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A beacon for free healthcare in Pakistan

BMJ 2016; 352 doi: (Published 22 March 2016) Cite this as: BMJ 2016;352:i1681
  1. Talha Burki,
  2. freelance journalist
  1. London
  1. talhakburki{at}

Can the model of Karachi’s Sindh Institute of Urology and Transplantation be replicated, asks Talha Burki

The Sindh Institute of Urology and Transplantation is a specialist kidney hospital in Karachi. It is unusual in that it offers free care for all. Housed in the Civil Hospital on land provided by the government, the 750 bed facility offers 24 hour emergency care and provides around a quarter of a million sessions of dialysis every year.

Since 1985 surgeons at the institute have performed almost 5000 kidney transplants, including Pakistan’s first cadaveric and paediatric transplants. The institute has treated around 10 million patients since its inception. Several satellite branches are dotted around Sindh. There are also advanced plans for a dedicated paediatric urology, nephrology, and cardiology unit that will be named after Philip Ransley, a paediatric urologist from Great Ormond Street Hospital who has often visited the institute to teach and perform complex reconstructive surgeries.

Refused treatment entirely

The hospital was founded by the urologist Adib Rizvi. As a medical student in 1950s Karachi, Rizvi realised that healthcare was a precarious proposition for most Pakistanis. Those who did not have the means to pay could be refused treatment entirely.

“I began to think that healthcare should be the basic right of every human being—a birthright, like education,” Rizvi told The BMJ. In the UK, where he spent much of the 1960s undertaking a fellowship in surgery and working in NHS hospitals, no one was denied treatment. “I thought, ‘Why can’t we in Pakistan provide health facilities without …

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