HEALTH: BRINGING ‘DR BAHU BACK TO WORK
Hussain Dada
Published April 20, 2025
DAWN
A doctor, with her child next to her, provides remote video consultation as part of the eDoctors project | EducastDr Adeya Ahmed comes from a family of doctors. After completing her five-year MBBS degree from the Karachi Medical and Dental College in 2011, she started her house job at a local hospital.
Two years later, she got married and, as happens with a disproportionate number of female medical graduates, Dr Adeya opted to take a break from her career to “focus on her family.”
For the majority, this break can stretch interminably. It can be for a variety of reasons, ranging from personal preferences — as was the case with Dr Adeya — to family restrictions, societal expectations of traditional gender roles and challenges within the healthcare system, such as long and odd hours without commensurate pay.
A collaborative research by Gallup Pakistan and Islamabad-based PRIDE Consultancy, based on the 2021 Labour Force Survey of the Pakistan Bureau of Statistics, found that 35 percent of the 104,974 female medical graduates in the country at the time were either unemployed or had opted out of the labour force.
Professor Jahanara Hassan, who is the pro-vice chancellor at the Dow University of Health Sciences (DUHS), echoes these findings. She tells Eos that, in a batch of 500 MBBS students, around 70 percent are women. “Of these women, roughly around a third end up not practising,” she says.
A significant number of female medical graduates end up not practising medicine, wasting educational investments and further burdening Pakistan’s fragile healthcare system. But one digital education and healthcare platform is determined to change that…
At least one third of medical students — of both genders — also aspire to practise abroad, which contributes to the healthcare crisis in Pakistan. According to one article published in The Lancet in 2013, Pakistan’s health system: performance and prospects after the 18th Constitutional Amendment, the doctor-to-patient ratio was estimated to be around 1:1,524, significantly less than WHO’s recommended ratio of 1:1,000.
THE POTENTIAL OF TELEMEDICINE
Dr Adeya is now among the roughly 1,500 female doctors who have returned to medical practice. They started as part of the eDoctors project of Educast, a Karachi-based social enterprise which started as a virtual education platform in 2016, before expanding to digital health and training.
The idea was to bring back women who had left medicine, sometimes referred to as ‘doctor bahus [daughters-in-law]’, back into the workforce, says Abdullah Butt, Educast’s founder and chairman.
Educast rolled out the eDoctors pilot programme in 2018, with the help of DUHS, and Dr Adeya was one of the applicants. “We had expected 15-20 queries, but we received 350 applications,” Butt tells Eos.
They selected 280 applicants, who went through a rigorous, albeit flexible, six-month online refresher course, designed in coordination with DUHS and sat through an exit exam.
This worked for Dr Adeya, who could keep track of her toddler at home while taking the course. This flexibility also allowed Dr Faizah Ayub — who graduated in 2000 and is now living in the Middle East with her family, including four children — to return to medicine.
Both women say that they had kept in touch with developments in the healthcare field, which facilitated their reintegration. It also helped that their families were supportive, they pointed out in separate phone interviews with Eos.
But it wasn’t all easy going.
Butt, who is in his sixties, points out that the applicants ranged from people who had graduated in the 1980s to those who had passed out only a few years ago. “Some applicants lacked the digital know-how required to take part in online sessions,” he tells Eos.
There was also the issue of clinical experience, with successful candidates paired with clinics. For doctors based abroad, Educast has to organise ‘shadowing sessions’ in Pakistan — in which the out-of-workforce doctor observes a practising doctor in person and ask questions about patient handling for hands-on experience — during the candidates’ visit to the country.
It was challenging, continues Butt, before adding that their efforts were surely bearing fruit, as their graduates started providing medical services.
Then came the pandemic.
Abdullah Butt, the founder and chairman of Educast, stands before a panaflex backdrop in his office, with photos of the 1,500 reintegrated female doctors | Photo by the writer
THE COVID FILLIP
As the world went into lockdown mode in the face of an inexplicable virus, the demand for medical expertise skyrocketed.
In 2020, the Educast team volunteered its services to the Sindh government, training 450 such female doctors, who went through a Covid-19 specific course designed by the Stanford University School of Medicine. “For the next two years, these reintegrated women doctors monitored and treated Covid patients remotely, with 500,000 patients benefitting from their voluntary service,” states Butt.
Butt points out that most doctors are paid a nominal retainer. “For those working part time — which is four hours a day, four days a week — we pay at least 30,000 rupees,” he says. For those putting in more hours, the remuneration goes up substantially.
However, some of them also volunteered their services.
“I studied medicine because I wanted to help people,” says Dr Adeya. “The blessings I receive from my patients are enough,” she continues.
The investment in telehealth and developing a cohort of medical practitioners has since given Butt his just rewards.
GETTING BIGGER BY THE DAY
Also in 2020, eDoctors was selected from among 5,000 projects in a competition organised by the Islamic Development Bank (IsDB). This allowed Educast to scale up their projects, from remote consultations and interventions to rapid tests for diagnostics, and to make the remote online clinics available on doctors’ smartphones. This includes 16 types of blood and urine rapid tests, including for cholera and Covid-19.
Today, reveals Butt, their 1,500 doctors are spread across 27 countries and providing remote medical services in 11 countries, including partnering up with local organisations in sensitive or fragile states with poor health infrastructure, such as Yemen, Sudan, Somalia, Afghanistan, Syria and Palestine.
“In Yemen, we have been operating for the last three years, providing training to doctors and paramedics,” he tells Eos. In remote areas, paramedics are provided telemedicine equipment to monitor patients and gather their biomedical data, to be shared with overseas experts to provide assessments and treatment, he continues.
“We are probably the only company in the world using technology, artificial intelligence-based healthcare platforms, and robotic interventions to fetch data,” Butt adds.
Similar projects are underway in other countries, with the support of the IsDB and the Organisation of Islamic Cooperation, who were instrumental in setting up the Afghanistan Humanitarian Trust Fund.
With their support, Educast carried out a pilot project in six Afghan provinces last year. During the project, 1,000 consultations were provided, benefitting 5,000 individuals, reveals Butt. “Educast also trained 1,500 local healthcare professionals and work on setting up 20 medical education facilities is underway,” he adds.
GOING FULL CIRCLE
Butt’s latest intervention is focused on elderly care, for which his company has partnered with local universities, which require their students to undergo mandatory community service. Students of participating universities are required to spend time with elders — for now of their own families.
Butt says it has benefitted both parties, with the interaction between students and their elders — usually grandparents. “The youth learn new things about themselves, their families, and are better prepared for their future, while the senior citizens feel reinvigorated,” he says.
Butt’s drive for the elderly care project appears to come from the same place that made the eDoctors project a success: remembering the value and skills of those who are in the process of being phased out by society.
For Dr Adeya, now 38, the project served as a catalyst not only to re-enter the workforce and pursue her passion, but to also build on her skills. Last year, she completed her MCPS in Family Medicine, a postgraduate programme offered by the College of Physicians and Surgeons in Pakistan.
She aspires to achieve more in her career and is already working as a family physician. For that, some of the credit surely goes to Abdullah Butt and Educast.
*The writer is a member of staff. He can be contacted at hydada@gmail.com
Published in Dawn, EOS, April 20th, 2025
THE COVID FILLIP
As the world went into lockdown mode in the face of an inexplicable virus, the demand for medical expertise skyrocketed.
In 2020, the Educast team volunteered its services to the Sindh government, training 450 such female doctors, who went through a Covid-19 specific course designed by the Stanford University School of Medicine. “For the next two years, these reintegrated women doctors monitored and treated Covid patients remotely, with 500,000 patients benefitting from their voluntary service,” states Butt.
Butt points out that most doctors are paid a nominal retainer. “For those working part time — which is four hours a day, four days a week — we pay at least 30,000 rupees,” he says. For those putting in more hours, the remuneration goes up substantially.
However, some of them also volunteered their services.
“I studied medicine because I wanted to help people,” says Dr Adeya. “The blessings I receive from my patients are enough,” she continues.
The investment in telehealth and developing a cohort of medical practitioners has since given Butt his just rewards.
GETTING BIGGER BY THE DAY
Also in 2020, eDoctors was selected from among 5,000 projects in a competition organised by the Islamic Development Bank (IsDB). This allowed Educast to scale up their projects, from remote consultations and interventions to rapid tests for diagnostics, and to make the remote online clinics available on doctors’ smartphones. This includes 16 types of blood and urine rapid tests, including for cholera and Covid-19.
Today, reveals Butt, their 1,500 doctors are spread across 27 countries and providing remote medical services in 11 countries, including partnering up with local organisations in sensitive or fragile states with poor health infrastructure, such as Yemen, Sudan, Somalia, Afghanistan, Syria and Palestine.
“In Yemen, we have been operating for the last three years, providing training to doctors and paramedics,” he tells Eos. In remote areas, paramedics are provided telemedicine equipment to monitor patients and gather their biomedical data, to be shared with overseas experts to provide assessments and treatment, he continues.
“We are probably the only company in the world using technology, artificial intelligence-based healthcare platforms, and robotic interventions to fetch data,” Butt adds.
Similar projects are underway in other countries, with the support of the IsDB and the Organisation of Islamic Cooperation, who were instrumental in setting up the Afghanistan Humanitarian Trust Fund.
With their support, Educast carried out a pilot project in six Afghan provinces last year. During the project, 1,000 consultations were provided, benefitting 5,000 individuals, reveals Butt. “Educast also trained 1,500 local healthcare professionals and work on setting up 20 medical education facilities is underway,” he adds.
GOING FULL CIRCLE
Butt’s latest intervention is focused on elderly care, for which his company has partnered with local universities, which require their students to undergo mandatory community service. Students of participating universities are required to spend time with elders — for now of their own families.
Butt says it has benefitted both parties, with the interaction between students and their elders — usually grandparents. “The youth learn new things about themselves, their families, and are better prepared for their future, while the senior citizens feel reinvigorated,” he says.
Butt’s drive for the elderly care project appears to come from the same place that made the eDoctors project a success: remembering the value and skills of those who are in the process of being phased out by society.
For Dr Adeya, now 38, the project served as a catalyst not only to re-enter the workforce and pursue her passion, but to also build on her skills. Last year, she completed her MCPS in Family Medicine, a postgraduate programme offered by the College of Physicians and Surgeons in Pakistan.
She aspires to achieve more in her career and is already working as a family physician. For that, some of the credit surely goes to Abdullah Butt and Educast.
*The writer is a member of staff. He can be contacted at hydada@gmail.com
Published in Dawn, EOS, April 20th, 2025
Pakistani and Palestinian flags are hoisted at D-Chowk in Islamabad amid the Jamaat-i-Islami’s ‘Palestine Solidarity March’ on April 20. — Umar Bacha
