The Miracle of Shaukat Khanum

Published: July 3, 2016
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Half of the hospital’s budget is generated by provision of services, mainly by the labs. The other half is raised from donations

Half of the hospital’s budget is generated by provision of services, mainly by the labs. The other half is raised from donations

Your can tell whether a hospital is failing or succeeding by looking at the way the public transport lines up, even before you enter the premises. You can test this theory of mine by comparing any hospital in Lahore with Shaukat Khanum Cancer Hospital and Research Centre (SKCHRC). You can see scenes of chaos, disorder and aggravation in front of all hospital entrances, and that applies to ambulances as well as other traffic. Not so at the SKCHRC.

As soon as you enter the complex, you notice the large number of people and the total lack of noise. Things hum along with a cool, purposeful and quiet efficiency. The central air conditioning has a calming effect against the enervating heat of Lahore. You take a token and wait for your name to be called out by an automated queue management system. There is no jostling or anxiety at the counters.

The System

The doctor will see you at the appointed time. All appointments are through prior booking, except in the walk-in centre. All records are electronic and online, accessed from a central database. You can have the test done in Peshawar and it will end up in your record, so that the doctor can retrieve it in Lahore. You can actually access your own test on line. There is very little in the way of paper records. All the functionalities are integrated into one computer system, including the clinical notes, lab results, X-Ray images, endoscopy, pharmacy, laundry, kitchen, and inventory.

This is jaw dropping for any one visiting from the UK, as I am. There, the National Health Service had to scrap the National Programme for IT and write off a large part of the 12 BILLION pounds budget. AND the SKCHRC system was developed for a pittance by a team of young, in-house professionals and has been operational since 2005.

The Accidental CEO

How does a first world facility pop up in a third world country? Is it through accident or design? I asked Faisal Sultan, my friend from the KE days. Faisal was always very bright but I don’t think he ever took himself too seriously. He was a top class physician and a researcher and had to step in during the early years of Shaukat Khanum when there was a leadership crisis. Faisal says that there is a policy of no compromise on the quality of care and the absolute commitment to the equality of access for the non paying cancer patients.

The Key Factor

Imran is the key factor. He was and remains an icon for millions of people. His political fortunes have seen ups and down. His policies have received their fair share of criticism. He has ardent followers and fierce opponents. But his financial integrity and passion to help cancer patients, have always been beyond doubt. This means that he still remains the bedrock of fundraising campaigns. Shaukat Khanum has an annual budget of eight billion rupees, half of which is generated by the provision of services, mainly by the labs. The other half is raised from donations.

This is serious business and is performed to the highest professional standards, by a team which has grown with the hospital and gained experience over the years.  Apart from a short duration in 1997, when Imran had to sell his property to pay the salaries, there has never been a short fall.

Shaukat Khanum pays well and employs the best. This is good policy, as the money spent on quality is money well spent. They are able to employ highly qualified physicians from all over the world. Having said that, I think that the doctors who work here do not come for the pay alone, as they can make much more in western countries, where most of them have trained, or indeed in Lahore. There is a sense of achievement in succeeding against odds and making something work in an environment where nothing works. I think it is this feeling that keeps many people going.

The Realist

Aasim Yusuf, the Chief Medical Officer, is my classmate from King Edward and, like me, a gastroenterologist. He was trained in England and gave up a consultant post in the UK when he came to join the Shaukat Khanum just before it opened, in 1994. He is a pragmatist, with a lot of personal discipline and common sense and has a very clear view of the future of the organisation and its  core mission. He is responsible for all clinical activity, and for maintaining clinical excellence at both the Lahore hospital and at the new Shaukat Khanum in Peshawar, which is progressing nicely. Hopefully, he will also be setting up the Karachi Hospital in the not-too-distant future. I attended a few endoscopy lists with him. About one third of the patients were from Afghanistan. I did not see anyone who was paying. About 75 percent of the cancer patients are treated free and to exactly the same standards as the paying patients.

The Landscape

Take a trip around the hospital. Have a seat on one of the wooden benches next to the duck pond and look at the fountain playing, the serene water and the lovely red brick building in the background. Kids, both patients and visitors, love feeding the ducks. One forgets the troubles of the world for a delicious moment. Or hang around the glass-fronted inner courtyard, to watch the peacocks, I have always seen little kids watching the birds with fascination. Step into the gift shop which has a tastefully done interior and a few children and their mums watching the Disney cartoon, dubbed in Urdu. You can’t help feeling a lump in your throat.

Visit the clinical areas. There are two patients to a room, with the provision for a relative to stay. The rooms are quiet, private and dignified, all with a toilet and a shower. The ITU is probably the best in Lahore, both in terms of design and functionality.

Aasim tells me that all departments operate to the highest professional standards, and many are affiliated with international quality standards organisations. The pathology laboratories, for instance, participate in quality control programmes run by the College of American Pathologists. Even the food service is certified for Hazard Analysis Critical Control Point (HACCP) from an international food standards organisation. This is no small achievement.

All the patients are given their meals from the hospital, in individual trays, with a caloric value printout. They have a menu to choose from. The pharmacy will dispense drugs, with the instructions printed on the packs. The chemotherapy day unit is comfortable, dignified, not crowded and unhurried. The hospital as a whole has been prepared for some years to be audited by a leading international hospital quality certification organisation, whose inspectors have been unable to travel to Pakistan owing to a travel advisory issued by the US State Department.

All these things are taken for granted in the developed world but they are a tremendous leap forward for medical care in Pakistan, perhaps even a miracle.

The Surgeon

Aamir Ali, affectionately known as ‘the Pole’ from his days at King Edward, because of his great height, is the associate director of surgery. He has been at Shaukat Khanum since 1996. He is the technical maestro who has done all sorts of surgery over the years in the way of the old school general surgeons. He is currently doing mostly gastrointestinal surgery. He regularly puts in 12 hour days, six days a week and remains a happy man.

I have wondered,  like many people, whether the hospital and the larger organisation will outlast Imran Khan. With the kind of people I have seen working here and the systems in place, I am sure it will. In fact, I think the management and IT systems are scalable, meet the local needs, are to international standards, and have immense commercial as well as public welfare potential. They are beginning to be used in other public and private hospitals.

Go, see the hospital, it is world class, made in Pakistan.

The author is a gastroenterologist, currently working in the UK. For more information on Shaukat Khanum go to www.shaukatkhanum.org.pk

Published in The Express Tribune, July 3rd, 2016.

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Reader Comments (13)

  • Mohammed
    Jul 3, 2016 - 2:20AM

    Are you listening Khawaja Asif, despite your pathetic attempts to destroy this public institution, the public back it with their hard earnt cash.Recommend

  • Malik Saab
    Jul 3, 2016 - 3:34AM

    I have a great respect for this Project. But the way it has been cashed for political motives is a great disgrace. This hospital will be cashed by one political party time and again. Even recently I met person who was giving the example of this hospital as the Ethnic Superiority Marvel of the people of one region Sad indeed.Recommend

  • AH
    Jul 3, 2016 - 9:16AM

    I have a personal experience with SK. I took my mother there for treatment. I don’t know how people say its for poor people. SK is a very expensive hospital. Only very rich people can get treatment there. We did all the lab tests when cancer was diagnosed. But SK has a policy of doing all the tests from their own labs and their labs are very expensive, not just twice the price of ordinary labs, they are five to six times more expensive. A normal test that costs Rs 2500, it will cost you around Rs. 15000 at SK lab.
    Apart from that staff at their labs and hospital are arrogant and rude. I had already spent around Rs. 100,000 on tests and then they gave me an estimate of Rs. 800,000 – 1,000,000 for treatment. We came back and did all the treatment from MH and then radiations from Nori hospital, Islamabad. All the treatment was done in Rs.250,000. Nori hospital, Islamabad is very cheap, they have very good system.
    The guy at financial assistance department at SK was very rude. I didn’t ask him to waive off all the expenses. I asked him that if we can pay in installments or deferred payment or something. But he was so rude like he is talking to a beggar. So we decided to leave SK and come to MH for surgery and that was a way better option.
    And at MH and Nori, we found a lot of people who had bad experience at SK. I would advise people if they are rich and can afford an expensive treatment then go to SK otherwise don’t waste your time there.Recommend

  • Ali Quaid Johar
    Jul 3, 2016 - 3:53PM

    “Apart from a short duration in 1997, when Imran had to sell his property to pay the salaries, there has never been a short fall.” – Sold his own property for a cause. Real leader.Recommend

  • Jul 3, 2016 - 5:11PM

    Thanks AH, for sharing your experience. I hope the management will respond. Dear readers, please share your experiences (positive and negative). Author Recommend

  • Chaudhry Archad
    Jul 3, 2016 - 5:15PM

    It is a world class facility, and I have seen some of the better hospitals in the west. SK is comparable in every aspect. Imran khans financial integrity has played a huge part in keeping in afloat. I hope it outlives Imran. It’s a perfect example for all of us who have that “yaha kabhi kuch theek nahi ho sakta” attitude!Recommend

  • PakPower
    Jul 3, 2016 - 10:30PM

    @AH:
    I have visited SKMH once, and I saw more poor people there than even public hospitals. There were queues upon queues of them. While, there is no denying that you may have had this experience but to say that the hospital doesn’t treat its poor visitors is grossly unjust and hypocritical on your part.Recommend

  • Aamna
    Jul 4, 2016 - 2:42AM

    Now that it’s established that SKMH is clean and there’s no way to malign Imran Khan and defend Sharif’s corruption, let’s just resort to Qandeel Baloch’s newfound love for IK & Tyrine White.

    A Patwari’s Plan B after this article.
    Recommend

  • Dear Author
    Jul 4, 2016 - 12:13PM

    @A Saeed:
    You might not get a clear response from the comments sections coz not many poor people use Internet and read english newspapers online. It would be best if a reporter went to SK and asked the people there of how they were being treated and made a video of it and post it on youtube and share the link here.Recommend

  • Maria Butt
    Jul 4, 2016 - 5:28PM

    @AH – Everyone has its own point of view but I completely dislike your thoughts. Shaukat Khanum Hospital is one of a kind in Pakistan. It’s a place where people can go to with dignity, where they are treated with respect. The hospital itself is clean and hygienic, not like other hospitals where cleanliness is out of the equation. Cancer is an inherently expensive disease but it’s a place where poor people can get treatment without discrimination.

    You are doing Apples with Nihari comparison :) Please don’t spread the wrong words for an institution which is an honor for all of us. I feel that it is an honor for Pakistanis to have such a model institution. I visited many times and every time i saw rich and poor standing in a same queue, i admire their dedication for the goodwill of every one residing anywhere… lots of prays for all who support this cause.Recommend

  • Saad Kayani
    Jul 4, 2016 - 5:41PM

    @AH: It is really sad to read your judgemental comments about a goodwill gesture. My younger brother also been patient of shaukat khanum hospital. his treatment continued for 4 yrs at skm n we didnt have to pay single rupee. I know very well that Shaukat Khanum hospital’s system is a very sophisticated based on a proper merit. Patients are registered for financially supported treatment after a thorough evaluation of the nature and stage at which each patient has presented to the Hospital. They treat patients irrespective of their ability to pay and this is simply a miracle. This hospital is really blessing for poor patients of our country. stay blessed!Recommend

  • sara
    Jul 5, 2016 - 6:57PM

    @AH
    You aren’t the only one with the bad experience. My mother was diagnosed with liver cancer following cirrhosis of the liver. Took her to shaukat khanum in Lahore and guess what? They turned her down. It wasn’t about the money… I could pay. The so called biggest cancer hospital in the country turned a cancer case down because “there’s nothing we can do”. It wasn’t even in the advanced stages it was in the initial stages at the time. We had to fly her to Karachi and take her to good old JPMC where an oncologist advised her symptomatic treatment options at least. Recommend

  • khalid Saeed
    Jul 11, 2016 - 4:39PM

    @AH, I dont want to comment on your experience with SKCHRC, but I do like to comment on what you wrote about the laboratory test. I have been working in the accreditation of testing and medical laboratories for the past two decades. Unfortunately there are very few laboratories in the Pakistan who can deliver reliable results. Result from the laboratory is one of the powerful tools for correct diagnosis of the disease and if the results are not correct then the treatment is also flawed as it is based upon incorrect results. If SK charge you more for tests mean they are giving you results you can rely upon and thus the diagnosis. People are generally not aware of the importance of quality assurance associated with the laboratory results and therefore are not able to see the benefit of paying more money for reliable results.Recommend

  • khalid Saeed
    Jul 11, 2016 - 4:44PM

    I will advice SKCHRC to go for accreditation only if it is mandatory. Accreditation of organizations has become a big industry particularly in US, the inspectors/auditors/assessors exert a lot of unnecessary subjective influence on shaping the quality management system of an organization be it a hospital. Recommend

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