But first, when it comes to providing innovative health care, Pakistan is not a country that
usually comes to mind.
But in Karachi, one public-private partnership is trying to address some of Pakistanis' most
pressing medical needs.
In cooperation with the "Associated Press", special correspondent Fred de Sam Lazaro has
the latest in our series, "Agents for Change".
(BEGIN VIDEOTAPE)
FRED DE SAM LAZARO, PBS NEWSHOUR SPECIAL CORRESPONDENT (voice-over): On any given day at Karachi's
Jinnah Hospital, some 5,000 patients arrive, many wheeled in on rusty, bare metal gurneys
by family members who wait sometimes for days in the outer corridors.
Inside are long lines-for X-ray scans or appointments with overwhelmed staffers.
There are lots of exhausted children.
Jinnah is one of the oldest, biggest public health care facilities in Pakistan's commercial
capital, a city of 15 million and the hospital hasn't been immune to the violence and terrorism
that has gripped this country, including this bomb blast in 2010 in its own emergency department.
DR.
SEEMIN JAMALI, CEO, JINNAH HOSPITAL: We nearly missed to die.
I was standing right at the gate and very, very injured.
About 18 people lost their lives at that point.
DE SAM LAZARO: Yet hospital CEO Seemin Jamali notes that just 30 seconds after the blast,
staff are back on their feet, tending to the injured.
She says it's a metaphor for a hospital that is transforming itself amid all the chaos,
replacing its decrepit old buildings and bringing some of medicine's most modern equipment and
care to Pakistan's poorest patients who may never otherwise have access.
Six-year-old Noman Azim was brought in after losing his sight when a growing brain tumor
began to affect his optic nerve.
SHEENA AZIM, MOTHER OF NOMAN (through translator): He was scared of everything.
He lost his eyesight for two months.
He was completely blind.
Thank God my son has a new life.
He goes to school, he studies, he plays outside.
DR.
TARIQ MAHMOOD, RADIOLOGY CHIEF: This is pre-treatment images.
And this is post-treatment images.
Look at this, that whiteness has almost completely gone.
DE SAM LAZARO: Radiology chief Dr. Tariq Mahmood (ph) says Noman was treated with some of the
most sophisticated technology anywhere.
He was restored to sight with a $4 million robot like device called a cyberknife.
In the U.S., the price tag for such treatment ranges between $50,000 and $90,000.
Here it is free, true of all services in government hospitals.
Patients can chip in after their care but it's voluntary.
On average, these donations defray about eight percent of the hospital's costs.
All this equipment was donated to the hospital by a non-profit group called the Patient's
Aid Foundation, private citizens who've provided guidance and much of the funding for the hospital's
facelift.
MAHMOOD: From 1984 to 1994, we were doing 200 scans in a year.
Today, we are doing 300 scans, CT scans in a day.
DE SAM LAZARO: This public private partnership began in 1992, when a group of business leaders
were moved by the desperate conditions at the hospital.
Businessman Mushtaq Chhapra says it began with pleas from the hospital to replace broken
refrigerators in the blood bank and parts for medical equipment.
MUSHTAQ CHHAPRA, VICE CHAIRMAN, PATIENT'S AID FOUNDATION: The government didn't have
the budget to do these repairs or renovation.
And this is where my organization stepped in and virtually, these were small things
which were remedied within hours.
DE SAM LAZARO: Those small things have added up quickly; $35 million so far, in donations
from prominent business families in Karachi, for buildings, equipment and some staff at
the hospital.
Chhapra says at first they were skeptical about partnering with a public sector notorious
for inefficiency and corruption.
He says they forged a clear understanding of key roles each side would play.
CHHAPRA: We have not let the government abdicate their responsibility.
The government has 3,000 people working in this hospital, the government is paying salaries
for those people, the government provides the utilities, the medications.
What we do is we bring the ideas, we bring the systems and we bring the much-needed equipment.
DR.
TASNEEM BUTT, VOLUNTEER, PATIENT'S AID FOUNDATION: Doctors, obviously everybody wants to work
in a neat and clean environment.
DE SAM LAZARO: Retired radiologist Tasneem Butt volunteers as a patient advocate at the
Jinnah Hospital.
She says the upgrades have not only improved patient care but also morale among providers.
BUTT: We did not have any mammography machine.
It took like 20 years for us and now as I speak of, we have the latest technology of
mammography machines.
And this is probably the largest radiology center in Asia.
DE SAM LAZARO: It is large and state of the art but ironically, it is perhaps the least
busy section of a very busy hospital, even though the incidence of cancer is growing
in Pakistan, including the highest rate of breast cancer in Asia.
(on camera): A lot of the cancer that occurs in Pakistan goes untreated.
Patients in many cases can't afford therapy, if it's available.
And even in places where it is available, doctors say the vast majority of patients
come in in advanced stages, when it's too late for any effective treatment.
(voice-over): That was the case with this seven-year-old boy, brought here by his father
from Peshawar, a city some 850 miles away near the Afghan border.
His brain tumor had progressed too far to benefit from radiotherapy.
Dr. Tariq Mahmood says only five percent of the cancers seen here are in the early treatable
phases.
MAHMOOD: There is lack of the availability of the proper equipment for the early diagnosis.
And at the same time, there is lack of education.
DE SAM LAZARO: Public education is a big challenge, but Dr. Mahmood says the Jinnah Hospital offers
a model for delivering high quality care to the poor.
A public private partnership is inherently fragile amid Pakistan's volatile politics
but the foundation's Chhapra says he's not deterred.
CHHAPRA: We are pumping in millions and millions of dollars into a hospital which is owned
by the government.
Tomorrow, they may turn around and say enough is enough.
Get out.
We as a group have decided, come what may, we are here to stay.
DE SAM LAZARO: And despite the challenges, the foundation has ambitious plans to expand.
A state of the art, $25 million outpatient department is slated to open early in 2018.
For the PBS NEWSHOUR, I'm Fred De Sam Lazaro in Karachi, Pakistan.
(END VIDEOTAPE)
WOODRUFF: Fred's reporting is part of the Under-Told Stories Project at University of
St. Thomas in Minnesota.