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A Broken Leg

Updated: Aug 31, 2018

By Farkhanda Naheed


Shamim Begum, widow of Shaukat, resident of Dhoke Hassu Tehsil Rawalpindi was brought to emergency room of Rawalpindi General Hospital in excruciating pain on 8th October 2015. She had slipped at home, fell to the ground and broke her right leg below knee.


At 48, Shamim was no stranger to misfortunes. As recently as three years back, she lost her elder son of the two, newly married to brain tumor. The widow of the deceased son was remarried to the younger son. Two years later, her husband also lost his battle of life partly due to the grief of their lost son and in part to a deadly paralysis attack.


The younger (now the only one left) son of the patient is a laborer at a local factory and earns Rs. 6,000 per month.


Twenty years back at a mere age of 28, Shamim had a similar accident and had broken her right leg exactly at the same point as this time. Given her age, the frail bones could not withstand the impact this time.


Prior to the current incident, Shamim also used to work as a domestic help to a family nearby to support the miniscule income of her son and earned Rs. 5,000 per month. After her accident, this partly but ‘significant’ chunk of the family income was lost, pushing the family further into poverty. In the emergency room, she was given necessary first aid and her x-rays were carried out which revealed a fracture in right leg. She was advised costly surgery and was shifted to Orthopedic ward at Rawalpindi General Hospital. Together the disposables of the surgery and the implant itself had a price tag of above Rs. 50,000.


The poor widow explored every available avenue to secure finances for the operation. As with all people of this socio-economic strata, she did not have any access to a social circle who could arrange such a big sum. In agonizing pain, she desperately awaited help, wondering if it would come at all. The doctors at the Rawalpindi General Hospital’s Orthopedic ward witnessed first-hand that she had no means of financing her procedure although she was still clinging to “some” hope that miraculously might come.


Convinced that the patient was genuinely ‘ultra-poor’, the local doctor at RGH Orthopedic ward—a registered Heartfile Financing site—sent a plain text SMS to Heartfile Health Financing on 27th October 2015 requesting financing assistance worth Rs. 52,000 for Shamim begum. Heartfile Health Financing mobilized its socio-economic validator to conduct a socio-economic profiling of Shamim bibi on 30th October 2015. Her socio-economic validation happened in the hospital at her bed side and her financing was approved on the same day. She received her financial award letter from Heartfile socio economic validator bearing a testimony to her financing having been secured. Heartfile’s registered supplier for the facility was ordered to provide medical supplies for Shamim bibi. She was operated in Rawalpindi General Hospital (RGH) Rawalpindi in first week of November 2015. Heartfile’s latest follow up shows that she has been operated with help of HHF for which Heartfile is thankful to its donors for writing off the cost of this surgery.

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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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