Sara Saeed Khurram, M.D. is the Co-Founder and Chief Executive Officer of Sehat Kahani. Sehat Kahani works on improving basic health care in communities through a spectrum of services focused on primary health care consultation, health awareness, and health counseling. Dr. Sara Saeed recently won the APTECh Young Entrepreneurs award for Sehat Kahani, and her work was also featured in a BBC documentary (see below).
Dr. Sara Saeed Khurram has won notable awards including CRDF Global, Ashoka Changemakers, ISIF Asia, the Unilever Sustainable Living Young Entrepreneurs Awards, and the Unicef-Global Goal Campaigner Award 2016 for her role formerly with doctHERs. She has been part of a well-known accelerator in Pakistan, Invest2 Innovate. She is also a part of the regional Acumen fellowship cohort 2016.
Dr. Sara Saeed Khurram grew up in Karachi, Pakistan. She completed her MBBS from DOW University of Health Sciences, and she is a graduate of the Health Policy Management Programme at The Aga Khan University of Health Sciences.
A Couple Quotes From This Episode
About the 2022 ILA Healthcare Conference
Resources Mentioned In This Episode
About The International Leadership Association (ILA)
Connect with Scott Allen
Note: Voice-to-text transcriptions are about 90% accurate
Scott Allen 0:01
Okay everyone, welcome to Phronesis thanks for checking in today, I have Dr. Sara Saeed Khurram, and she is the co founder and chief executive officer of Sehat Kahani . Sehat Kahani works on improving basic health care in communities through a spectrum of services focused on primary health care consultation, health awareness, and health counseling. Dr. Sara Saeed recently won the APTECh Young Entrepreneurs award for Sehat Kahani, and her work was also featured in a BBC documentary. Dr. Sara Saeed Khurram has won notable awards such as CRDF Global, Ashoka Changemakers, ISIF Asia, the Unilever Sustainable Living Young Entrepreneurs Awards, and the Unicef- Global Goal Campaigner Award 2016 for her role formerly with doctHERs. She has been part of a well-known accelerator in Pakistan, Invest2 Innovate. She is also a part of the regional Acumen fellowship cohort 2016. Dr. Sara Saeed Khurram was born and bred in Karachi. She completed her MBBS from DOW University of Health Sciences, and she is a graduate of the Health Policy Management Programme at The Aga Khan University of Health sciences. Dr. Sara enjoys travel music. And she spends a lot of time with her two daughters who are eight and three, she has an incredible TED Talk, which you will find a link to in the show notes. She's referred to herself before as a doctor printer, which I love. I had not heard that terminology before. And she's very, very interested in health tech. Dr. Sara, thank you so much for being with us today. What did listeners need to know more about you? Thank you, Scott.
Sara Saeed Khurram 1:55
Thank you for having me here. So I come from a traditional middle-class family in Pakistan. I'm the youngest of two brothers; I became a doctor at 24. And I got married at 24. I had my first daughter when I was 26. And the second one that I was 31. So I'm a mother of two girls, I am a person who doesn't like things the way they're spelled out for someone. So I like to make my own way. I'm a problem solver. I like problems. I like to solve them. I'm a strategy and an operations person. So I like making strategies and implement them. I also am a person who will take feedback and accept failure when it is there. And my team and my colleagues and my peers and my friends, they call me a kind of perfectionist because I like doing things in a particular way. And I like making sure that they're done 100% Perfection. And I think at the end, I'm someone who really feels that the way healthcare is given in Pakistan it's a big challenge. And I do believe that technology has to play a big role in fixing the healthcare issues in Pakistan. And that's what I've committed my life to creating solutions and primary health care through technology and using an underutilized network of female doctors.
Scott Allen 3:14
So let's talk about that. Let's talk about your passion. In the TED talk, you cite some statistics, which were pretty staggering. Talk about some of those statistics and share those with listeners. And so they have some context and some framing. And then and then maybe let's talk about some of the early days of your work, and how you work to solve.
Sara Saeed Khurram 3:33
So Scott, I mentioned, I was born in a in a very traditional middle class family in Pakistan. And that has been a very relevant part of what I do today. Because in Pakistani middle class families, their parents save up for the children education, if they have a daughter, you will see 80 to 90% of times they would want their daughter to become a doctor that has a huge relevance in Pakistan. Pakistan is primarily a patriarchal society, women are not, they're not allowed to work or it's looked upon when they work because it you know, it kind of precedes the cultural boundary that we have. So women generally are homemakers and who work in the major part of our society. When I was growing up, and I was the youngest of three brothers at the age of five, my parents told me that you have to become a doctor because they thought that if I do become a doctor, I'll be socially respectable. I'll be joining a noble profession, which everyone around me with like society would, would put me on a higher social credit score. And at the end of it, I would get a better hand in marriage, doctors in Pakistan, female doctors a couple it with being tall and pretty and fair. They get the best handled managers kicked out and sought after by all the men and the men mothers. And majority of the time you have arranged marriages so you know, it's fixed by the family. So with this thought, and you know, with this history, I went into medical college and getting into Medical College is very hard. You have to study a lot. Eight, nine years of your life into medical school in Pakistan. And I went to medical school, I saw that my class was 90% female and 10% men. And what do you have those woman, my peers, my peer students had gone in with the same thought with their parents asking them to become a doctor or they wanted to become a doctor, because it's a noble profession, but be somewhere it gets you a better hand in marriage. And as we started passing through medical years, just six years, I saw that the girls who were taking positions and were very ambitious, they have to serve the communities of the society. They started getting married, they started having children, and they kind of started to drop off. And the entire vision in life from becoming a doctor became getting that degree, putting it on a wall, and then becoming a homemaker. Sometimes it was cost. And sometimes the decision was taken by the person themselves because of societal pressure. When I graduated, I also became a doctor. My parents got me married off one year after my graduation, and three months after my house dropped, which is the practical part of medicine that you have to do after you graduate. And I had an arranged marriage completely. But I was different because I was very ambitious, and I wanted to work. So I enrolled myself straight off in a residency program. And my husband in mind was very supportive. But I got pregnant in the first year, and I had to leave because I was doing it in radiology. And to kill time, I started working in a clinic in a small community in my city, Karachi. I did that throughout my pregnancy, I carried that project as as a project manager as well, at that community clinic. And then, after my child's birth, one month after my child's birth of my first daughter, we moved to Lahore which is another city in Pakistan with my husband, because he got a promotion. Nice job. Now I'm all my life I had either studied or worked. I came from a working resident to a working Doctor into a house, which is huge for two floors, with the one month old daughter. And now I had to become a doctor bright in reality, because I had to look after the house, I had to look after the baby, I couldn't leave her at anyone. And suddenly, I realized that I have to become a doctor cried, that just pushed me very deep into postpartum depression, because I had never imagined myself being in a house and not being able to work. And it didn't seem at that time that I would be able to go back. And I used to be lost in my day what to do. But then I started working, I started writing some research papers, I started writing a one day I got a call from the nurse that I used to work with in the clinic in my original city, Karachi. And she said that, you know, we have a lot of patients coming in, and they're not able to find a doctor in this community because it was a politically polarized community at that time, and not that safe for female doctors to go to. So she said, What should I do? So I had to kill time she had a problem. So I said, Okay, I'll see patients on call, you know, just give me a call whenever a patient comes in, and I'll see them and late, because that nurse was also young, and she had a laptop, she stuck a camera on top of her laptop, to small camera webcam, and I started to do video calls for patients. And I realized, and I discussed it with the next partner and we realized that you know, I'm sitting in one city, the patient is in a community clinic in another city. All it took was a laptop and an internet connection for me to see a patient from one city to another city. Yes. Okay. In the mobilize all those female doctors in Pakistan, I will give you some stats to give you tell you the gravity of the situation, please. What is it two 220 million population by the fifth largest population in the world, you have so many people, half of our population 110 million people never get to see a doctor in their lifetime. That's a stat. Wow, half half 110 million people. And for that population for two 20 million people, we have 250,000 doctors so we have one doctor for 1000 patients, which is the minimum who standard 80% of our medical workforce is female. And only 40% of the number works rest all become doctor brides sit at home don't work. And additionally 15% of doctors go out of the country to better work opportunity. So they immigrate to us to UK for getting their postgraduate degrees. So in actuality, in Pakistan, there are 90,000 doctors for 220 million people. That means there's half a doctor but 1000 patients Wow. And even those doctors 85% work in urban areas. 160 3% of Botsman lives in rural areas. So health in Pakistan is absolutely non equitable for patients. So while I had seen a lot of Doctor brides in my college, when I was doing my house job, I had also seen that a lot of patients came to a major tertiary care hospital in Karachi in Karachi is the biggest city of Pakistan just to die comfortably because their primary care issues had become so worse that when they came into the hospital with with with those issues, they couldn't be here. It could just be managed. So I always knew that a patient not having a doctor in their community is very directly linked to a lot of doctors not working in Pakistan. So I started to write about it, I wrote up a startup idea. And I pitched it in a grant. And I got a grant, I pitched it in Nepal, it was competition between 10 countries, I was a doctor, I'd never pitched before, no idea of how business works, no idea how business models are made. I just made a pitch. And I went there, and I pitched it. And I got, I won the first prize, and I bought a brand. Now when I got a grant, I realized that "Oh, my God, someone has trusted me with this pool of money, I need to get a company out of it." So I came back, came back to my parents city, so that my parents can help look after my daughter. And I started working on this idea. Wow. And the initial idea was that we find clinics in low income communities where nurses are sitting, but patients eat a doctor. And we train that nurse through a software so that when a patient comes into that clinic, that nurse connects the patient will online doctor. Now I was one person, and I found a co founder. And it was just two or three of us, I had a desk at best. And I started working on this company. And because I had no knowledge of how to run an entrepreneurial venture, I thought that what should I do, because I had trained to be a doctor. And in my country, doctors have no knowledge of business at all. They're miles away from it. Then I learned you know, I participate in a lot of accelerator programs, I started seeking out mentors, I made a business plan, I made a financial model, I made sure that you know, everything is being done in a way that this is this could be scaled and not just dies off as a one plan guide. So we started making a chain of clinics, and it was pretty it was going pretty okay, we were expanding across Pakistan, we got doctors, but female doctors working with us, my team grew to eight or nine people. And then me and my co founder realized that why do we only have the solution for low income communities? There are so many of Pakistani people live in Peri urban urban areas as well and still can't see a doctor, why are we only limiting our solution to low income areas. At this point, in 2017 18, mobile phones became mobile phone adoption became big in Pakistan, lot of apps started coming in. So we created a version of our software that we use in clinics in the form of a mobile application as well. What we had learned by interestingly, in our clinics is the biggest high that a patient got the aha moment that a patient got was when they traveled to a clinic in their community. And they got instantly connected to a doctor. So they didn't have a wait time. They didn't have to travel outside the community. So on our app, and this is something that no other app and box on has, we created an instant consultation option. Anyone who downloads our app today gets connected to a doctor in less than 60 seconds. So there is no waiting time, there are a lot of doctors available, and you can instantly connect to a doctor doctor and get a consultation. And that's how the attorney does today, we have a network of clinics for low income communities. And we have a mobile application for mass users. This mobile application is used by almost a million users today. And we also give it to corporations for b2b champion and a lot of corporations in Pakistan loser for their employees. And
Scott Allen 13:23
It's an incredible story. And how many how many lives? Have you touched in this process? would you estimate at this point? Both physicians that potentially you've brought back into the fold, because I imagine some of the physicians you've partnered with? Maybe were some of those women who were no longer practicing. Is that accurate?
Sara Saeed Khurram 13:43
Yes, so we have a network of 7000 doctors today. 90% are women 10% Are men because we needed male doctors for some of the issues that have a cultural boundary in Pakistan to be addressed. 30% of our total 10,000 workforce is actually female doctors that we brought back, and retrained and put back into the system. So very proud about that. And you know, it has been a phenomenal journey, because some of these stories are very grave. You know, we had a doctor who was facing physical and mental abuse at home, and she was society. And you know, when she came to our, into our network, she slowly regained her self esteem or self respect. She started working on the platform, then she started working physically as well. So when a doctor loses her ability to work by force or by guilt, it also really impacts your mental health, your emotional health, because you've given so much to become a doctor. Yeah, I'm glad you're able to put some of these doctors back to work. And through our platform, we've till date seen almost 930,000 patients on the platform, including our clinics, as well as patients on our mobile application.
Scott Allen 14:58
So Sara, what I'm really interested sit in. I mean, obviously, incredible work, obviously, you saw an opportunity. Obviously, if half the population does not have access to a health to health care, there's an incredible opportunity there to make a wonderful impact in the world. And you've done that. Talk about the process of influencing others to be engaged in this work of building that team, mobilizing others to see your vision, because like you said, you know, writing a business plan, they don't teach that in medical school. And nor do they probably teach, you know, influencing others and really mobilizing large factions of people to see your vision and be excited about your vision. So would you talk a little bit about that process of leading because I find it fascinating. It's just such a beautiful, I got goosebumps, as you were telling the story. Thank you for the work you do. It's incredible.
Sara Saeed Khurram 15:54
Thank you. Thank you. I think it's, I think if you asked me what has been my biggest challenge in life is proving myself as a leader. In a country, which is predominantly patriarchal, and very male dominated. Even today, you can count female entrepreneurs on fingertips in Pakistan, very little of women generally don't make leadership positions. They're stuck in that muddy managerial position, because that is a time when they're having children, they're making their family grow. And generally, I don't think we accept female leadership as comfortably as we accept me, Michelle, and me and we are a female founder driven companies were two female founders and a very headstrong, independent, strong woman. So that generally also doesn't sit well with a lot of circles that we work with. But I think, Scott, a lot of it has to come with my own family. Although my parents were very traditional. And I was the youngest of two brothers. I think from the very beginning, they gave me this confidence, and I'm no less than a man. As I entered into business, I got so many shut doors. When I told people initially that we're creating a female doctor network to solve healthcare issues in Pakistan, people laughed at me, people said, this is not possible. No one will leave telemedicine healthcare is very healthcare was very physical in Pakistan. So they thought that until a doctor checks a pulse of a patient, there is no health care, so many myths to fight, as we were, as you were expanding our network, people always pushed us and said that you are an NGO, you know, although we're a for profit company, but that image of a female leader leading an NGO, or a software image is so much easier to accept than a female entrepreneur running a tech business. So when we created a chain of clinics, and me and my co founder thought of making an app, all advisors, all mentors, all friends told told us not to do it, because he thought they said that, oh my god, you do such beautiful work in the communities just keep doing that. Why do you need to create a tech business? Why do you want to create a commercial business out of it? So it was very difficult to make people understand that we are impact business, where we are doing a business for social work. But I think one thing that has really worked for us is persistence, and perseverance. You know, we have worked on it for the last five years of our lives. And every day as as me and my co founder come to work. It almost feels like we fall in love with our work everyday. You know, in COVID When COVID came in Pakistan because they have the honey app was one of the few telemedicine apps that were existing in the country. We got picked up very early by the government to be launched in primary health care for people in lockdowns to be launched in ICUs across Pakistan to connect to senior critical care specialists, it gave us a big boost. And we were the first one that they reach out to that okay, we need to give it to everyone and knock down into give it an ICUs and while other people were enjoying gardening, or you know, rediscovering their, their interest in life and COVID when when everything was kind of slowing down me and my co founder working 20 hours a day with our team to make sure that everything is up and running - our app is handling patients as they're coming along because we got massive flows of patient coming on the platform. So I think one way that I've learned as a senior leader is a you need to make yourself heard. You need to be persistent. You need to know your work more than anyone else. And once you walk into that room, you have to leave that male female gender bias outside yourself. So when I walk into a room today, it's an 90% of the time I walk into a room filled with men, I walk into corporate meetings, I walk into investor meetings, I work in government meetings, men owner, never once I feel that I'm a woman pitching to a man, I always feel that I'm founder, I'm here for my business. They are here to listen to me and they will respect me with the work that I do. And when you make yourself believe that you know this is how the situation is ultimately, you become that person that will that will make sure that their voice is heard their story is heard and the vision is followed. Today my company has 40% Men, majority of them more experienced than I have hired those men but they're more experienced than me. They are older than me, but they also work We all understand the vision that the company has that two females have built, because they've seen the work that we put into the scene, the hours of work that we put into making that possible.
Scott Allen 20:09
Sara I think you said something that that really resonated for me. And I just want to make sure that this is what you said. You said, "there are so many myths to fight." Was that the phrasing you used? Yes. So many myths to fight. That's just incredible. I mean, it's so beautifully said. Because whether it's some of the gender myths, some of the myths around how we can conduct health care, I mean, we can just go down the list. You, you've been battling a lot of myths. Right?
Sara Saeed Khurram 20:48
It comes down to, you know, can, can a female entrepreneur be a good mother? Because, yeah, I was asked by an investor once, and that investor knew me as a family friend, and he asked me straight to my face, if you had to choose between your family and your company, what would you choose? And at that moment, I could not answer because if I had said my company, he would have gone back and told my family. And if I had said my family, he would say, Oh, you're not serious about the business that you do. That's just one of many, many examples I can give you of what, how much, and how many times you have to prove that you're good at everything in those segments of life, as a female leader, or as a female entrepreneur.
Scott Allen 21:32
Sara would you talk about, what have you done to help you, as you've battled all of those myths? What is it that recharges you? Do you have mentors that have helped you? What else have you done? Because you said something else that was also wonderful. I mean, when you're walking in and you're the only female in the room and you're trying to battle all of these myths, you have to you have to believe it, you have to put that those things to the side and do the work and charge forward. I just have so much respect, how do you take care of self? And have you seen an identity shift in yourself? Do you believe more and more that you are the leader that you can be the leader that you are a successful leader, when maybe everything was telling you that you couldn't be that 10 years ago.
Sara Saeed Khurram 22:18
Women are raised woman and you know, in a in a very traditional family in Pakistan, women are raised to be people pleasers, you know people, you will also say yes, yes, everyone was very hierarchical. And also if an editor tells you something, you will not say no, even if you feel like saying no. And majority until my 22, I was 25 years of age, I had this version of myself, who actually believed that this is the right way of living, I think through my company. You know, I work very hard for it. I think my business and the work that I do, has given my personality, the courage to do something which I believe so today, the person that I am, I will only take a decision, if I will. I will not give society things, what norms are what people walking around me. Because in the end, I know that I need to be comfortable in my skin, I will find people who will be comfortable with that. And it happens, you know, when you start making decisions that suit you and not others, you face a lot of resistance. But over time people realize that this is who you are. And this is the normal the natural you and they start accepting it. And that happened with me. You know, my mother always wanted to work, but she couldn't. She had to face a conservative system. But she made sure that I work well, when I'm making sure and what motivates me is my I have two daughters. And I'm doing this for the day that they don't even have to ask anyone when they do something for themselves. So I believe that if they see me making my own decisions, they will feel much more important empowered in making their own decisions. And they will not waste 25 years of their lives thinking if what they actually are is right or wrong. They will do it from category because they will see a mother doing it. And I think it's very important for the woman of my generation to do that for the generation of women to come whether they're doctors, whether they're engineers, everyone faces this bias in Pakistan, and in countries like Pakistan. So I think that's my motivation. Now the thing is, you know, I can see the impact being created right in front of my eyes. Every day to doctors through us, and we treat we have treated patients with thyroid cancer being detected on a video call. years of infertility being treated by simple counseling, suicidal patients stuck in bathrooms counseled by doctors in a mobile phone. All the stories that we carry see in front of us every day, makes us coming back to God because in the end someone's life is being impacted positively through the one that
Scott Allen 24:49
Yep, so beautifully said in the end someone's life is being positively impacted by the work that we do. Beautiful and that's leadership. Right? That's that's helping others see the vision and mobilizing others to act on that vision and then feel the work that you're accomplishing and the work that you're doing to feel the results, that only then continues to energize and excite individuals to be a part of it. I mean, I think it's, it's such a beautiful story, Sara on on six, or seven or eight or 10, or 20 levels. So thank you, thank you for the work that you do. Now, when it comes to this topic of leadership. Are there sources that you turn to that you find valuable that help you think about the work of leading not necessarily the healthcare or building the business, the business plan, so to speak, but but leading? Are there sources that have been beneficial for you?
Sara Saeed Khurram 25:54
I think when I was when I was starting out this journey, I got the privilege to become an acumen fellow. And they reach to something which is called the moral leadership doing what is right and not what is easy. Listening to your authentic voice, I think those are some of the lessons that have really changed my life. Because I think if as a leader, you're not true to yourself, you're not authentic to yourself, can't bring about any change. So I think I've always been, I've always looked upon the mentors or the people in the ecosystem that Pakistan has, so even the world has, who have built great businesses. But I've also empowered other people while building those businesses. I think it's very important to me, that the team that I'm creating, even if I'm not there tomorrow, even if you know, God forbid, I'm not there, I changed my vision and lives, the work should continue. And so that you need a team under you, that believes in the same vision that you do. And I've seen how people transmit their vision into other people while they're building the business. And I think what we've tried to do me and my co founders to create such a team that feels about the work that we do as people. So I think there's so many people who are doing amazing work and thoughts. They might not be very famous, or they might not be working on but in their smaller circles they bring about change, and both those have become a source of inspiration for
Scott Allen 27:13
Would you close us out with just a story, a story that impacted you, when you heard it, you thought, wow, this is pretty incredible the work that we're doing, is there something that comes to mind for you?
Sara Saeed Khurram 27:26
I've told this story, I think only once or twice. You know, everyone, I start with the story that you know, I had, I just started video consultations in a clinic. And that's how the company started because everyone asks me that, you know, how did it start? Yeah. But if I tell you an incident that actually made me think that is this something that I want to do all my life, the moment that I fell in love with is, so I started I had started a company company and I had started the work and we were making clinics all across Pakistan. And one day I traveled to northern province in Pakistan, it's called KPK. And I met someone and he said that, you know, I'll take you to a hospital where I think that telemedicine is needed. So it was a Sunday morning, second of January. We traveled there at six in the morning. It was minus two degrees. I was in this jacket, you know very big they won jacket to meet make myself almond. So I was feeling College. We went into a hilly area, and there's a mental hospital there. It's called the data mental hospital. And I saw that there were two walls, one male and one female, filled with patients in very terrible condition. No warm clothes, no heaters, no one water. It was an asylum. And they did not have a doctor for the last eight years. Wow. Every night, there was a dispenser who gave them sleeping pills or sleeping injections to put them to bed. Because they were obviously they were they had mental challenges. Some of them should have panic. And this was the hospital where all the people from the nearby villages used to drop their patients and go back to an unmanageable positions. And I saw that and I still remember, you know, when I went there, and I saw the state and when I when I saw the discrepancy in the disparity of how I'm living my life and how they're living their lives. I think that is the point where I realized that you know, these patients need these solutions to get better. And that clinic we couldn't open the money because it was an a government hospital. So I pitched in the money myself with a donor and you open that clinic, that clinic still runs today. You're able to then upgrade the facility with the government. We did a lot of lobbying to make sure that the patients also got one clause and water and food and all the nutrition issues were very loud. But in those last few years, we have sent 6000 patients back home in stable conditions. Wow. 6000 patients have left the hospital because of psychologists and psychiatrists that we put them in a small room in that clinic. Because very small room that we set up. And I think that clinic is very close to my heart. That hospital is very close to mine. RT, because it really it really showed me that the power of telemedicine, and how a group of people can come together and solve a big challenge. That means did not even have internet connection. So they actually called PDA, which is a box on telecommunication authority. And I requested them to put a phone line there so that you can run the internet. And I think that to do all that, you know, these are big things that you're doing as a small, as a young person, you know, you're calling PTA you're calling the government, you're setting up clinics, you're enabling psychologists and psychiatrists from Karachi. And I think that process just gave me this vision that I can do this in maybe 1000s and 1000s of clinics across Pakistan. So that's something that has stuck with me forever.
Scott Allen 30:44
Well, you are making a difference in the world. And you are doing that work each and every day. And I just I am, I have so much respect for the work that you're doing. So much respect for the myths that you are battling.
We could do a whole other podcast on that!
We will, we will have you back in the future on on mythbusting. Well, Dr. Sara, thank you so much for being with us today. Thank you for the great work that you do in the world. keep innovating, keep creating and keep helping others. It's wonderful. It's just a wonderful story. Thank you so much.
Sara Saeed Khurram 31:28
Thank you Scott, and thank you for becoming a voice. I don't think a lot of people would have heard a lot about Pakistan or the entrepreneurial work that we do. But people like you really help us speak about our work to a wider audience. And I think it's so important. And it's so helpful to people like me, all the other entrepreneurs when they listen to it, they will feel that you know their work is being spoken about. So thank you for for also making us heard too.
Scott Allen 31:52
Well. I'm excited for listeners to hear the story because it's incredible. Be well, thank you so much for all you do.
Sara Saeed Khurram 31:59
Thank you. Thank you, Scott.
Transcribed by https://otter.ai