Indus Heroes

MAKING PRIMARY CARE ACCESSIBLE: DR. HIBA ASHRAF

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“I came into this field to help every person in need, without discrimination. I did not just want to treat my patients, but also guide them based on their medical needs.”

Having spent over 17 years associated with the field of primary care, Dr. Hiba Ashraf’s passion for helping others has only intensified with time. She has always been concerned with enabling the people of Pakistan to access quality healthcare, regardless of their age, gender, economic standing, or geographic location. During her time at The Indus Hospital, Korangi Campus, she has brought major reforms to the field of healthcare in Pakistan.

Her Motivation

A major pull to the field of primary care was the emphasis on its continuity. Rather than a standalone interaction, continuity of care considers healthcare to be a process that develops over time. Dr. Hiba always knew that she wanted to provide comprehensive treatment in whatever field she chose. She desired to enter the communities of her patients and bring healthcare to their doorstep. The area of primary care perfectly encapsulated those aspirations. Another factor that attracted her was that it was holistic and unbiased with whom it catered. Furthermore, it provided medical assistance to people of all ages, genders, and socio-economic classes. Dr. Hiba’s sincerest wish was to help all those around her.

Dr. Hiba has highlighted the major problems in primary healthcare provision in Pakistan. Although Pakistan has sufficient infrastructure relating to primary healthcare systems, there is a fragmentation in the provision of care. Moreover, there is a lack of referral linkages between primary, secondary, and tertiary healthcare facilities. Most budgets focus on tertiary care, nearly forgoing primary care altogether. Research has shown that developed countries with high Health Outcome Indicators have robust primary healthcare systems. This led to Dr. Hiba making it her mission to amend and transform the landscape of primary care provision in Pakistan.

Her work with the IHHN

She joined The Indus Hospital, Korangi Campus as a Junior Consultant. Her objectives of making indiscriminate healthcare accessible to all perfectly aligned with Indus Hospital & Health Network’s (IHHN) vision of “quality healthcare, free-of-cost.” Dr. Hiba’s expertise and endless compassion for her patients helped her rise quickly through the ranks at the hospital. She was soon promoted to the Director of the Residency Program before being promoted to the Head of Department of Family Medicine. She has now advanced to the Director of the Primary Care Program at Indus Hospital & Health Network. Her responsibilities include strategic planning, monitoring, evaluating, and developing the network of primary healthcare sites throughout all IHHN centers across Pakistan. Dr. Hiba furtively believes that standardization of facilities is crucial and works to ensure that the same quality that is offered in Karachi is maintained at Badin, Tharparkar, and all IHHN sites.

Dr. Hiba has used her platform at IHHN to achieve her vision of a more integrated primary care system in Pakistan. She developed a model based on the Hub and Spoke model and implemented it across the 26 Indus Hospital & Health Network sites. The hospitals acted as hubs and the independent facilities as spokes. For the successful execution of the model, Dr. Hiba established sturdier referral linkages between primary, secondary, and tertiary institutions, integrating these services more deeply. Her efforts were rewarded, as she managed to help over a million patients with her primary healthcare model over one year.

Her Accomplishments

In a society where women are largely not offered the same opportunities as men, Dr. Hiba is proud to lead a primarily female-dominated team. Under her tutelage, the team provides innovative solutions to complex problems. As a result, they generated plans for a container clinic, Pakistan’s first-ever mobile Boat Clinic, and other creative ideas to reach people across Pakistan. These helped facilitate healthcare provision to areas that had not received quality medical attention in over 70 years. From the southernmost city of Karachi to Kashmir in the high north, Dr. Hiba and her team are determined to make primary care accessible at every doorstep.

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Indus Hospital & Health Network is a not-for-profit company registered under section 42 of the Companies Ordinance 1984. The company has tax exemptions under the Income Tax Ordinance 2001.

Charity Registration No. PCP-R2/2019/234 National Tax No. 3162706-4
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Indus Hospital & Health Network is a not-for-profit company registered under section 42 of the Companies Ordinance 1984. The company has tax exemptions under the Income Tax Ordinance 2001.

Charity Registration No. PCP-R2/2019/234 National Tax No. 3162706-4

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Zakat is one of the five pillars of Islam. It is the specific amount of wealth that a mature Muslim, who is Sahib-e-Nisaab, gives to the poor with the intention of Zakat, upon the completion of the Zakat year.
“And those in whose riches there is a specified right. For the one who asks and the one who is deprived.” (Qur’an 70:24-25)

The meaning of Nisab is a specific amount of four types of wealth, which if owned by a mature Muslim, Zakat will be compulsory upon. The four types of wealth are:

  • Gold (7.5 Tolas, 87.48 Grams)
  • Silver (52.5 Tolas, 312.36 Grams)
  • Business wealth (value of which equals 52.5 Tolas Silver)
  • Currency/Cash (value of which equals 52.5 Tolas Silver)

Zakat is not just a fundamental pillar of Islam. It is also a revolutionary concept with the potential to ease the suffering of millions around the world.
As Allah (SWT) tells us in the Holy Qur’an:
“And be steadfast in Salah (prayer), and give Zakah. Whatever good you send forth for yourselves, you will find it with Allah. Certainly, Allah is watchful of what you do.” (Qur’an 2:110)
It is also a right that the poor have over us.
“And those in whose riches there is a specified right. For the one who asks and the one who is deprived.” (Qur’an 70:24-25)

Zakat is 2.5% of the wealth one possesses above the Nisab.

If someone is a Muslim, non-Sayyid, and they do not possess 52.5 Tolas silver, or its value in gold, currency, business wealth, or wealth surplus to their needs, they are eligible to receive Zakat.

No, Zakat is only obligatory upon Muslims.

There are eight categories of people who are eligible to receive Zakat:
  1. The poor
  2. Needy
  3. Administrators of Zakat
  4. Those whose hearts have been recently reconciled
  5. Those who have been enslaved
  6. Those in debt
  7. In the cause of God
  8. Travellers (including refugees)
As Allah (SWT) tells us in the Holy Qur’an: The Sadaqat (prescribed alms) are (meant) only to be given to the poor, the needy, to those employed to collect them, to those whose hearts are to be won, ¹⁹in the cause of the slaves and those encumbered with debt, in the way of Allah and to a wayfarer. This is an obligation prescribed by Allah. Allah is All-Knowing, Wise.

‘Hawl’ refers to a lunar year. E.g. When a person achieves the Nisab for the first time, then from this date till the same date in the next lunar year his ‘Hawl’ is complete.

For Zakat to be due, it is a condition for one lunar year to have passed. If one lunar year hasn’t passed on someone’s wealth, then Zakat is not due.

Yes, Zakat will be due at the time of Zakat due date for this amount. Even though a year hasn’t passed on having the amount. This is known as ‘Maal-e-Mustafaad’ in Shariah terms, as in wealth received midway through a year.

The midway of a year is not taken into consideration, but the zakat due date is considered. For example, you Zakat due date is the first of Ramazan , and before the first of Ramazan, your wealth decreased to below the Nisab, but on the coming of the first of Ramazan, your wealth met the Nisab criteria, then Zakat will be due. The drop earlier in the year beneath the Nisab criteria will not be considered

Yes, you will still be required to pay Zakat of 2.5%. For the payment of Zakat, ‘intention’ or ‘Niyyat’ is mandatory and common charity/donation cannot be considered as Zakat. Therefore, you are required to calculate your Zakat on your Zakat calculation date and then the calculated amount may be given to the identified Mustahiq-e-Zakat either in full or in tranches throughout the year, with the intention of that amount being considered as Zakat only.

For every year that you owe Zakat, take 2.5% from the total wealth you had at the end of that year and pay that in Zakat. If you are not sure how much wealth you had, you must estimate it to the best of your ability. For example, it is now Ramazan 2022. You have not paid Zakat for the last 5 years. You need to work out how much wealth you owned every Ramadan for the last five years and pay 2.5% of that.

There is no Zakat on the wealth of a minor.

The best way for you to do this would be to take the jewellery to a jeweller and ask them to value just the gold and silver parts of the jewellery. The valuations they give will be the total on which you have to pay Zakat. Precious stones are not liable for Zakat.

If money for Hajj has been paid and the place has also been confirmed, then there is no Zakat on this amount. But if the Zakat date falls before payment, then there will be Zakat due on this amount.

Yes, Zakat is due on this amount. But it is up to you – you can either pay Zakat on the amount each year, or when the money is received, you can pay for the previous years.

If your friend accepted that he had the debt and did not deny it, then Zakat is due on this amount. Calculate your zakat here

Yes, you can exclude this loan, but if your wealth increased by Zil-Qadah, then Zakat will be due on the extra amount as well.

In this scenario, there is no Zakat due on the house value. However, whatever rent was received, add this to your other wealth on which Zakat is due and pay the total due Zakat amount for the Zakat year. Also, there is no Zakat on the house until you sell it. Once you have sold the house and received the money, then there will be Zakat payable on that amount, if it remains in your possession till your Zakat due date.

Every year at the time of paying Zakat, you would need to calculate the total selling price for all the goods for sale in your shop. For example, all the clothes for sale in your shop add up to a total selling value of a particular sum of money. You would add this to your other wealth when calculating your total payment.

If you haven’t received the funds, then Zakat isn’t due. But if you have received the funds, Zakat is due.

This amount is the group’s collective ownership. Thus, each participant will pay Zakat on his/her share, or permission can be given to one person who will pay Zakat from the fund on behalf of everyone.

In Shariah terms, poor and needy is classified as someone who does not have the Nisab amount in their ownership. The meaning of Nisab here is 52.5 tolas silver or the equivalent of that in cash/gold, or extra to what is needed.

Zakat cannot be given to ‘Usool’ and ‘Furuu’. ‘Usool’ is parents, grandparents and so on. ‘Furuu’ is children, grandchildren and so on. Similarly, Zakat cannot be given to husband or wife. Besides this, Zakat can be given to other relatives.

If the orphan doesn’t possess the ‘Nisab’, and he isn’t a ‘Sayyid’, then he can be given Zakat. If he possesses something of the value of nisab, he cannot be given Zakat.

Zakat can only be given in those projects wherein possession is achieved of the Zakat amount. This means the person who can claim Zakat and is eligible for Zakat payment becomes the owner of the amount. Thus, to give food, clothing, medicine etc. to a poor person from the Zakat money is permissible. And those projects wherein ownership of the Zakat money is not achieved, Zakat cannot be given for example, spending in Masajid, digging wells etc.

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