DoctHERs: Mind the Gap

One organisation bridges gap between out-of-practice female doctors and women with no access to healthcare

My story is the story of many women out there who grapple with their identities after they are married. Some of us are unable to comprehend our status not only within our families and societies, but find our self-image and individuality becomes a tad hazy after we sign on the dotted line.

The idea for doctHERs — a digital health platform that connects female doctors with patients — came shortly after I conceived my baby. During my first trimester, I was on bed-rest and I was scared — did this signal the end of my medical career? I obsessively wondered, “Will my professional life come to an end now? How is it fair that I should have to choose between my child and my work?” While the world of medicine is where my heart found its beat, its true calling, I was given the impression that if I prioritised my work, I would be neglecting my child. “Am I being an ungrateful mother?” I questioned.

doctHERs’ second clinic was set up in Karachi’s Hijrat Colony. In two months here, doctHERs remotely connected more than 400 patients with doctors. PHOTOS COURTESY DOCTHERS 

This is a conundrum that many female doctors in Pakistan face. A staggering 80% of all medical school graduates in Pakistan are women; yet, only 25% put their education to practice due to socio-cultural constraints. Additionally, 95% of women living in poverty cannot access affordable care and qualified doctors. And so, I asked myself, what if we bridge the gap between female doctors culturally constrained to work and marginalised women who lack healthcare?

I have always been drawn towards social innovation, public health and policies that can bring change at the mass level rather than at an individual level, and preventive health care that can change the health status of our society. This interest found root the minute I started practicing medicine. I was part of the tertiary care units at Civil Hospital, Liaquat National Hospital, Jamal Noor Hospital and Lyari General Hospital in Karachi for more than two years.

I have always believed that women and men should have equal access in professional opportunities and public services. After working in the public sector in Pakistan, I realised that women are heavily disadvantaged, both in their access to the workforce (and meaningful positions within the workforce) as well as their access to affordable, quality healthcare. It became a particular passion of mine to correct these two major market failures in Pakistan and I decided to leave my personal — and lucrative — medical career behind to focus on this issue at a systemic level.

An orientation session with students from Karachi’s Model Colony, where doctHERs’ first clinic was set up. PHOTOS COURTESY DOCTHERS 

The change wasn’t easy; I faced severe criticism for changing my career path from a settled clinician to a career of uncertainty. Being a wife, a mother and a social entrepreneur is not an easily accepted phenomenon in our society.

Working on my own company was extremely challenging as there are no fixed working hours, no days off, and no sick leaves as you are solely responsible for the goals that you have set for your organisation. To tackle these challenges and handle the expectations of those around you is difficult, particularly as people do not always understand what entrepreneurship entails and it is challenging to explain and convince them of your cause. However, I made it my mission to prove my critics wrong and that kept me going despite the hardships.

Here’s how it works: using mobile and Internet-enabled technologies/video conferencing, doctHERs connects female doctors with urban and/or rural patients, aided by a nurse at the patient’s end. For instance, Rania, a member of doctHERs, trained as an OB-GYN and was forced to quit her career after marriage. Via video-conference from her home, Rania is beamed into a clinic in a slum area of Karachi. She works in tandem with a trained nurse and examines her patient of the day. While the trained nurse can carry out antenatal tests (fetal heart monitoring and ultrasound), Rania is able to see all results simultaneously via her monitor. Without doctHERs, Rania would not have been able to work outside her home — let alone in a slum area — while the nurse does not have the training or skills needed to run diagnostic tests independently and the female patient would have been at the mercy of quacks or at risk of suffering medical complications.

An orientation session for residents of Hijrat Colony in Karachi, home to more than 250,000.  PHOTOS COURTESY DOCTHERS 

On May 11 this year, doctHERs launched its first clinic in a slum located next to Quaid-e-Azam International Airport in Karachi known as Model Colony. Here, a population of over two million people used to be served by three qualified doctors — and only one of these doctors was a woman. To date, more than 1,200 patients have been examined at the clinic so far, which comprises a mini-pharmacy, a family planning lab, a test collection point and tertiary care referral services, as well as basic OPD services.

Our second clinic was set up in Hijrat Colony, where a population of more than 250,000 people live. Here, women are largely deprived of affordable healthcare access. In two months, doctHERs remotely connected more than 400 patients with doctors. Seven women from the colony were examined during their pregnancies and have had safe deliveries under the supervision of doctHERs staff.

The numbers are gratifying, but it has not been easy reaching out to so many people. When we started out, we were interacting with different communities — residents of Hijrat Colony, for instance, are tribal Pashtuns — and we had to learn to engage with them and explain the concept of doctHERs to them so community leaders would get on board. I had to learn the art of storytelling in order to get our message across to thousands of people, to show them a vision they can believe in.

I have never doubted the merits of this project. I believe doctHERs is the future of digital health care delivery in Pakistan and the doctors involved in the project are a beacon of hope for thousands of women who fear they have to sacrifice years of education for socially acceptable roles. And if millions of marginalised Pakistanis can receive quality health care while young female doctors rework or tweak these socially acceptable roles, that sounds like a dream come true.

Make it work

Eyes on the prize: Be true to your vision and mission, and never deviate from your goal.

Find a mentor: Always be eager to learn from experienced people in the field. I wish we had mentors who could have guided us when we started out.

Never accept ‘no’: Don’t take ‘no’ for an answer and always think of three alternative solutions to your problem.

Find the right team: Create a great team that shares your motivation and passion. Be smart in choosing those who will work with you.

Stay focused: Be focused on your operations, never fear to prototype and beta test.

Sara Khurram is the co-founder and project director of doctHERs. You can find doctHERs on Twitter @DoctHERs

Published in The Express Tribune, Sunday Magazine, October 11^th, 2015.