Karachi’s medical wonder woman shows the way

Ever since she entered medical school, Shereen Bhutta knew how to make a difference in Karachi - she wanted to work for women by becoming an obstetrician-gynaecologist.

Now, as professor and head of the largest public-funded obstetrics and gynaecology department at the Jinnah Postgraduate Medical Centre (JPMC), she has also developed initiatives for poor rural and urban areas. “These are tremendously challenging times for Pakistan and living and working among the poorest sections of our society has been an enormous education for which I am so grateful,” she said while talking to The Lancet, a leading international medical journal.

No woman is refused admission or treatment in Shereen Bhutta’s department. “This puts tremendous strain on the faculty and departmental resources,” she said, adding, “But the very fact that we can provide quality care to these women, who do not have the option of going elsewhere, is extremely rewarding.”

This arrangement at the JPMC has made the provision of low-cost obstetric care a reality for the many millions of women in the city who live in abject poverty, according to the report published in the journal’s June 5-June 11 issue.

Bhutta attributed the improved healthcare services to the optimum use of public and philanthropic funds. She said the department has already trained hundreds of obstetricians and gynaecologists, now “serving the women of Pakistan”, including those in remote rural areas and deprived districts.

Her husband and academic collaborator, Zulfiqar Bhutta, who is head of the division of women and child health at Aga Khan University Hospital (AKUH), told The Lancet, “Shereen has always fiercely defended her stance on focusing on training and capacity development as opposed to principally focusing on public health research. Her achievement in securing philanthropic support for improving maternal services at a large public-sector hospital, which is perennially starved of resources and fundamentals like running water and electricity, is a remarkably understated example of perseverance, ingenuity, and resourcefulness.”

Shereen Bhutta has extended her vision of accessible obstetric care through setting up projects in rural areas of the province and in the most impoverished populations of Karachi. “Facilities and services in such population clusters are very limited and despite living in urban areas, women have limited mobility and access,” she said. “Presently,” she told The Lancet, “most deliveries are conducted at home by unskilled birth attendants, with a third seeking care in public-sector hospitals such as mine. A small maternity station will become functional soon, where skilled birth attendants will be available round the clock in the community.”


Another successful project that Shereen Bhutta oversees is the Pakistan Society of Obstetricians and Gynaecologists’ collaboration with the International Federation for Gynecology and Obstetrics in rural Sindh province. After four years, the implementation of the first emergency obstetric and newborn care services in the area has been challenging. “But the effort was worth it because it has contributed to reduction of maternal and perinatal mortality.”

These achievements reflect Shereen Bhutta’s positive outlook, said Seemin Jamali, the joint executive director at JPMC. “Shereen is always willing to take on extra responsibilities and is never afraid of voicing her opinion, but does so without offending others.”

Shereen demurs, “I was never a very ambitious person who planned my career in advance. With hard work and sincerity of intentions, things worked out for the best.”

Prompted and encouraged by her mother to become a doctor, she got married after graduation and did all her postgraduate training with three young children, writes The Lancet. Training in Pakistan and the UK took her away from home, sometimes for long periods. Her husband, Zulfiqar, “was always supportive and demonstrated faith in my capability and capacity in those difficult times,” she recalled. But Zulfiqar Bhutta is equally grateful. “Without her support, none of my own work on rural perinatal care would have come to fruition,” he said.

Shereen Bhutta sees the role of privileged women as being visible and vocal advocates for the less fortunate women.

“The only way women can break the shackles of poverty and social injustice is to be given an opportunity to get educated. A shift is required in societal attitudes towards women.”

Published in the Express Tribune, June 7th, 2010.
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