SOCIETY: HOW CITIZENS CHANGED JPMC

Published June 15, 2025
A young patient in one of the wards managed by the Patients’ Aid Foundation
A young patient in one of the wards managed by the Patients’ Aid Foundation

While looking around the Jinnah Postgraduate Medical Centre (JPMC) of today, it is difficult to imagine it operating out of barracks. This sprawling facility, now spread over 75 acres and with new buildings coming up, used to be a makeshift hospital for Britain’s Royal Air Force during World War II, with wards and operating theatres inside army-style barracks.

But the hospital has come a long way from its humble beginnings in 1930 — providing medical aid to military personnel exclusively — to becoming, by far, the most-utilised healthcare facility in the public sector across Pakistan. It now offers round-the-clock services free-of-charge to more than 2.2 million patients every year. 

The over 2,200-bed facility has buildings housing various departments, of which some are entirely government-run and while others are run in collaboration with the Patients’ Aid Foundation, a non-profit charitable entity that was set up in 1990. Over the years, the private Foundation has funded over 20 departments, including one that it set up and manages on its own: the Cyberknife Robotic Radiosurgery section, used to treat tumours and other conditions with non-invasive, precise radiation therapy.

The largest public sector healthcare facility in Pakistan, the Jinnah Postgraduate Medical Centre in Karachi, provides services free of charge to more than 2.2 million patients a year. Its ongoing transformation into a state-of-the-art facility has been facilitated by a model of public-private partnership, via the Patients’ Aid Foundation…

Exterior of the Cyberknife and Tomotherapy department at JPMC in Karachi
Exterior of the Cyberknife and Tomotherapy department at JPMC in Karachi

HELPING THOSE WITHOUT HOPE

One of the patients at the Cyberknife Robotic Radiosurgery section is 34-year-old taxi driver Enayatullah from Kabul, Afghanistan. Despite being his family’s sole breadwinner, Inayatullah had to leave his wife and five children back home in Afghanistan to come to Pakistan in search of a cure for the sagging right side of his face. “I spent months seeking medical help in Kabul, until it was suggested that I travel to Pakistan,” he tells Eos.

In Pakistan, Enayatullah was diagnosed with glomus jugulare disease at a private hospital. He had a rare tumour in his jugular foramen (an irregular opening at the base of the skull). The treatment cost was estimated to be around Rs2.1 million, which was raised through the generosity of friends and family and by taking out loans.

Following treatment at the private hospital in Karachi, Enayatullah returned to Afghanistan thinking that he had been healed. But he soon realised that that wasn’t the case and misunderstandings regarding his follow-up treatments led to a resurgence of his symptoms. By then, though, he had no money left.

One and a half years passed and Enayatullah felt trapped and alone. Then, a friend in Karachi suggested he visit the Cyberknife facility at JPMC. Enayatullah then made another trip to Pakistan, and Karachi, where he underwent Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans.

The scans confirmed Enayatullah’s diagnosis and the Cyberknife team meticulously planned his treatment, using specialised protocols. Each session lasted 37 minutes, as part of a five-fraction treatment option, in which five sessions take place over a week.

The machine used in treating Enayatullah was equipped with advanced technology that captured images of his position every five seconds, ensuring accuracy throughout the treatment. “If I moved even slightly, the machine would stop,” Enayatullah says. “I also did not feel any pain during treatment.”

Fully recovered now, Enayatullah is happy to report that he is going back home, where his family needs him. “I’m a poor man, I could not afford private treatment,” he says. “While I was here in Pakistan, even my family’s groceries were bought on loans,” continues Enayatullah, adding that he was worried what would become of his family if something were to happen to him.

“I can never thank the staff and generous donors of the Patients’ Aid Foundation, who run the Cyberknife department, enough. They didn’t just treat me, they saved my life,” he says.

A patient undergoes a procedure at the Cyberknife Robotic Radiology section
A patient undergoes a procedure at the Cyberknife Robotic Radiology section

BUILDING ON THE GAINS

The Cyberknife Robotic Radiosurgery section started in JPMC in 2012. At the time, they had fourth generation machines that were able to treat six to eight patients in a day, as it took 45 minutes per session.

Over the years, newer equipment was imported, including the Equinox in 2016 — which is part of the treatment planning system used for highly precise radiation therapy plans for the Cyberknife — a positron emission tomography (PET) CT scanner in 2017, a second Cyberknife in 2018, a tomography (Radixact X-9) unit I in 2020 and unit II in 2024. 

With the new top-of-the-line Cyberknife (S7 FIM), which arrived at JPMC in 2024, the treatment time for one patient has gone down to 15 to 20 minutes, allowing 25 to 30 patients to receive treatment every day.

Before the Cyberknife facility, the JPMC had gamma knife radiosurgery, which was used only for brain surgery. But with the Cyberknife department, they can carry out spine, lungs, liver, prostate and pancreas radiosurgery in addition to that for the brain. 

The procedure involving the Cyberknife kills the tumour in the shortest duration while giving the highest dose of radiation. But for bigger tumours or oral cancers, you can’t give such high doses. In that case, radiotherapy or tomotherapy is recommended.

In the tomotherapy section, right across the cyberknife department, is a machine that resembles a normal CT scanner. It is actually a linear accelerator machine, designed to destroy cancer cells while sparing surrounding healthy tissue. The linear accelerator handles 50 to 55 patients a day. The treatment time varies from three to five minutes.

There is also the PET CT section, which estimates cancer staging and follows up on the patients’ response to treatments. The section’s manager, Rab Nawaz says that it is the standard imaging technique the world over.

“The standard cost of one PET scan is around 80,000 to over one lakh [100,000] rupees. And for follow-ups on treatment, there are at least five scans done in one year,” explains Nawaz. “That means expenses of over 500,000 rupees in a year. But we provide it for free here,” he tells Eos. “A PET scan will tell us which patient needs what treatment first,” he adds.

A radiology technologist stands over a patient undergoing a PET CT scan, with results visible on the monitor in adjoining room | Patients’ Aid Foundation
A radiology technologist stands over a patient undergoing a PET CT scan, with results visible on the monitor in adjoining room | Patients’ Aid Foundation

JPMC AND PATIENTS’ AID FOUNDATION

Marium Kamran, who heads the resource mobilisation department at the Patients’ Aid Foundation, says that the department currently has two Cyberknife machines that, she tells Eos, allows them to manage the volume of patients for now. “There is no waiting list. We call patients by appointment after carrying out diagnostic tests, which are also done here before the actual treatment,” she says.

Marium also explains how the Patients’ Aid Foundation works in collaboration with the JPMC, which is run by the Sindh government and has its own staff. “We came to JPMC in 1993 and offered four basic things — infrastructure, machinery, staff and healthcare,” she points out.

At that time, the hospital had old and dilapidated buildings housing various departments, continues Marium. “But the most visible changes that you see here happened in the last 12 to 14 years,” she adds. 

Those include the setting up of an out-patient department (OPD) and surgical complex, which is run by the Foundation. “There is a normal oncology department, run by the JPMC, and there is the robotic surgery side, with Cyberknife and the tomotherapy section, which is run completely by the Patients’ Aid Foundation,” Marium adds.

Although the oncology department is run by the government of Sindh, Marium points out that the Patients’ Aid Foundation supports it through the construction of buildings, providing it with machinery and equipment and by taking care of treatment costs. “We also sponsor chemotherapies,” she tells Eos.

The Foundation also helps the JPMC with fundraising, with funds raised from a recent golfing event diverted towards the oncology department of JPMC, says Marium. “Similarly, we organised a cycling event for funding the treatment of thalassemia patients,” she adds.

Marium explains that, even though the Cyberknife procedure is used for cancer treatment, it is only after assessing whether the cancerous growth is eligible for treatment using it. “If the cancer is in the first stage or is in the form of a tumour, which is approved for treatment through Cyberknife, the patient will be brought here,” she says. “Those not eligible for the Cyberknife treatment are referred to JPMC’s oncology department,” Marium points out.

While radiology treatment is free at JPMC, in some cases such as MRI or CT scans, there is some cost involved. “For the patients who cannot afford that fee, the Patients’ Aid Foundation has a healthcare department for support,” Marium continues. “Besides sponsoring treatments, this department also provides free-of-charge medicines,” she adds.

The support to JPMC can also be extended on an ad hoc basis, says Marium. By her estimation, some 12,000 patients visit the sprawling facility every day, and the resources are routinely stretched. “Whenever there is a need of staff, from consultant to guard, the Patients’ Aid Foundation also provides such staff to JPMC and helps in paying their salaries also,” she concludes.

A newborn is handed over to the parents at the gynaecology ward
A newborn is handed over to the parents at the gynaecology ward

HOW IT STARTED

Mushtaq Kassim Chhapra, the driving force behind the Patients’ Aid Foundation, is a known philanthropist who has the experience of navigating complex government processes to deliver service. He makes it a point to ask his interlocutors not to refer to his Foundation with its acronym. “Using ‘PAF’ for the foundation may cause confusion between us and the Pakistan Air Force,” he tells Eos only half-jokingly.

Chhapra adds that his charity has been working in JMPC for over three decades, as part of a public-private partnership (PPP) with the Sindh government. Referring to the arrangement as ‘PPP’ again prompts Chhapra into pausing. “It may cause confusion between us and the Pakistan Peoples Party,” he says smilingly.

Basically an industrialist, Chhapra turned to philanthropy back in 1985 with the construction of The Kidney Centre in Karachi. “We were a group of friends who used to sit together and lament about the problems of the people, until we decided to do something about it all,” Chhapra says.

“When The Kidney Centre was successful, we set up the art school, the Indus Valley School of Art and Architecture,” he continues. In that, the architectural firm Arshad Shahid Abdullah also played an important role, he adds. “Starting something for the benefit of others and making sure that the good work carries on can become a passion,” he says with a smile.

“It was around the early nineties, 1991 or 1992. The executive director of Jinnah Hospital, Dr I.H. Bhatti, told us about a problem they were facing with their blood screening service,” says Chhapra about the origins of his foundation. “We sorted out that problem within six months, to match the standards of the World Health Organisation,” he continues.

With the solution in place, Chappra felt his involvement with the hospital was over. “But it doesn’t happen like that,” he continues. “When you begin something, you are pulled into the running of it,” Chhapra points out. “Now, we have been in this hospital under the PPP-model partnership for the last 31 to 32 years,” he adds.

In between, in 1995, agreeing that education was the key to solving a wide range of social problems, the same group of friends joined hands again to come up with The Citizens Foundation schools, now one of the largest privately managed networks of schools in the world.

Just like that successful endeavour, the transformation of the Jinnah Hospital is also proceeding apace in very positive terms.

The Foundation’s doctors during a procedure in the modular operating theatre
The Foundation’s doctors during a procedure in the modular operating theatre

FUTURE PLANS

The Patients’ Aid Foundation continues to expand its operation and services, including the construction of the Sardar Yasin Malik Medical Complex at the JPMC premises, a 12-storey medical tower with more than 500 beds, and a two-storey OPD complex, through donations amounting to over $22 million. “The structure of the medical complex is complete and it should be operational in 2026,” says Chhapra.

Another seven-storey building, the Rabia Rashid Soorty Building, will be connected to the medical tower. It is being constructed at a cost of around $2 million dollars, adds Chhapra. This special ward will have around 60 private rooms for those getting treatment at the hospital, he continues, which will then be handed over to the JPMC administration.

Chhapra explains that the existing special ward is currently located next to the Cyberknife department. “The Sindh government has agreed to hand over the land of the current department to us at a future date, to set up a cancer institute,” he says.

“The private sector takes care of the expenses, while the government provides the manpower and equipment. It is quite a healthy arrangement and things are functioning very smoothly this way,” Chhapra explains.

“We are very mindful of how we spend donor money, which comes from Karachi’s civil society and many business houses,” Chhapra continues, adding that the Foundation is very mindful of using the funds only for what they are meant for. “That’s why the Patients’ Aid Foundation is directly involved, in partnership, with the administration of JPMC,” he says.

The Foundation is also deeply involved in thalassemia treatment, including having set up a blood bank for thalassemia patients. The Foundation has equipped an entire building dedicated to thalassemia patients, with the doctors provided by the government.

Similarly, the gynaecology ward at the JPMC has also been completely revamped by the Patients’ Aid Foundation, with a new labour room, operation theatre, emergency department and a neonatal intensive care unit.

All of this only goes to show what all can be achieved when the government and concerned citizens come together, with sincerity and a clear vision.

The writer is a member of staff.
X: @HasanShazia

Published in Dawn, EOS, June 15th, 2025

Opinion

Seizing the moment

Seizing the moment

The provinces bear the primary responsibility for improving access to family planning services, particularly for poorer families.

Editorial

PIA privatisation
Updated 11 Jul, 2025

PIA privatisation

While it does give the privatisation authorities a much-needed head-start, it will not be sustainable unless preceded by policy and regulatory reforms.
Beyond expectations
11 Jul, 2025

Beyond expectations

THESE are tough times, but the country is lucky enough to still be considered home by a large expatriate workforce,...
Train in vain
11 Jul, 2025

Train in vain

TALK of ‘revival’ of the long-dead Karachi Circular Railway has turned into a running joke for denizens of this...
No negotiations
10 Jul, 2025

No negotiations

IT seems like the appeal from Kot Lakhpat Jail has fallen on deaf ears. “[…] The time for negotiations has...
Speech policing
Updated 10 Jul, 2025

Speech policing

Sweeping accusations have once more exposed just how broadly and arbitrarily Peca is being applied.
Continued detention
10 Jul, 2025

Continued detention

THE continued detention of BYC head Mahrang Baloch and five other activists indicates that the state is uninterested...