REPORT

Submitted on (12-August-2014)

Submitted to

Submitted By

Sir Asif Khan

1) Tayyab Ahmed Chughtai (12081)

2) Syed Kashir Raza Zaidi (xxxx)
3) Farrukh Asad (xxxx)
4) Yumna (xxxxx)

HOW THEY STARTED

In a countr y, where gover nment spending is just PKR 560* (US$
5.6) annually on t he healt h of one person and medical charges
are several times t he average per capit a GDP, a few noble
doctor s, businessmen and philant hropist s joined hands in 2007
and laid t he foundation of countr y s fi r st multi-speciality,
paperless and st ate-of-t he-ar t 150 bedded healt hcare facility
where medical ser vices were off ered on absolutely free-of-cost
basis,wit hout discr imation and exceptions to t he ones in dire
need.

BACKGROUND
In t he 1980s a g roup of medical students at Dow Medical College
in K arachi for m ed an organization called t he Patients Welfare
Association to raise funds for t he poor patients at Civil Hospit al.
When a deva st ating ter ror ist bom b blast occur red in K arachi
a fter t he Russian invasion of K abul in 1984, Civil Hospit al was
unprepared to cope wit h t he cat a strophe. In response, a g roup of
young, idealistic Patients
Welfare Association members led by A bdul Bar i Khan, raised
money to refurbish t he emergency depar tment and build a blood
bank at Civil Hospit al. The exper ience ear ned t he g roup a

g lowing public reput ation for honesty and t he ability to achieve

results. It also sparked in t he students a lifelong commitment to
expand poor patients access to quality medical care.
Over t he next two decades, Bar i dedicated his career to building
a cardiac surger y depar tment at Civil Hospit al. Instead of
supplementing his gover nment salar y wit h a pr iva te af ter noon
practice, he raised pr ivate money to buy new technology,
subsidize salar ies, and sponsor cardiac procedures at t he public
safetynet hospit al.
A fter 20 years and 3,000 bypass surger ies, Bar i came to believe
t hat t here were two ways to improve healt h care in Pa kist an
fi ght t he gover nm ent system or create exter nal deliver y models
of highquality, effi cient care t hat would prompt people to
demand t hat t he gover nment off er t he same. Bar i had tired of
fi ghting cor r uption and ineffi ciencies in gover nment. He called
on his Patients Welfare Association

Colleagues to join him in realizing t heir yout hful dream of

r unning t heir own full ser vice, char ity care hospit al. They had
all trained and worked in t he United St ates and United Kingdom
and had retur ned to Pakist an, where t hey had est ablished
successful career s.

I was ver y clear from day one t hat t he hospit al had to be free,
Bar i said. The people we see are t he poorest of t he poor. They
dont have money for transpor t, let alone to top off t heir care. I
know t hese
patients from my work in t he public sector.
Not all t he founders initially believed t hat t he hospit al could
su st ain itself long ter m if it provided free care. Af ter witnessing
t he outpour ing of char ity following Pa kist ans deva st ating
ear t hquake in 2005,
however, Dr. Zafar Zaidi, Indus Hospit al Medical Director and an
initial skeptic, became convinced t hat Pakist a ni philant hropy
could suppor t Bar is vision. All deeply religious, t he founder s
had fait h t hat t hrough t heir hard work resources would become
available. Additionally, t hey had est a blished broad networks of
wealt hy Pa kist anis willing to donate to t heir char it able
initiatives.
The founder s also believed t hat all patients had a r ight to high
quality care, regardless of ability to pay, and t hat donor s, in
tur n, would more eagerly suppor t a char ity hospit al t hat off ered
patients t he latest technology and t he highest quality ser vice
available in Pa kist an. The chair man of t he hospit als board of
directors, who was also a major donor, wrote in a quar terly

hospit al newsletter, In my eyes, it is not enough to help provide

healt h care to t he poor. It is essential t hat t his healt h care is of
t he same quality t hat we would want for ourselves and our
family. It is indispensible to keep in mind t hat by giving to t he
poor, we mu st add to t heir dignity and not t ake it away from
t hem .

MISSION:
Wit h t he sole motivation of PLEASI NG ALL AH SwT, The Indus
Hospit al will enhance t he Islamic value of ser vice to humanity at
large.

VISION:
The Indus Hospit al focuses on providing excellence-dr iven (as
stipulated in t he Islamic concept of Ehsan), comprehensive, free
of cost, unconditional healt hcare to t he creations of Allah
SwT.The Indus Hospit al is a not-for-profi t entity and is funded
by t he Islamic concept of WAQF, Zakat, Khairat, Sadqat and
shar ing of excess wealt h wit h t he Ummah.

GOVERNANCE AND TRANSPARENCY

To ensure strong gover nance and transparency, The Indus
Hospit al was registered wit h t he Secur ities and Exchange
Commission of Pakist an under section 42 of t he Companies
Ordinance, 1984 as a not for profi t Company. Ta x credit u/s 61
of t he Incom e Tax Ordinance, 2001, is available on all donations
to The Indus Hospit al. The management of The Indus Hospit al is
super vised by a Board of Director s, compr ising
of Technocrats, Entrepreneurs and Philant hropists from
diff erent fi elds and walks of life.

PAKISTAN'S FIRST PAPERLESS HOSPITAL

The Indus Hospit al has t he distinction of being Pakist ans fi rst
paperless hospit al. F rom patient registration and appointments
to complete medical records, all infor mation is entered directly
into a highly advanced Hospit al Managem ent Infor mation System
(HMIS) t hat was developed by our core team of Healt h
Infor matics professionals, doctors and surgeons.
Apar t from patient infor mation, administrative processes are
also recorded electronically on The Indus Hospit al HMIS to
ensure t hat t he hospit al r uns on a completely paper free
environm ent. New employees who join our team are given a
t horough training on eff ective utilization of t he system in t heir
core areas of work so t hat t he hospit al continues to der ive
maximum leverage from technology.

The sof tware which has also been deployed by The Indus
Hospit al in NICVD hospit als on t he gover nm ents request , is
cr itical for our success as it ensures preser vation of impor t ant

dat a and enables us to manage systems and processes wit hin

t he hospit al effi ciently and accurately.

COLLABORATIONS, ALLIANCES AND PARTNERSHIPS

Program Funding
o World Healt h Organization
o USAID
o Inter national Developm ent & Relief Foundation
o Amer Haider Char it able F und USA
o Healt h Foundation
o Inter national Society of Nephrology / Association of
Pa kist ani Cardiologists of Nor t h Amer ica
o

Resea rch
o

The Global Alliance for Vaccines and Immunization

(GAVI)

John Hopkins Bloomberg School of Public Healt h

Ponseti Inter national Association/University Of Iowa

Har vard School of Public Healt h

University of Texas Healt h Science Sector

Massachusetts Institute of Technology

SERVICES PROVIDED
Managed by a passionate team of local and expatr iate healt h
professionals who are all top not ch in t heir respective fi elds, our
facilities at The Indus Hospit al include clinical ser vices in t he
following areas:
o Community Healt h Center

o Endoscopy

o Consulting Clinics

o Lit hotr ipsy

o In-patient Ser vices

o Hemodialysis

o Day Care Ser vices

o R a diology

o Emergency Ser vices

o Clinical Laborator ies

o Cr itical Care

o Phar macy Ser vices

o Invasive Cardiology

o Nutr ition and Food

o Physiot herapy Ser vices

o DO T S and DO T S Plus
Prog rams (Directly
Obser ved Thera py) for TB

Ser vices
o Continuing Medical
Education (CME)

and DR TB

General fi lter clinics are conducted daily at The Indus Hospit al

Out-patient F ilter Clinic, where walk-in patients are assessed
free of charge. The patient is t hen refer red according to his/her
need to t he concer ned specialist clinic. Patients requir ing urgent
medical treatment are directly transfer red to t he Emergency
Unit, where investigations and management are initiated
immediately.
This is only the beginning ...
The Indus Hospit al has so far completed its fi r st phase of
development and has 4 more st ages planned ahead. Our longter m vision extends far beyond t he fram ework of treatment and
inter vention to prevention, education and socio-economic
development for a healt hy and sust ainable Pakist an. Seeing t he
condition of t he countr ys healt h care infrastr ucture and t he
ever-g rowing number of patients, The Indus Hospit al
managem ent decided t hat t he cur rent 150 bedded facility needed
to be expanded wit h t he aim t hat no patient is retur ned wit hout
being provided quality treatment. The expansion plan involves:

CURRENT

POST EXPENSION

150 Bedded Hospital

1500+ Bedded Hospot al

9 Bedded Emergency Room

104 Bedded Emergency Room

1000 Out-Patients per day

5500 Patients out per day

30 In-Patients per day

371 Patients in per day

Phases of Expansion
Phase 1
150

600 Beds
Phase 2

600

1000 Beds
Phase 3

1000

1500+ Beds

POST GRADUATE MEDICAL EDUCATION

The Indus Hospit al off ers a st r uctured training prog ram for
post-g raduate medical education t hat is recognised by t he
College of Physicians & Surgeons, Pakist an (CPSP).

Ten training prog rams in Eight specialties are cur rently in place
at The Indus hospit al for post g raduate medical education.

o 01A

Anest hesiology (Four Years Residency Prog ramme For

FCPS)
o

01E

Anest hesiology (Two and a Half Years Residency

Prog ramme For MC PS)

o

02B

General Surger y (Two Years Residency Prog ramme

For IM)
o

02C

General Surger y (Three Years Residency

Prog ramme For FCPS)

o

03C

Or t hopedics (Four Years Residency Prog ramme For

FCPS)
o

04C

Urology (Four Years Residency Prog ramme For

FCPS)
o

05C

Nephrology (Four Years Residency Prog ramme For

FCPS)
o

06D

Infectious Diseases (Two Years Fellowship

Prog ramme For FCPS)

o

07C

Cardiology (Three Years Residency Prog ramme For

FCPS)
o

08E

Family Medicine (Two Years Residency Prog ramme

For MCPS)
Much emphasis has been laid by our faculty to carefully design
t hese training prog rams as per CPSP requirements wit h regular
monitor ing of t he resident s academic activities by our PGME

offi ce.
A system of bilateral assessm ent of super visors and trainees has
also been developed to improve and assess t he prog ram on
frequent inter vals. The implement ation of t he prog ram has had a
ver y positive impact on patient care at The Indus Hospit al
across va r ious disciplines.

RESEARCH AND SERVICE DELIVERY

Indus Hospit al has entered into a strategic par tner ship wit h
Interactive Research and Developm ent (IRD) to est ablish and
operate t he joint Indus Hospit al Research Center (IHRC).
Indus Hospit al and IRD share common interest s in providing
free, high quality preventive and curative care to vulnerable
communities. IHRC has developed Indus Hospit als community
outreach prog ram, and secured research and ser vice deliver y
g rants in excess of USD 12 million.
IHRC continues to shape t he broader strategic vision of Indus
Hospit al, most recently by est ablishing a joint research prog ram
wit h t he Univer sity of Texa s Healt h Science Center at Hou ston.

CLINICAL RESEARCH UNIT

Th e Clin ica l Res ea rch Un it (CRU ) wa s e st a bli sh ed a t Th e In du s
Ho spit a l in 201 1, w it h seed fun din g fro m Get z Ph a r ma ceu t ica ls. Th e
a im of t h e CRU is to deve lo p an d co n t in u o u sly i mprove u pon
so lu t io n s fo r t h e clin ica l an d p ro g ra mma t ic man a gemen t o f h igh bu rden a n d n eg lec ted disea ses fa ced by Pa kist a n is. Th e Un ive rsit y o f
Tex a s Hea lt h S cien ce Cen ter at Ho u sto n is a key pa r t n er providin g
tech n ica l a ssist a n ce a n d t ra in in g to st ren gt h en lo ca l ca pa cit y.

PROGRAMMES AT INDUS HOSPITAL

The Indus Hospital Tub erculosis Control Program

Pa kist an

is

susceptible

one
and

of

t he

top

ten

dr ug-resist ant

high

burden

tuberculosis

countr ies

(TB).

The

for

Indus

Hospit al TB Control Prog ram uses innovative community-based

models of care susceptible and dr ug-resist ant (DR-TB) in Sindh
and

Balochist an

provinces.

Since

its

inception

in

2007,The

Indus Hospit als prog ram is now recognized as a regional and

g lobal resource for TB control, and team members contr ibute
directly to g lobal eff or ts for scaling-control of DR-TB.
1) Community-Based TB and Dr ug Resistant TB (DR-TB)
Prog ram
The Indus Hospit al st a r ted a free, comprehensive
community-based DO T S (susceptible TB) and dr ugresist ant (DR-TB) prog ram meeting WHO recommended
guidelines in Nov 2007. Our cur rent treatment sites include
K arachi, Hyderabad, Kotr i (Institute of Chest Diseases )
and Quett a (Fatima Jinnah Chest and General Hospit al).
The Ghor i Infectious Diseases Clinic located at The Indus
Hospit al is an open-air facility for pur pose-designed for
airbor ne infection control. Wit h over 300 prog ram and
clinical st aff , The Indus Hospit als TB Control Prog ram
became t he second highest TB notifi cation center in t he
count r y dur ing 2011.
Our clinical, laborator y and social suppor t teams are
devoted to relieving t he burden of TB and insur ing t he
highest quality of patient care. Treatment Coordinator s in
Sindh and Balochist an collectively super vise nearly 200
Treatment Suppor ter s. Treatments Suppor ter s are
individuals selected from t heir communities to ensure
patient compliance, and are provided transpor t and living

stipends as incentives for good per for mance. All prog ram
st aff is trained and operates in accordance wit h
inter national and national guidelines for TB control.
The Indus Hospit als DR-TB Prog ram is unique as it
provides patients wit h free diagnosis, consult ation,
medication, and addresses as many of t heir social needs as
is possible. Our social suppor t prog ram includes
professional patient counseling, household food and
nutr itional suppor t, mont hly travel allowance to treatment
centers, screening of household cont acts for TB, daily home
visits by treatment suppor ters to monitor dr ug compliance
and to provide ongoing psychological and social suppor t
dur ing t he 2-year long treatment t hat averages between
USD 9,000 -11,000 per patient.
2) Pediatr ic TB Prog ram
The Indus Hospit al pediatr ic TB prog ram st ar ted in
Novem ber 2007. The fi rst set of patients enrolled were
household pediatr ic cont acts of index patients receiving
treatment t hrough t he MDR-TB and DO T S prog ram. The
prog ram has g radually expanded over t he last four years
and has becom e a key refer ral center for pediatr ic TB
suspects in Sindh and Balochist an.
3) Operational Research In T uberculosis
Wit h suppor t from t he Stop TB Par tnership TB REACH
initiative, The Indus Hospit al aims to increase case
detection and case holding of TB patients by providing
conditional cash transfer to Community Healt h Workers
screening patients at GP clinics, hospit als out-patient
depar tments, and phar macies, and by engaging pr iva te
laborator ies in rapid diagnostic of TB.

Global Surger y Prog ram

Th e re is an in crea sin g n eed to view su rgica l ca re a s an in te g ra l pa r t
o f t h e pu blic hea lt h do ma in in co u nt r ies wh e re reso u rc es a re
limi ted. Th e In du s Ho spit a l ha s t a ken a lea d in t h is evo lvin g fi eld
a n d h a s in it ia te d seve ra l m ea su re s to un der st a n d an d a ddres s lo ca l
n eeds.

1) Pehla Qadam
Peh la Qa da m is a clu bfo ot t rea t men t p ro g ra m . Th is p ro ject is
co o rdin a te d by t h e n ewl y est a blish ed Clin ica l Resea rch Un it
(C RU ) a t Th e In du s Ho spit a l K a ra ch i, in co lla bo ra t io n w it h t h e
Depa r t men t o f Or t h o pedics.

Th e p ro g ra m a ims to in crea se awa ren es s a n d re co gn it io n o f

clu bfo ot in t h e ca t ch men t po pu la t ion ; a n d to en co u ra ge t h e u se
o f t h e Po n set i met h o d to t rea t clu bfo ot du r in g in fa n cy. Th e
p ro g ra m tea m is wo rkin g
clo sely w it h Po n set i In ter n a t ion a l A sso cia t io n (PIA ), ba sed at
t h e Un i versit y o f I owa .

2) Surgical care Deliver y Models

Th e In du s Ho spi t a l is n ot o nly co mmit ted to p rovidin g h ea lt h
ca re to peo ple t h a t co m e to t h e fa cilit y, bu t is a lso ma kin g
eff o r t s to improve a ccess to h ea lt h ca re, especia ll y su rgica l
ca re, in vu ln era ble po pu la t ion s. Un der st a n din g t h e ba r r iers
t h a t limit a ccess to ca re an d a da pt in g lo ca lly rel eva n t mo dels to
a dd ress t h ese ba r r ie rs is a key co n cer n a t Th e In du s Ho spit a l.

Training Programme
Hospit al leaders met wit h all st aff to reinforce t he hospit als
mission and values. A donor descr ibed why he felt t his was
impor t ant: The philosophy should not remain in t he board
room . It must tr ickle down
to t he all levels. Now, t he leaders br ing in batches of employees
and repeat t heir philosophy to all t he employees. This is not
nor mal in Pa kist anto educate t he employees.
Additionally, t he hospit al developed st aff training prog rams
based on inter nally created st andard operating procedures. To
ensure reliability and cor rectness of care delivered, t he hospit al

was working toward developing ways to assess care quality and

hold clinicians account able. Several depar tments had developed
care protocols. For example, t he em ergency depar tment adopted
a st andard procedure for responding to chest pain cases, and
surgeons completed quality checklists dur ing each operation.
These protocols were a st a r ting point for quality and cost
controls, a manager said, but t he hospit al still had much work
to do around developing a quality improvement process .Af ter
repor ts of poor nursing quality, including neg ligence and
incor rect dr ug administration, leaders decided t hat new nursing
g raduates needed fur t her training and t hat Indus had too few
nurses working per shift , even t hough t he ratios were in line
wit h t hose of ot her K arachi hospit als. In 2010 Indus lowered t he
hospit als nurse topatient ratios to match inter national quality
st andards. The hospit al also developed st r ict nursing guidelines
and st a r ted an inter nal training prog ram. Indus trained its best
nurses to becom e managers and instr uctors who t hen trained
and monitored t he rest of t he nursing st aff . New nursing
applicants had to pass two ssessments before being hired on a
conditional basis. Nurses who made it t hrough t he initial
probation per iod received ongoing training and specialization
based on inter nally designed teaching modules.
In 2009 Indus received approval from t he College of Physicians
and Surgeons of Pa kist an to train medical residents. The
depar tments of urology, or t hopedics, general surger y,
anest hesia, and infectious
diseases each took on two residents in 2010. The fi scal year
20112012 budget called for creating a family medicine

residency prog ram. Leaders hoped it would improve t he quality

of outpatient care and develop a cadre of future pr imar y care
doctor s. The hospit al planned to eventually build a medical
school on its campus. Indu s senior leaders wanted to identify
r ising st ars and cultivate in t hese individuals t he hospit al
philosophy, Bar i said. Su st ainability is how you transfer your
mission to future leaders, he said. Our responsibility at Indus
is to make a good system and develop future leaders to r un.

HOW YOU CAN HELP

1) Zakat
Around 70% of t he patients at The Indus Hospit al are treated
t hrough t he Za kat we receive from our donors. An organized and
adequately equipped system of patients welfare assessm ent is in
place in t he hospit al where each patient is properly assessed
wit h respect to Zakat eligibility.
Our requirement for t he fi nancial year 2012-13 for treating
Zakat eligible patients is Rs. 602 million.
2) Donation
Don a t ion s recei ve d to da te h ave en a bled u s to ser ve t h e po o r a n d
n eedy by n ot on ly providin g t h em w it h qu a lit y h ea lt h ca re fre e-o f-co st
bu t a lso design n ew p ro ject s a n d develo p n ew fa cilit ie s w h ich w ill
co nt in u e to ser ve t h em in t h e fu t u re.
Yo u r do na t ion s an d mon et a r y co nt r ibu t io n w ill go a lo n g way towa rd s

ma kin g a mea n in g fu l diff e ren ce in t h e li ves of n eedy peo ple in n eed of

me dica l in te r ven t ion .

3) Sponsor a Equipment
S in ce day on e, Th e In du s Ho spi t a l h a s inve sted in t h e la test st a te-o ft h e-a r t tech n o lo g y a n d ha s co n t in u o u sly st r i ve d to ma in t a in t h a t
n ich e w it h t h e so le o bject ive o f providin g qu a lit y ca re to o u r pa t ien t s.
Th e In du s Ho spi t a l rema in s to t h is day, t h e o n ly pa pe rless ho spit a l in
Pa ki st a n . Th e In du s Ho spit a l is con t in uo u sly ex pa n din g an d so is t h e
n eed to a cqu ire n ew equ ipmen t s. Du r in g t h e cu r ren t yea r, t h e
Ho spit a l will be a cqu ir in g mo re medi ca l equ ipmen t an d n eeds t h e
su ppo r t o f it s don o rs.

3) Sponsor a patient
Th e In du s Ho spi t a l w ill be co n t in u o u sly ex pa n din g it s fa cilit ies
du r in g t h e n ex t fi ve yea rs in lin e w it h it s ma ster pla n . At t h e
mo men t , t h e ho spit a l is a 150 bed ded fa cilit y an d t h e pla n is to t a ke
it to 1,000+ bedded level by 2017, In sha A lla h .
Th e h o spit a l t h erefo re requ ires do no r s w ho a re w illin g to be pa r t o f
t h is ex pa n sion a n d ma ke a co n t r ibu t ion wh ich w ill ben efi t t h em n ot
o nly du r in g t h is life time bu t in t h e h erea f te r a s well.

EXPENSES
60% medicines and ser vices
30% staff salaries
10% overheads
All of t he expenses are made from t he Za kat, Donations,and
Char ity from t he people.