Going online helps Pakistan’s women doctors back to work
She is one of thousands of Pakistani female doctors who have returned to the profession through “telemedicine” after leaving it due to family obligations and workplace barriers to women in the conservative society.
Although women outnumber men in Pakistan’s medical records, many stop working after marriage, further exacerbating the doctor shortage in the fast-growing country.
Jafri, a mother of three children, left cardiology after getting married.
“I didn’t want to choose long working hours and stay away from home for long periods of time,” he told AFP.
But an initiative by digital health firm Sehat Kahani helped her return to the workforce by providing a digital platform to connect mostly female doctors working at home with patients in underserved communities.
The needs of private customers are also met. Its co-founder says the startup has reactivated 7,500 doctors and aims to improve health services in disadvantaged areas of Pakistan where services are lacking, especially for female patients who feel more comfortable talking to female healthcare staff about their health issues.
Gallup surveys and physician associations suggest that more than a third of female medical graduates in Pakistan never enter the profession or leave it after marriage due to lack of family support, inadequate childcare opportunities and harassment.
This situation is symptomatic of larger challenges for women in Pakistan, who face significant economic and social inequalities; The World Economic Forum ranks the country second to last in terms of gender equality.
‘Doctor Brides’
Jafri now balances taking care of her children and housework, as well as dealing with patients online.
“I wanted to stay with my kids,” the 43-year-old said of the flexible arrangement.
The overwhelming majority of the tens of thousands of candidates vying for admission to state-run medical universities are women; This is a rare example in Pakistan where female students are accepted more than male students.
But working in hospitals and clinics is widely seen as incompatible with family life for women, especially women with young children.
Zakiya Aurangzeb, President of Pakistan Islamic Medical Association, said, “The female doctor who advises mothers to breastfeed exclusively for six months does not have such an opportunity in her own workplace.”
The risk of sexual harassment and mob violence from families of patients who face long working hours and poor outcomes also puts off women and their families, she said.
Seeing these challenges, as well as Pakistan’s dismal access to healthcare in poor communities, doctor Sara Saeed Khurram founded Sehat Kahani, a digital network of 80 clinics where patients visit for a remote consultation with a doctor under the guidance of a nurse.
She hoped to reap all the benefits of years of education and government subsidies for degrees that many families sought for their daughters, as well as the social status they provided in Pakistani society, where the title “Dr” was thought to improve women’s marriage chances.
“When the wedding card comes out saying you’re marrying a doctor, it just elevates the social status of the entire family,” Khurram said.
“Once that goal is realized… then it becomes very difficult for you to challenge the social norms that exist in that family to allow it to work.”
Khurram understands the situation firsthand.
“I have also become a doctor bride or what we call ‘doctor bahu’,” she said, using the Urdu term meaning “bride”.
Although she remained in the workforce, Khurram watched her mostly female medical school group leave one by one and faced pressure from her mother-in-law to focus on taking care of the household.
health deficit
The shortage of female doctors is deepening pressure on Pakistan’s health services, which are a mix of public and private systems in the country of 250 million people, with stark disparities between cities and rural areas and poor outcomes for urban working-class neighbourhoods.
According to medical associations, approximately 70,000 women (almost a fifth of the total 370,000 registered doctors) are registered but not working.
The return of female doctors to the workforce online also provides better options for patients.
In a poor neighborhood of Karachi, Muhammad Adil was able to take his eight-year-old son to the nearby health unit run by Sehat Kahani because it saved him time and money.
“We can save our daily wage when we come here because it’s close,” he said, after offering free advice to Jafri about his son’s chickenpox.
Jafri said digital health services increase resilience and can help women return to the workforce, but cautioned that ultimately family support is important.
“A female doctor can be successful if she receives support from her husband, parents and mother-in-law,” he said.
“Those who succeed continue to succeed, but many who fail are forced to give up.”
