Indus Health Network
Introduction
The Indus Hospital (TIH), founded in 2007, is a non-profit organization with multidisciplinary hospitals and the largest healthcare system in Pakistan. Indus aims to provide indiscriminate quality healthcare to all its patients, absolutely free of cost. Starting with only 150 beds in Korangi, one of the most densely populated areas in Karachi, the hospital has now evolved into Indus Health Network (IHN), with 12 hospitals in Sindh and Punjab; 4 Physical Rehabilitation Centers; 4 Regional Blood Centers; one of the largest Pediatric Oncology Unit; Primary Care Centers; and a large number of public health initiatives in 52 districts across Pakistan. Indus is still expanding in remote areas of Pakistan to expand its spread further and reach more people.
Origin
The founder of The Indus Hospital, Dr. Abdul Bari Khan along with the co-founders served in the public sector hospitals for many years. While serving government-run hospitals, he witnessed the need for a proper healthcare system for the poverty-stricken patients of Karachi. The idea of a ‘free public hospital’ was conceived after the 1987 Bohri Bazar bomb blast site which flooded the emergency ward of Civil Hospital Karachi, and exhausted their capacity. Dr. Bari’s dream came true exactly 20 years later when the Indus Hospital was established in 2007.
Board Members and Directorates
- Dr. Abdul Bari Khan – Chief Executive Officer
- Yunus H. Bengali – Chairman, Board of Directors
- Anwaar Ahmad Khan – Member of the Board
- Hafiz Muhammad Aamir – Member of the Board
- Khaleequr Rehman – Member of the Board
- Mian Muhammad Ahsan – Member of the Board
- Muhammad Yahya Chawla – Member of the Board
- Nasim Hyder – Member of the Board
- Salim Razzak Tabani – Member of the Board
- Sardar Yasin Malik – Member of the Board
Indus Health Network
The Indus Hospital has long played an important role in Pakistan’s healthcare environment. In order to serve on a national level, the hospital has expanded its mandate and is now a well-spread network. Indus Health Network (IHN) also focuses on education and research, along with improving its healthcare facilities.
Healthcare
Healthcare has been the prime focus of IHN. Since August 2007, the Indus Hospital has been providing ‘quality care free-of-cost.’ The hospital started transitioning into a network in 2014 with more campuses coming onboard. The Korangi campus was extended to AL-Fakir Trust Campus and Sheikh Saeed Memorial Campus.
Maternal and Neonatal Health
Maternal and child care is one of the most important and neglected areas of public healthcare in Pakistan. IHN has a dedicated campus for women and neonatal health. Along with a dedicated hospital, Maternal, Neonatal, Child Health (MNCH) is also part of the primary care model and is being run through the Global Health Directorate (GHD).
Sheikh Saeed Memorial Campus, Korangi
Sheikh Saeed Memorial Campus started its services in August 2015 with 45 beds and 4 nursery beds. It is one of the few hospitals in Pakistan where every newborn is screened by an audiologist for deafness. During 2019, 1,380 gynecological, and 1,990 obstetric surgeries were performed; 1,808 babies were circumcised; and the campus admitted 12,607 patients.
Maternal, Neonatal, Child Health Program of Primary Care Program
Maternal, Neonatal, Child Health (MNCH) program has been the integral part of the PCP. As of June ’20, the program has immunized 82,461 children; dewormed 5,418 children; provided family planning services to 8,579 women, managed lactation services to 8,106 women, screened 27,440 patients for nutrition, IMNCI to 38,031 children and has also launched its first midwife-run labor room.
Scale-up of Zindagi Mehfooz Program in Sindh
ZM is a national and provincial level Digital Immunization Registry Program used to record and analyze program data to identify gaps in the vaccine coverage through web-based monitoring framework. Up till June ’20, TIH has enrolled and immunized 1.6 million children and 0.6 million pregnant women; and trained 2,423 vaccinators on Zindagi Mehfooz App.
Public Health Initiatives
The aim of the Public Health Initiatives is to prevent disease at an early stage and provide relevant help for early diagnoses through education, research, and community engagement.
Community Engagement Center
Community Engagement Center aims to empower communities and connect their needs with programmatic outcomes by utilizing participatory approaches. CEC includes Youth Engagement, Community Empowerment, Awareness Raising and Psychosocial Support. As of June ’20, CEC has engaged 387,828 people through its initiatives.
Pursukoon Zindagi
Pursukoon Zindagi program aims at increasing access to mental health services in low income setting by utilizing innovative community-based approaches. Through this program, by June ’20, 28,216 individuals were screened, from which 998 were found to be symptomatic of depression and anxiety. 798 of these were enrolled in counseling by professional counselors.
Pehla Qadam Program
Pehla Qadam Program, in collaboration between Amer Haider Charitable Foundation, aims to eliminate clubfoot in Pakistan by providing free-of-cost treatment, along with capacity building at a national level. More than 1,000 patients have been enrolled in the program as of June ’20.
HCV Program
The HCV treatment clinic was established at Indus Hospital, Korangi Campus in 2016 as a solution to provide easy access of treatment in HCV high burden communities. During January to June 2019, up to 25,500 patients above 13 years were actively screened using WHO-approved rapid diagnostic test. The intervention helped in identifying an additional 1,300 confirmed cases.
HIV
Pakistan is facing an epidemic of HIV. IHN started a sole clinic for key affected population in October 2018. Up till June ’20, antiretroviral therapy clinic enrolled 366 patients out of which 305 were treated. 297 male, 28 female, 41 transgender, 195 injection drug users, 50 men who have sex with men, and 80 patients were from the general population.
Primary Care Program
In 2018-19, the Primary Care Program managed 25 Primary Care Facilities across Pakistan. These facilities include 11 hospital-based facilities such as the flagship Family Medicine Clinic at Indus Hospital, Karachi, and others in Badin, Muzaffargarh, Multan, and Lahore. It has also launched and operates 12 standalone clinics in the districts of Tharparkar, Jamshoro, Muzaffargarh, Kashmir, Rahimyar Khan, and Karachi. Jahangir Siddiqui Hospital, Sehwan has treated over 10,000 patients since December 2018. Khorwah Chowk container clinic has treated over 7,000 patients since March 2019. Islamkot Hospital, Tharparkar has treated over 800 patients since May 2019. A&M Memorial Hospital, Kashmir was handed over to PCP in July 2019.
TB Program
IHN has been a major stakeholder in carrying out ‘Zero TB’ initiatives in Pakistan in partnership with public and private sector partners. The teams screened 880,110 adults and 268,303 children for TB during the 2018-19 fiscal year and started treatment of 4,792 adults and 3,120 children on for drug sensitive TB across Karachi, Hyderabad, Sukkur, Rahimyar Khan, Quetta, and Peshawar. The team enrolled 1,182 patients on treatment for drug resistant TB at 11 sites in Sindh and Baluchistan. 5,639 patients were offered preventive therapy. As of June ’20, 55 X-ray vans have now been mobilized across the country to broaden the coverage and reach.
Education
Indus University of Health Sciences
University of Health Sciences was chartered in 2015 under which 11 activities are undertaken. Some of the activities are:
- Development of the Center for Health Professional Education
- Improvement and Regulation of Postgraduate Residency Programs
- Establishment of College of Physical Rehabilitation
- Capacity building of academic staff and program directors of residency
- programs and nursing faculty
- Development of e-Learning management system
- Development of certification courses for capacity building of medical and paramedical staff
Postgraduate Medical Education
The Postgraduate Medical Education program is running 17 specialty programs recognized by the College of Physicians and Surgeons Pakistan. As of June ’20, there were 182 residents registered under various stages of training.
Indus College of Nursing and Midwifery
The Indus College of Nursing and Midwifery (ICoNM) is the oldest educational institute of the IHN. As of June ’20, the strength of students had become 644, with 27 faculty members who are teaching various streams of courses.
Indus College of Allied Health
The College is recognized by the Sindh Medical Faculty and Sindh Technical Education Board. As of June ’20, 66 students were enrolled. It offers a two-year Diploma and a one-year certification Program.
Infection Control Program
One-year online certification course in Infection Control is being conducted for students across Pakistan. In 2019, 70 students completed their certification.
Research
Cochlear Implant and Rehabilitation Program
Focus of program team is to provide patient-centered outcomes and follow ups. All patients are given free-of-cost speech language therapy, mapping sessions, audiology services, and psychological support, following the international standard of care. Since 2014, 73 cochlear implant surgeries have been done as of June ’20.
Rabies Free Karachi
Rabies team has successfully piloted and completed mass dog vaccination and animal birth control at Ibrahim Hyderi and adjacent areas of Karachi. The program is supported by WHO, Indus Hospital, and Getz Pharma. Up till June ‘20, in an area called Ibrahim Hyderi, 2,065 dogs were neutered and spayed and 17,974 dogs were vaccinated.
Improvement of ER Conditions in Pakistan
In collaboration with Policy Analytics - a Swiss health research company – IHRC is working on improving the conditions of ER in public hospitals using the behavioral sciences approach.
Vero Cell Trial
It aims at testing the efficacy of an anti-rabies vaccine (Vero Cell) on healthy participants in terms of anti-body titer buildup and to report the side-effects, if any. The study hopes to potentially shorten the number of doses to accelerate treatment regimen.
My Child Matters
Through teaching and training, the program is addressing holistic improvement in the care provided at five existing pediatric oncology units in Pakistan. The program includes oncologist training, nurse training, chemotherapist training as well as data documentation and management.
Halo Trial
IHRC and the Infectious Disease Department are conducting the Sepsis Trial in collaboration with the University of Manitoba.
Total Knee Replacement Surgery Impact Assessment
This research study has furthered the work of the time-driven activity-based costing (TDABC) study to assess the impact of educational intervention as well as to assess patient satisfaction with the educational material developed and provided to the total knee replacement patient by the team. The study is done in collaboration with team from Harvard Medical School.
Neonatology Heating screening Program
The IHRC program team assisted the audiology department in restructuring the neonatal hearing program at Sheikh Saeed Memorial Campus. The optoacoustic emission tests are performed using the international standard of testing and care. This ensures correct and early diagnosis and treatment of hearing problems.
Support to Value-Based Healthcare Group
IHRC is providing support to the VBHC group working at IHN level. The process mapping experts at IHRC collect data and chart out the patient pathways for different conditions. This is to increase patient value which subsequently helps in streamlining the process and bringing efficiencies to the systems, hereby reducing costs and minimizing wastages using TDABC concept.
Technical Expertise Consultancy
The statisticians, epidemiologists, program and grant teams at IHRC provide consultancy and technical expertise in their respected areas. The program team successfully provided technical services to external as well as internal stakeholders for TDABC as well as lean management practices.
The Indus Hospital Blood Center
The Indus Hospital’s Blood Center is the first centralized blood center of Pakistan. It came into existence with the mission to mobilize the nation towards 100% voluntary blood donations. The entire blood banking process in all blood centers and associated hospitals’ blood banks is driven by an in-house developed work flow software, employing International Society of Blood Transfusion (ISBT) 128 barcode systems, and built around the American Association of Blood Banks regulations, thereby ensuring 100% traceability. The Indus Hospital Blood Center has a technical training laboratory with full audio-visual facilities with the capacity to train 20 blood bankers. It was commissioned in October 2014, at a cost of around $75,000. The training lab at the Indus Hospital, enables training of Blood Center and all RBC employees, as well as staff of external organizations on fee for service basis.
Physical Rehabilitation Center
TIH established rehabilitation centers in Karachi, Lahore, and Muzaffargarh, with the support of the International Committee of the Red Cross; CHAL Foundation; and provincial governments. A new Rehabilitation center has recently been launched at TIH Badin. The purpose of physical rehabilitation was to restore the function and/or cosmetics of the residual part of patient’s body, affected by loss of function, deformity or amputation, to the maximum possible level as the technology may allow, enabling them to become independent and contributive citizens rather than being dependent on others. This is being achieved by the provision of prosthetic and orthotic devices, mobility aids like wheelchairs, tri-cycles, crutches, and physiotherapy.
During the reporting period 2018-2019, the centers provided 5,579 prosthetic devices to 768 patients in Karachi; 1,936 patients in Lahore; and 2,875 patients in Muzaffargarh. The Center provided 3,379 orthotic devices to 1,706 patients in Karachi; 397 patients in Lahore; and 1,276 patients in Muzaffargarh. 4,732 patients were registered to receive orthotic/prosthetic devices. 2,398 pediatric patients and 6,565 adults benefitted from these services. 912 patients received upper limbs.
Innovations in Healthcare
- TIH devised Pakistan’s first and the only paperless Electronic Medical Record (EMR) system to create a Hospital Management and Information System which is efficient, cost-effective, and environment-friendly.
- IHN is embarking upon a new journey to provide primary care services through the first-ever Boat Clinic in Pakistan soon to be launch in October, 2020. The initiative will serve the vulnerable population of 105,000 inhabitants who lack basic communication access and are constantly exposed to flooding risks in Southern Punjab. This makes healthcare by boat the only available option.
The clinic will provide quality screening and primary care services free-of-charge. At each docking point, the patients will be registered, screened, and have their vitals assessed before a doctor’s visit. The boat will have a lab collection unit and pharmacy as well. The unique initiative will integrate public health services and provide access to immunization, pediatric, nutrition, family planning, breastfeeding, deworming, Hepatitis C, and mental health services.
- Biosafety Level 3 (BSL-3) laboratory in Korangi, Karachi is one of the largest in Pakistan, with experienced staff that have been well-trained in Tuberculosis (TB) diagnostics and biosafety practices. It was built to meet international specifications, and TB diagnosis are conducted according to the World Health Organization and other international guidelines.
The capacity of the new BSL-3 lab enables TIH to carry a monthly workload of 20,000 AFB smears, 20,000 GX tests, 5,000 AFB cultures tests, 500 DSTs, and 1,200 LPA 1st and 2nd line tests. The lab’s equipment currently includes 5 MGIT 960s, 3 (16 Module) Gene xpert machines, 6 Biosafety cabinets Type II, a double door autoclave, 5 LED fluorescent microscopes, 2 twin incubators with two thermal cyclers, and 5 -80 degrees Celsius freezers.
The capacity of the lab will enable TIH to expand the equipment even further and enable the analysis of a large number of samples to provide a timely diagnosis, leading in turn to faster treatments.
- The Indus Hospital installed a new and most modern Total Lab Automation system. The new system is a hi-tech and advanced automation system increases Indus Hospital’s capacity to perform the diagnostic analysis.
- After performing Microwave Ablation Procedure to treat benign tumor of the bone, the Indus Hospital became the only health facility in Karachi to use minimally invasive technique to treat osteoid osteoma (bone tumor).
Alliances and Partnerships
The Indus Health Network is offering healthcare services for Pakistani nationals with the help of multiple national and international supporters, allies, and partners. These prestigious institutes support the IHN in various health projects and establishment of centers while also providing funds and educational expertise.
- Government of Sindh
- Government of Baluchistan
- Government of Punjab
- International Committee of the Red Cross and Chal Foundation
- Global Fund to fights Aids, Tuberculosis and Malaria
- Harvard Center of Global Health Delivery, Dubai
- St. Jude’s Children’s Research Hospital
- University of Manitoba, Canada
- Harvard Medical School
- Karachi Metropolitan Corporation; World Organization for Animal Health; Food and Agriculture Organization; Getz Pharma
International Affiliates
Friends of Indus Hospital, USA
Friends of The Indus Hospital Inc. is a 501(c) tax-exempt charity established to support The Indus Hospital. The goal of FOIH is to raise awareness among the Pakistani expatriates in the US and international donor agencies about the trailblazing efforts of The Indus Hospital in order to raise funds for sustaining the provision of free healthcare services. It is driven by a highly passionate and successful group of professionals who have a wealth of medical knowledge and fundraising experience at hand.
Friends of Indus Hospital, Australia
The objective of Friends of Indus Hospital Australia is to support the efforts of Indus Hospital in providing quality health care, absolutely free of cost to underprivileged patients. The activities of this charity include creating awareness about the efforts of Indus Hospital, arranging fundraising events, mobilizing individual and corporate volunteers to support Indus Hospital with finances, knowledge and skill transfer.
Indus Health Network, UK
The charity in UK helps to raise awareness, organize events and activities to raise funds for the Indus Health Network and its associated services to help provide absolutely free of cost quality healthcare to the under-served community in Pakistan, without discrimination.
Indus Development Foundation, Canada
Indus Development Foundation (IDF) is a Canadian registered charity registered under Canada Not-for-Profit Corporation Act. It’s an initiative taken by Canadians of Pakistani origin expatriate and supported by wider community in Canada. The objective of Indus Development Foundation is to support the efforts of Indus Hospital in providing quality health care, absolutely free of cost to underprivileged patients. All the donations given to IDF are eligible for Tax benefit of the citizen of Canada.
The Indus Hospital, UAE
The Indus Hospital’s international affiliate in Dubai serves to raise funds through events and activities by creating awareness about the Hospital’s efforts in Pakistan among the Pakistani community residing in the UAE.
Achievements
- Dr. Abdul Bari Khan recognized for his services: For the outstanding contribution and selfless service to change the paradigm of the provision of quality healthcare across Pakistan, Dr. Abdul Bari Khan, CEO, Indus Health Network, was conferred the second highest civilian award – Hilal-e-Imtiaz. He also received a Gold Medal for his services by the Federation of Pakistan Chambers of Commerce and Industry.
- The Indus Hospital case study was published at the Harvard School of Public Health in 2012 https://repository.gheli.harvard.edu/repository/10728/
- Faculty’s Research Publications: Approximately 30% of the 211 IHN peer reviewed publications were published between January 2018 and June 2019. Among these, 44 peer-reviewed publications were published in 2018 - 19 while 75% of them were published in international journals.
Campuses & Expansion
The Indus Hospital, Korangi Campus, is a prototype of a unique healthcare system. Established in 2007, the campus has grown from 150 to 330 beds and offers a range of services including;
- Critical Care and Emergency Services
- General Surgery
- Orthopedics
- Gynecology
- Urology
- Pediatric Oncology
- Cardiology
- Diabetes & Endocrinology
- Blood Center and Laboratory Services
- Family Medicine and Community Health
Keeping in view the steady increase in the number of patient visits, admission ques, the management realized the need to expand to cater to a larger segment of society. The current bed facility will expand from 330 to 996 bed state-of-art facility. Total plot area will stretch to 20 acres.
QF NST Campus a.k.a. Lahore Campus will soon be serving the population of Lahore and adjoining areas. The new campus has an estimated covered area of 0.93 million square feet, while the total estimated cost of the project is Rs. 10.5 billion. The project comprises of four buildings. The 600-bed tertiary care hospital will contain all modern healthcare facilities. It is anticipated that annually more than 1 Million patients will receive medical care.
References
[The Indus Hospital, https://indushospital.org.pk/]
[Friends of Indus Hospital, https://foihus.org/]
[Indus Hospital, UK https://indushospital.org.uk/]
[The Indus Development Foundation, Canada https://indushospital.ca]
[Friends of Indus Hospital, Australia https://foih.org.au/]
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