Transforming Healthcare

A majority of the transgender community (~300,000) in Pakistan are undocumented and lack the National Identity Card (NIC) required for employment. This leaves the community financially and legally ostracised from employment, education, and healthcare. 

We aim to recruit and train transgender ‘Guddi Bajis’ (good ‘elder sisters’)  - frontline health workers (FHWs) from within the trangender community who can serve as trusted intermediaries and: (i) connect their communities to a remotely located network of gender-sensitised, healthcare providers (doctors, therapists, dentists, pharmacists, etc), (ii) stimulate demand for relevant healthcare services and products including prescription medicines that ‘Guddi Bajis’  can provide their communities with direct access to and (iii) facilitate their communities access to National Identity Cards (cNICs). 

If scaled globally, this FHW-assisted,  telemedicine, telepharmacy and digital identity model can become a template for all ‘excluded’ communities across the globe, in both industrialised nationals and developing countries.

This project aims to solve the massive disparity in access to quality healthcare and public sector services for the marginalized, global transgender community starting off in South Asia with Pakistan. 

Pakistan ranks an abysmal 152 out of 189 countries on the Human Development Report-Gender Inequality Index which measures gender equality based on reproductive health, empowerment, and economic activity. This is unsurprising given that Pakistan spends less than 1% of its GDP on public healthcare. Accordingly, seventy-five percent of Pakistan’s population relies on unaffordable private healthcare facilities, resulting in the exclusion of almost all members of low-resource communities such as the transgender community. 

Transgender patients are frequently turned away from public primary healthcare facilities - due to widespread societal and medical ignorance around the unmet needs of transgenders, especially related to effected management of HIV/AIDS and STDs.

The transgender community of Pakistan remains both socially and legally ostracised with only 10,000 officially registered transgenders who have been issued national identity cards. This represents less than 0.3% of the estimated LGBTQI population of 300,000. The vast majority of this community remain excluded from the mainstream and susceptible to IV drug abuse, needle-sharing,

We aim to recruit and train ‘champion health workers’ from within the trangender community to serve as trusted intermediaries who can mobilize their communities and stimulate demand for relevant healthcare products and services. These champions will be equipped with tablets and 4G wifi connectivity with which they will conduct home health visits and be able perform sophisticated diagnostic and interventional procedures through AI enabled telemedicine in real-time under the clinical supervision of remotely located female doctors and female pharmacists at a price of $2 per consultation. They will also have access to an inventory of SHRH products and supplies which can be prescribed (if necessary) in real time via doctHERs e-pharmacy platform. docHERs already has a wide network of specialized female doctors that practice via a telemedicine online portal. This program will allow us to activate specialized healthcare professionals to cater to the needs of the transgender population by specific trainings for our doctors for sexually transmitted diseases (STDs), hormone therapy, substance use and problems caused by injectable silicone - some of the leading causes of morbidity and mortality in Pakistan within the trans community, especially in youth. 

The total number of transgender persons reported by Pakistan’s Sixth Popu­lation and Housing Census is 10,418 - However, a majority of the trans community still live undocumented lives and their population is estimated to be over 300,000 nationwide. The transgender community in Pakistan was not given any  legal status before 2009.  Prior to this, they lived without any sort of legal identity, e.g. the computerized National Identification Card (cNIC), a prerequisite for all transactions in the public sector (including access to services and benefits) as well as for private sector employment and financial services/banking.  Without access to any public sector services or public/private sector employment, the transgender community has been financially and legally ostracised and has faced serious challenges in accessing Sexual Health & Reproductive Health (SHRH).  Transgender patients are usually turned away, mocked and harassed at public healthcare facilities - partly due to widespread societal ignorance about individuals who are different from the mainstream binary, but also because healthcare providers lack clinical expertise in dealing with the SHRH needs of transgenders. Many transgenders within the community resort to self-medication with drugs and hormones provided by other community members including ‘gurus’ - leaders of small, scattered transgender communities. Transgenders often use non-sterile medical supplies,  and visit untrained individuals for surgical procedures. Health issues are very common, including early onset of diabetes and hypertension, along with early mortality. Botched surgical procedures often end up in more disfigurement, which compounds psychological distress.

The problem is no access to healthcare due to social stigmas and unavailability of quality, efficient and personalized care for marginalized communities such as transgenders. The solution bridges all these gaps while also integrating them into the healthcare workforce as frontline health working, teaching them valuable skills and providing them with the ability to be financially independent. The solution equips anyone with the digital economy (telemedicine, AI and Telehealth) to enable their participation.

doctHERs has deployed its community-health worker (CHW)- assisted telemedicine in over 24 districts in KPK, Punjab & Sindh, impacting over 2.7 Million lives (mostly women) since 2019.  This is the first instance, where it is specifically targeting the transgender community, in collaboration with the TransPride Society (The implementing Partner). TransPride is an NGO founded by Pakistan’s first transgender lawyer, Nisha Rao. TransPride  is the first NGO of its kind in Pakistan, focused on empowering members of the transgender community, by providing them with breakthrough opportunities and access to essential healthcare and public sector services. 

We are leveraging technology to solve three major challenges, lack of access to healthcare, integration of the trans community back into the workforce and financial inclusion for them. This will create a paradigm shift in the community. Our innovation will improve the quality of life of our users by providing financial security and making health care services convenient and easily accessible to the community.

Current: 2.7 Million

In 1 Year: 3.5 Million

In 5 Years: 15 Million

By the end of 2021, we expect to be serving over 3 million lives across 32 districts of Punjab, KPK & Sind. 

By the end of 2025, we we expect to be serving over 25 million lives across  South Asia (Pakistan, India, Bangladesh), i.e. '25 by 25'

Our goals over the next 12 months are to:

(i) Positively impact the health & socioeconomic outcomes of 2 million+ transgenders, women and children in our target population in 3000 rural villages across Punjab in which Unilever is co-implementing the 'Guddi Baji’ community health activation + last-mile retailer model. 

(ii) Deliver over 500 life-saving interventions at point of care via our telemedicine platform that links to hospital-based EMRs

(iii) Demonstrate the technological and clinical feasibility of this data transformation model at a scale of 200 transgender frontline health workers deployed at the frontlines

Our goal over the next 5 years is to:

(i) positively impact the health & socioeconomic outcomes of 30 million+ transgenders, women and children in our target population across South Asia, N. America, ASEAN, MENA and Sub-Saharan African regions.

Full-TIme: 36

Part-Time: 52

Contract: 150

Dr. Asher Hasan is the Founder and Executive Chairman of NAYA JEEVAN, Pakistan’s first health & wellness plan for informal and formal workers in corporate value chains and the Co Founder & Executive Chairman of doctHERs/

A TED speaker, TED fellow and MIT SOLVER, Asher has previously served on the World Economic Forum Global Agenda Council for Social Innovation (2012-2014) and is a 2011 World Economic Forum/Schwab Foundation Asian Social Entrepreneur of the Year.

Prior to launching NAYA JEEVAN, Asher served in the capacity of Senior Director of US Medical Affairs for Amylin, a leading bio-pharmaceutical company in San Diego, CA.

Asher completed an MBA from New York University’s Stern School of Business and conducted preclinical research at Harvard Medical School & Massachusetts General Hospital, followed by training in General Surgery at Beth Israel Medical Center.

Säbeen Fatima Haque

She was the Country Director for Ashoka and Advisor for the US-Pakistani Women’s Council. In 2014, Sabeen launched Concentric, leading women-centric projects including the World Bank pilot, womenX, which accelerated 250+ businesses with IBA. She was also the brainchild and Angel behind doctHERs.She is a Vital Voices Fellow, Social Entrepreneur in Residence at INSEAD, and an alumni of Harvard Kennedy School.

Sabeen has been invited to speak at Forbes Women and Fortune MPW, and has participated in global events such as the Women in the World Summit, President Obama’s Global Entrepreneurship Summit, G(irls)20 Summit, TED and World Economic Forum.

To create the change we need to, we need further support and funding that MIT solve could provide us with. If successful with the fund, we do hope to expand our reach with access to healthcare and the provision of SRHR awareness to the neglected trans communities of Pakistan then over developing nations globally. We hope to expand within Bangladesh and the South Americas in the coming years and this definitely requires strong partnerships for sustainable development and growth as this is where SRHR is more off track and challenging to tackle. In alignment with the strategy and theory of change we also hope to maximize our voice in the policy and advocacy aspect as that is key with our movement and our target population.