Each year, Shaukat Khanum Memorial Cancer Hospitals and Research Centres provide financially supported treatment to seventy-five percent of all patients. Image Credit: Supplied

Pakistan’s Shaukat Khanum Memorial Trust (SKMT) is Imran Khan’s commemoration of his late mother Shaukat Khanum, who passed away in 1985 after a prolonged battle with cancer.

Inaugurated in 1994, SKMT in February 2023 comprises the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, “the first specialised cancer facility in the entire region with all the cancer diagnostic and therapeutic facilities under one roof”; Shaukat Khanum Memorial Cancer Hospital and Research Centre, Peshawar, “built according to the latest international healthcare standards, inaugurated on December 29, 2015”; and Shaukat Khanum Memorial Cancer Hospital and Research Centre in Karachi, “construction work in progress.” SKMT has three outreach cancer screening clinics in Lahore, Peshawar, and Karachi. SKMT’s three diagnostic centres are also situated in Lahore, Peshawar, and Karachi. SKMT has one hundred and seventy-six laboratory collections centres across Pakistan.

Empathy is the most spectacular aspect of SKMT. I saw that compassion first-hand during my brief voluntary work in the hospital’s children ward in 2018. Countless stories of children and teenagers suffering from cancer and their parents finding free world class treatment at SKMT, endless gratitude expressed in heartfelt duas for Imran Khan, for SKMT’s doctors. The hospital filled with so much pain of cancer, one of humanity’s deadliest foes, was permeated with the purity of superhuman sabr of patients and the heroic grace of their loved ones. Visiting that hospital was a core-changing experience. In May 2019, seventy-three days after my younger brother’s passing, the most painful time of my life, I wrote my SKMT story for Gulf News.

So extensive is the range and reach of the empathy at SKMT, a multi-volume book is required for its proper encapsulation. Some day.

Year after year, SKMT continues to serve—giving hope, touching lives, healing broken bodies, saving lives.

For Gulf News, I asked SKMT Chief Executive Officer Dr Faisal Sultan a few questions:

Mehr Tarar: What is the mechanism for assessment of the most deserving cases for free treatment?

Dr Faisal Sultan: According to estimates by credible sources, more than 178,000 new cancer cases may be seen in Pakistan annually. Of these, around 50,000 reach our initial screening clinics (walk-in clinics) in Lahore, Peshawar and Karachi.

Comprehensive cancer care requires highly specialised and expensive treatment and a large number of qualified and well trained staff. To ensure that we only accept what can be treated with quality and attention to detail, no more than 12,000-15,000 new patients can be accepted yearly.

Consequently, SKMT prioritizes the intake of patients based on a number of factors, including availability of capacity (staff, equipment, facilities) for each type of cancer and nature and stage of disease. This ensures that the institution, as guardian of donated money, spends it in the most efficient way and with the optimum outcome for all accepted patients.

Initial screening of patients takes place through walk-in clinics located in Lahore, Peshawar and Karachi, where patients receive free consultation and undergo required tests to confirm the diagnosis and stage of disease. Once a patient is admitted and accepted in the Shaukat Khanum healthcare system, treatment commences at the earliest.

This filtering, based on medical and treatability and capacity criteria is step one. It is a difficult process for all concerned, but a consistent and fairly applied methodology, which has gained the respect of our donors who understand that unless a dozen similar hospitals open up, some prioritised intake is unavoidable.

After acceptance, patients are routed to the Financial Support Services section for financial evaluation to ascertain the extent of support they require. This is the second step, and the staff shares the expected treatment cost, and patients or their guardians share the details of assets, income sources, and dependents, among other details. Depending upon the patient’s financial position, a percentage for financial support is determined.

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Each year, Shaukat Khanum Memorial Cancer Hospitals and Research Centres provide financially supported treatment to seventy-five percent of all patients. Of these, the overwhelming majority receive hundred percent financial support because they cannot afford even basic needs let alone expensive treatment for cancer. A small proportion of patients receive partial financial support and are required to pay a range of partial, often nominal, amounts towards treatment.

For close to three decades, this achievement has been made possible owing to the generous support of our donors from across the world.

Cancer treatment is long, very painful. What components of that process are covered in SKMT’s pro bono services?

Patients accepted for treatment at the Shaukat Khanum Memorial Trust’s facilities receive comprehensive world-class cancer treatment, regardless of their financial status. This includes all the necessary elements throughout the continuum of patient care—expensive diagnostics, curative treatment, follow-up care after the completion of active cancer treatment, including surgery, radiation therapy, chemotherapy, consultations with specialty services, ICU care and so on, and where required, palliative care to improve quality of life including end-of-life care.

During the period of active cancer care, even pre-existing conditions that the patient may have (e.g., diabetes, high blood pressure and hosts of other medical conditions) are fully covered by the hospital. Even after the completion of active cancer treatment, which can take several years for some cancers, our patients undergo regular follow-up tests and consultations, according to international best practices. All these cancer services, from the beginning till the end of a patient’s cancer journey, are provided free of charge to eligible cancer patients.

During their inpatient stay, all food and nourishment is provided free, of course. Young children coming in for evaluations receive coupons for free nourishment from the hospital cafeteria.

SKMT’s main source of funding is through donations. How does the trust board ensure the complete transparency of every rupee donated to the hospital?

At SKMT, we treat donations and Zakat as a sacred trust, and we take all possible steps to ensure that these funds are utilised for deserving cancer patients. All donations received are recorded, and all donors are issued a formal receipt.

We receive donations from within Pakistan and from overseas, and we are formally registered as a charity in many countries and jurisdictions. The records of all donations to the Shaukat Khanum Memorial Trust in Pakistan and overseas, along with financial details, are duly audited by independent third parties to ensure compliance with all applicable local regulations. This financial audit data is shared on our website every year, and the publicly available information goes back to the hospital’s inception.

Additionally, as I said earlier, we ensure that patients receiving financially supported treatment meet eligibility criteria. Patients who claim to be eligible for Zakat are asked to fill a form, an Iqrarnama.

Patients accepted for treatment at the Shaukat Khanum Memorial Trust’s facilities receive comprehensive world-class cancer treatment, regardless of their financial status. Image Credit: Supplied

The implementation of this entire system, which ensures that every rupee is utilised in line with the eligibility of each patient every time a service is provided during the course of treatment, is made possible through our sophisticated Hospital Information System. This system is fully online and is integrated across clinical and financial domains in a way that every single test, consultation, test, and treatment is documented and linked to a patient, down to the last tablet of paracetamol.

It is pertinent to mention here that the entire amount collected in the form of Zakat is completely exhausted in providing direct patient care within the same year.

Shaukat Khanum Memorial Trust has also received a Shariah Compliance Certificate, confirming that the framework we follow for collection, utilisation, and management of Zakat funds is Shariah compliant and in line with Islamic principles. SKMT is also certified by the Pakistan Centre for Philanthropy for meeting standards in the areas of Internal Governance, Financial Management, and Programme Delivery.

Another example of third-party validation is the Joint Commission International (JCI) Enterprise Accreditation. Based in the United States, the JCI is the global leader for accrediting health care quality and patient safety. JCI Enterprise Accreditation evaluates and recognises health systems that ensure consistency across facilities and multiple care settings through system-wide governance, policies, and procedures. SKMT is one of the two healthcare organisations in the world to have achieved this new Enterprise Accreditation, after demonstrating commitment to patient safety and consistency of quality of care provided to all patients across its network.

Shaukat Khanum Memorial Cancer Hospital and Research Centre in Lahore and Peshawar, and Shaukat Khanum’s Karachi Diagnostic Centre & Clinic are now all JCI Enterprise accredited institutions, which is testament to the excellence of care provided across the SKMT healthcare system.

For you as SKMT’s Chief Executive Officer and the entire medical, administrative, and other staff, is there a particular philosophy that works as motivation to serve in a cancer hospital where most of the patients come from an underprivileged or low-income background?

The philosophy is very simple. This is a place, rare in Pakistan, where all people across the entire social and economic spectrum of the country receive equal and equitable treatment, care, and concern. This mission of providing quality cancer treatment to all our patients, irrespective of their ability to pay, is what drives me personally and my colleagues.

There are no VIPs in our system, other than our patients, each of whom brings with them, to us, an opportunity to serve and make a tiny difference in their lives and a great one in ours.