Closing the care gap: Where you live shouldn’t determine if you live

Many people in Pakistan know that the inspiration behind building the first Shaukat Khanum Memorial Cancer Hospital and Research Centre was Imran Khan’s mother. At the time, while the affluent could afford to travel overseas to access cancer treatment, ordinary Pakistanis were unable to receive anything but the most basic of services for cancer. Fewer people, however, know of the role of one elderly man in this story, whose story was almost as much of a defining moment in the fate of cancer patients in Pakistan. This man worked all day as a manual labourer, in order to be able to pay for medicines for his brother, who was battling cancer at a local hospital in Lahore. Whilst he was having his mother treated, Imran Khan met this man who symbolised, for him, the utter hopelessness that a diagnosis of cancer meant for most people in Pakistan. He often relates this unfortunate man’s story as being of almost equal importance in inspiring him to build the Shaukat Khanum Memorial Cancer Hospital and Research Centre, in Lahore.
The rest, as they say, is history. Imran began a nationwide, indeed worldwide, campaign to raise funds for the first cancer hospital. The entire nation came together to build Pakistan’s first tertiary care cancer hospital where world-class facilities would be available to everyone, regardless of their ability to pay.
The first Shaukat Khanum Memorial Cancer Hospital and Research Centre opened in Lahore, in December 1994, and thus began our journey of “Closing the Care Gap”, which is the theme for World Cancer Day this year. World Cancer Day, an initiative of the Union for International Cancer Control (UICC), is marked on the 4th of February each year and aims to advocate awareness of and action for reducing the global cancer burden. According to the UICC, 70 percent of deaths from cancer occur in low- and middle- income countries, many millions of which could be prevented by addressing disparities, providing equitable access to prevention, early detection and quality treatment of cancer.
To mark World Cancer Day, at the Shaukat Khanum Hospitals in Lahore and Peshawar, we are renewing our commitment to our core principles of “quality and equality,” by acknowledging and addressing underlying disparities in cancer care in our region. We believe firmly that where one lives should not determine if one lives. The fact that 30 percent of patients at our Lahore hospital hailed from Khyber Pakhtunkhwa and surrounding areas, and recognising the physical, emotional and financial obstacles they had to overcome in order to access treatment, led us to open our second hospital in Peshawar, in 2015.
Cancer patients in our region face numerous challenges in accessing care, including a paucity of cancer facilities, having to travel long distances to receive care and, most importantly, the prohibitively high cost of treatment, in particular of cancer chemotherapy drugs. Over the past twenty-seven years, we have demonstrated that closing the care gap for cancer patients in Pakistan is possible. At our hospitals, we evaluate disease, rather than financial status when offering treatment and provide the same high standard of care to all our patients. Each year, we provide top-quality cancer treatment entirely free of charge to over 75 percent of our patients. We ensure that our diagnostic and treatment facilities remain at the cutting edge, one recent example of this being the commissioning of two linear accelerators with stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) capability. These ensure extremely accurate and precise radiation treatment delivery, while minimising exposure to surrounding normal tissues.
We are committed to raising the standards of healthcare for all those who are suffering from cancer in Pakistan, and to achieve optimum treatment outcomes regardless of nationality, gender, or financial status. We ensure this by implementing continuous quality improvement programmes at our hospitals. The Joint Commission International, which is recognised as a global leader for healthcare quality and patient safety, has acknowledged our commitment to clinical excellence and the highest standards of quality by awarding its “Gold Seal of Approval®” to both SKMCH&RC Lahore and Peshawar.
In addition to bridging the cancer care gap for patients from KP, Afghanistan, and beyond, our facility hosts patients from many other diverse backgrounds including minority populations, refugees, and those facing other obstacles in treatment. These obstacles include language barriers and limited access to accommodation for patients and accompanying family members, to name a few. In Lahore, our generous supporters have established free accommodation facilities for cancer patients and their attendants, providing free housing and meals. In-house, we ensure that treatment plans are communicated to patients in their own language, and patient education materials are designed to convey information about treatment in an easily understandable manner. We provide nutritious meals to all patients admitted under our care, as well as to the parents of children admitted to the hospital.
While there are still many healthcare challenges in our country, we remain committed to playing our part in ‘Closing the Care Gap’ for cancer patients. Recognising that where you live must not determine if you live, we have undertaken the gargantuan task of building our third, and Pakistan’s largest, cancer hospital in Karachi, which is expected to open at the end of 2023. This new hospital will mark a new age in cancer diagnosis and treatment, not only for the people of Pakistan’s largest city and economic powerhouse, Karachi, but also for people from all over Sindh and from Southern Balochistan. Our major hospitals in Lahore and Peshawar, supplemented by future hospitals in Karachi and Quetta, will continue to serve as models for excellence in cancer care, diagnostics, and treatment, leading the way in showing that such excellence is indeed possible in Pakistan.
Over the next twenty-five years, we aim to develop a hub-and-spoke model where much of our cancer care will be provided in regional Shaukat Khanum Memorial Cancer Centres, thereby bringing cancer care in Pakistan closer to people’s homes. Most diagnostic procedures, and much cancer treatment, will be carried out in these smaller hospitals, with patients coming into the central, tertiary care hospitals, in Lahore, Peshawar, Karachi or Quetta, only for more complex and multi-disciplinary treatments. We look forward to the day in the future when most, if not all, cancer patients in Pakistan will have the option of going to a facility of the Shaukat Khanum healthcare system for diagnosis and treatment of cancer, because where you live can no longer be allowed to determine if you live.

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