SWAT: As the government of Khyber Pakhtunkhwa claims to promote its flagship Sehat Card Plus health initiative as a game-changer for poor, patients in Swat and other districts of Malakand division find themselves abandoned in their most desperate hours.

Despite having state-of-the-art cardiac facilities in several private hospitals in Swat, patients in urgent need of heart surgeries are being denied treatment under Sehat Card Plus, forcing them to travel to Peshawar, often without the means to do so. For many, the delay is not just inconvenient, it could be fatal.

Gul Rahman of Shogalai village in Tehsil Kabal stood helpless outside the cardiology ward of Saidu Sharif Teaching Hospital. His teenage nephew had been diagnosed with a serious cardiac condition that required urgent surgery. But the hospital’s Cath lab, a crucial facility for such operations, was out of order.

When he turned to SCP programme for help, officials told him to take the boy to Peshawar. “We don’t have enough money to go there. There are private hospitals here with proper Cath lab facilities, but they say heart surgeries are not allowed on the card in those hospitals,” Gul Rahman told Dawn.

His story is not an isolated one as in a similar case in cardiology ward of the hospital other patients were also faced with the same issue.

Official says private hospitals can be permitted to conduct surgeries if presence of cardiologists ensured

Izhar Khan, a daily wager, was attending to his father in the surgical ward. Like Gul Rahman, he too was asked to shift his critically ill father to Peshawar for a heart operation. “I’m surprised. The health card covers other surgeries in private hospitals. Why not heart surgeries? I don’t understand the logic. I’m now desperately trying to borrow money from friends and relatives to get my father the treatment he needs,” he told this scribe.

Across Malakand division -- including Swat, Shangla, Dir, Bajaur, Buner, Chitral, and Malakand districts -- families echoed similar concerns, questioning the rationale behind exclusion of cardiac procedures from Sehat Card Plus programme in local private hospitals.

Habibur Rehman, another distressed parent, had brought his son from a remote village to Saidu Teaching Hospital, borrowing money just for the travel. He was also told to take his child to Peshawar for surgery. “I have nothing left. Not even enough for transport. What will I do if my son’s condition worsens,” he questioned with tears in his eyes.

Locals say that the policy is not only illogical but cruel. The health card scheme is being praised for offering free treatment across the province, but its failure to cover lifesaving heart surgeries in private hospitals of Swat has created resentment among the poor.

The residents of Malakand division demand that heart surgeries should be allowed in private hospitals where proper facilities exist, so that patients can be treated in their home districts.

Dr Mohammad Riaz Tanoli, the chief executive officer of Social Health Protection Initiative at health department of Khyber Pakhtunkhwa, when contacted, said that private hospitals equipped with Cath lab machines must have cardiologists available for OPD duty at least three days a week.

“However, in those private hospitals in Swat where Cath lab facilities are available, cardiologists are often not present, and those, who perform the procedures usually come from their clinics,” he said. He added that such hospitals would be granted permission when they fulfilled the requirement of presence of cardiologists.

However, doctors in those private hospitals in Swat, where Cath labs are available, said that cardiologists were present on-site or within two to three kilometres, and in case of any emergency, they could arrive immediately.

Published in Dawn, Aug 1st, 2025