‘Help. Life. Hope. SIUT. Words that make a world of difference. Use your Zakat & Donations to reach out to those who can’t afford to live.’

These are the words on the banner before me as I wait for my flight to board at Quaid-E-Azam International Airport. When I landed in Karachi eight days ago, little did I know that I was embarking on a life changing journey that would allow me to see just how these contributions literally breathe life into the poor ill.

I thought I was going to CBEC SIUT to give a presentation on the ‘corporate physician’ and bio-ethical dilemmas in the global arena, and gather data for a research paper on the interactions between doctors and the pharmaceutical industry in Pakistan. I was actually about to be educated in emerging ethical issues in the biomedical arena from world-class presenters – and learn a lot more about humanity.

The view from the rooftop terrace outside CBEC will haunt me forever. I talk incessantly, but for once I was speechless. Men, women, children, babies in makeshift tents were waking up on the pavements below me. There were so many of them living on the streets, making breakfast in non-existent kitchens; some still sleeping in the littered lanes. I couldn’t quite believe that among them were patients being treated at SIUT, who were possibly waiting for kidney donors or needed dialysis or follow up treatments on a daily basis. The others were with their families, who had travelled from afar to be by their sides. I wondered how it was possible to work for a hospital surrounded by such pain and suffering and witness this heart-breaking existence every day. It all became clear when I was taken on a tour of the hospital and was told everywhere:

‘This isn’t a hospital; this is a phenomenon.’ ‘This is the only hospital in the world where you can be treated with dignity if you are poor.’ ‘Welcome to our hospital.’

It was in the paediatric nephrology department that I was overcome with emotion as a mother of a young child sobbed, and another grasped her son and asked me to check his files with urgency. I was surrounded by sick children and felt completely useless. The only thing I could do was nod and smile. They all smiled back.

Faced with the stark reality that the majority of the patients at SIUT (perhaps more than ninety per cent) are below the poverty line, it’s hard to imagine how any individual or company could do anything to harm them further and it is this sentiment especially that I take back with me to Scotland. My research interests lie in investigating how commercial interests impact on public health policy making – sometimes to the detriment of public health. There is evidence that pharmaceutical regulations put in place to protect the interests of patients may be ineffective and can be circumvented. Ineffectual rules or industry self-regulated codes of conduct may exist to create a veneer of respectability in developed economies, but are virtually non-existent in the developing world where multinationals flock to conduct clinical trials at a fraction of the cost.

In exchange, countries like Pakistan get ‘gifts’ in the form of corporate social responsibility – pharmaceutical companies plant trees in community gardens, which display their logos, instead of subsidising medicine for the poor. These promotional activities are often classed as philanthropy, but it’s only when you witness genuine altruism that you realise what the art of giving – without flashing the label of charity – is all about.

I’m grateful to everyone at SIUT and in particular those affiliated with CBEC for reminding me that there are very good people in this world, and reigniting my passion for research in bioethics. I am now convinced that there can be happiness and hope even for those who can’t afford to live.