she had to step down, leaving the job to the two male medical practitioners. So women became reluctant to come; they would also refuse to undress. Of course, this made examinations quite difficult.
This conservative culture is widespread in Pakistan. This is why in 1994 Prime Minister Benazir Bhutto launched the Lady Health Workers (LHWs) program. The goal was to ensure women have access to primary healthcare services. Today there are 110,000 LHWs across Pakistan, and over 70 percent of Pakistani rely on them for their medical needs.
Ali Mumtaz decided to use the Jaroka platform to connect the local LHWs with the doctors at the UM Healthcare Hospital. They distributed mobile phones to those operating in the region of Madran. When they had a doubt or did not know how to treat a patient, they would easily contact the doctors, so they could give them advice. Today 53 percent of the UM Healthcare Hospital’s patients are treated by Lady Health Workers using Jaroka.
The dream has gone beyond expectations
In only one decade, the dream of Mrs Umrana Mumtaz has come true, probably beyond her own expectations. Overall the UM Healthcare Hospital has provided medical treatment to over 200,000 patients, 90 percent of whom live beyond the poverty line. More recently, it has been tackling another critical public health issue: the prevalence of viral hepatitis in the region of Madran. For instance, at the UM Healthcare Hospital more than 20 percent of the patients suffer from Hepatitis A or E.
To try to eradicate the virus, Mumtaz and his team have been leveraging on the Jaroka setup. The Lady Health Workers raise awareness in the villages; they are also responsible for recording all the hepatitis cases they encounter. The data are then agglomerated in real time, allowing the UM Healthcare doctors to identify and prevent imminent outbreaks.
And since early detection is the key to complete recovery, it means that they are saving a lot of lives!
