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A Beating Heart!

Updated: Aug 31, 2018

By Bismha Nayyer

Lyari Town is one of the oldest towns of the city of Karachi, in the province of Sindh, Pakistan. It is the smallest town by area in the city but also the most densely populated. It has a population of over 1 million. Out of these one million people, a fisherman Muhammad Hussain lived under one-room space rented with his family of 10: himself, his wife, 4 sons and 4 daughters. Out of his 8 children, Salman- his 8 years old son’s deteriorating health kept him awake at nights. Like his other siblings, Salman didn’t show signs of a healthy boy since his birth.

Shortness of breath, pale complexion and slow growth compelled Salman’s father to get him checked from a local doctor whichever offered the lowest fees as this was all the poor father can afford.

Upon getting unnoticed by the local doctors, at the age of five Salman disease became more aggressive which landed him in National Institute of CardioVascular Diseases (NICVD), Karachi. Upon scrupulous physical examination and from his diagnostics test it was evident that he was suffering from a congenital heart disease - Patent ductus arteriosus (PDA). The ductus arteriosus is a fetal blood vessel that closes soon after birth. In a PDA patient , the vessel does not close and remains "patent" (open), resulting in irregular transmission of blood between the aorta and the pulmonary artery, generating left-to-right shunt.


After the diagnosis of his condition, the Cardiac Surgeon- Dr. Najma Patel at NICVD conveyed her family the estimated cost of the operation which was Rs. 140,000 .

For putting bread on the table and roof over the heads of his family , the poor father practically lived on the boat to catch good amount of fishery. Being away from home and family only earned him scanty amount of Rs.5000-6000 then how is he going to afford that surgery?

Even if he catches and sell all the fishes of Arabian sea, he can’t arrange that huge amount of money. While the congenital anomaly of their son was a self-explanatory of the fact that her mother was not being taken care of when she was carrying Salman. As one of the leading causes of congenital heart disease poor maternal health like exposure of gestational diabetes or not having vaccinated for infections like rubella virus which predisposes the fetus to these kinds of anomalies are enough indicators of poor income status.


Considering their financial crises and urgent nature of intervention, NICVD Cardiologist referred the case to Heartfile for health financing on February 12th, 2015. HHF quickly mobilized its assessment and verification team in Karachi to conduct a socio-economic evualuation of the patient. Upon successful completion of the assessment, the patient was found eligible for full assistance to underwrite the cost of the treatment. Latest follow up on March 11th, 2015 upon the patient showed that Salman is on the path to full recovery now. Pakistan has one of the highest rates of children with congenital heart disease in the world. Each year 40,000 -50,000 are born with this heart defects and Salman Hussain was a needle in a haystack.

Salman waited 8 years in agony and pain before he can be operated just because his parents couldn’t afford to pay for the surgery. Salman Beating heart is a testament of how impactful in HHF program.
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Heartfile Health Financing (HHF) is an access to treatment program for non-communicable diseases. It provides financial access for high-cost treatment for those who are unable to pay, are likely to spend catastrophically or forgo treatment. HHF's mobile phone-driven process is fully transparent and offers help to patients with dignity. HHF currently operates in selected hospitals in Pakistan and is being prepared for scale-up.  

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