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A route to Dignity

Updated: Aug 31, 2018

By Bismha Nayyer

Imagine yourself lying on the bed in mid-thirties at the mercy of some unknown disease which is slowly killing you and yourself being dependent on your brother and his family for emotional, physical and economical support. This is the story of 35-year-old Noor -Un-Nisa. The life lived by Noor-un-Nisa of Nowshera is both unfortunate and unjustified. On the account of her illness, after her parents died she was left with no place to find shelter except the makeshift accommodation by her brother and his family in a small cottage on the hill top deprived of basic living amenities: gas and electricity.


Noor-un-Nisa was only 16 years old when she developed clinical symptoms in the form of joint pains, recurring fever, shortness of breath along with overall weakness starting to manifest itself. Belonging to a remote area, her parents took her to the near accessible doctor who prescribed medications to mask her complaints without addressing the root cause of her illness. A time came when oral medications ceased to ease her condition. She was rushed to District Head Quarter (D.H.Q.) Hospital Nowshera. She was then referred to Pakistan Institute of Medical Sciences, cardiology department Islamabad. Upon meticulous physical examination and diagnostic tests, it was revealed that Noor-un-Nisa was suffering from Rheumatic heart disease which amongst other things is the disease of Mitral Valves (MV) of the heart.


Auspiciously, the advancement of medical science makes it possible to replace both valves by either mechanical or biological valves through an invasive surgery known as Double Valve Replacement under General Anesthesia(GA). This type of surgery is expensive and risky with higher mortality rate.


After the diagnosis of her condition, the PIMS Cardiologist conveyed her the estimated cost of the operation which was Rs. 230,000. Already under the debt of Rs. 120,000, having an underprivileged socio-economic status, how she could ever contemplate in her wildest dream to proceed for such an expensive surgery while the disease was itself a gift from her poverty as one of the causes of mitrial valve disease is rheumatic fever occurred from not treating streptococci through antibiotics which could not be accessed due to poor income condition. Earning skimpy amount of Rs 12,000 from daily wages and not having any cashable assets, his brother her sole care taker couldn’t afford such luxury treatment alongside putting a square meal on the table for his family.


Despite fate not being on her side, 3rd October 2016 will always be the fateful day which turned her life upside down in a positive way. On that day from DHQ Nowshera she ended up in PIMS cardiology department, where the cardiologist being aware of her financial crises referred the case to Heartfile for health financing. After waiting for her conclusive test results, she was assessed by HHF team on 19 Oct 2016 and the case was approved for funding on the same day. She was successfully operated on 16th Nov 2016 by team of cardiac surgeons at PIMS cardiology.


As per protocol, the patient was followed up telephonically on 2nd Dec 2016 after surgery in which her brother informed gladly that her stiches are removed and she never felt any better.

Through Heartfile Health Financing, this woman was able to secure access to catastrophic Health care from a Public-Sector Hospital. Her brother and she did not have to beg for it nor resort to undignified modes of financing. Through HHF she got her health back with dignity.

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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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