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Pakistan women fight gender norms to build online health business

After surviving a car crash that left her hospital-bound and unable to walk for months, Saira Siddique embarked on a mission: Making health care accessible to Pakistanis.

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The 45-year-old left her high-profile job in government health to pitch her app linking doctors and patients by video to investors.

Months later, with COVID-19 hurting businesses across Pakistan, Siddique’s firm, MedIQ, burst on to the scene as the country’s first “virtual hospital.”

“(The pandemic) really gave a boost to my company,” said Siddique.

With face-to-face doctors’ appointments restricted due to contagion risks, Siddique’s company, connecting patients across Pakistan with doctors and pharmacies, was suddenly in demand.

MedIQ served 16,000 patients in its first six months. Almost two years on, the number has increased by nearly 20 times.

Siddique is one of a growing number of women in Pakistan who are defying conservative gender norms by jumping into the health tech industry.

“Running a startup business is like riding a bull,” she told the Thomson Reuters Foundation by phone from the capital Islamabad.

“You never know which way or how hard it’s going to buck.”

Siddique’s company raised $1.8 million in an early stage of financing last week after receiving mentoring in the World Bank-backed WeRaise program, which helps women-led ventures in Pakistan raise capital.

‘Doctor brides’

Others are blazing a similar path.

Two entrepreneurs in Karachi wanted to use the untapped potential of tens of thousands of so-called “doctor brides” – women doctors who quit their medical practice after marriage in a country where millions have no access to medical care.

Iffat Zafar Aga and Sara Saeed Khurram’s platform allows female medics to provide e-consultations from their homes to patients in mostly rural communities.

In the country of some 210 million the doctor-patient ratio stands at just a little over one for every 1,000 patients, according to the World Bank.

Countries such as the United States, Japan and Brazil have more than two doctors for every 1,000 patients, while Britain has nearly four.

The pair has set up dozens of ‘e-health clinics’ in low-income communities where, for as little as 80 rupees ($0.43), a patient visits a nurse who uses the online platform to reach a doctor.

Khurram said they provided free consultations during COVID-19 after the government sought their help – a task made possible by their team of 7,000 doctors, many of whom are former doctor brides.

The phenomenon of doctor brides remains pervasive with many families encouraging their daughters to study medicine not for a career, but to bolster marriage prospects.

More than 70 percent of the country’s doctors are women, but only half will ever practice, according to the Pakistan Medical Commission.

‘Late-night deals’

From domestic violence to anxiety over job losses and grief of losing family members to Covid-19, requests for virtual appointments on ReliveNow, an online mental health care platform, surged during lockdowns.

Amna Asif, its founder and CEO, said most of the clients were women, including single mothers, struggling to juggle children while working from home.

“This put us on the radar, and helped increase our sales,” said Asif by phone.

Founded in 2018, ReliveNow has clients – 80 percent of whom are women – in dozens of countries including Pakistan, Britain, Canada and Australia.

But the road to success for firms like MediIQ and Sehat Kahani has been paved with misogyny, stereotypes, and discouragement.

Entrepreneurship has long been a boys’ club that rarely opens its doors to women in Pakistan where they are typically home-bound while men work and call the shots.

Businesswomen say they have to work twice as hard to be taken seriously and are scrutinized far more than their male peers.

“There is a perception that women cannot start a successful business, let alone scale it up,” said Siddique, adding that she had to pitch to nearly 140 investors – twice as many as men usually do.

Venture capitalists, nearly all of whom are men, frequently asked Siddique why she didn’t have male co-founders. Sehat Kahani’s Khurram was asked to be accompanied by a man in future meetings.

Her business partner Aga was pregnant with her second child when a prospective investor told her that he would invest only if he got a 70 percent share of the firm.

“On top of that he advised me to take care of (the) kids and my home and not take on so much stress,” she said as Khurram recounted how another asked her what she would do if she had to pick between her family and business.

Social and cultural norms limit women’s opportunities to meet potential investors or even mentors, the women said.

Aga said she had to decline several late night meetings over coffee or shisha.

“Many fundraising deals are clinched in a lighter, more informal environment after dinner or over a smoke,” said Siddique of medIQ.

“I wasn’t able to do that.”

Double bias

That may explain why there are so few businesswomen in Pakistan.

Despite the pandemic, 83 startups in Pakistan raised $350 million in 2021 – more than five times the amount in 2020 – according to a report by Islamabad-based invest2innovate, a consulting firm that supports early-stage enterprises in emerging markets.

But only 1.4 percent of all investments raised in the past seven years were by solely women-run startups, it found.

Kalsoom Lakhani, founder of invest2innovate, urged investors to stop asking women “ridiculous questions.”

“As investors it’s important to be more aware of … unconscious biases,” she said, adding that the first step was to rethink “how we speak to women founders who are fundraising.”

ReliveNow’s Asif said she has her male employees present the pitches.

“I am the brain behind them,” she said.

That’s why it is important for women investors to join the fray since they are more likely to invest in women-led businesses, said Shaista Ayesha, CEO and director of impact investor SEED Ventures.

“(They) understand their struggles and what a woman has gone through to be there, and would be more willing to offer assistance and mentoring,” she said.

Plus, she said, women find it more comfortable to pitch to female investors.

But Asif faces a double bias, with investors reluctant to fund a startup that works on mental health in a country where there is still a lot of stigma associated with mental illness.

“It has been extremely difficult to find investors,” she said, adding that the absence of a mental health authority exacerbates the problem of legitimacy.

While other women in the industry forecast their companies’ growth in the millions, ReliveNow, which largely survives on revenues, grants and awards, may be forced to shut shop, said Asif.

“It is good to know when to let go.”

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IAEA loses transmission from Ukraine’s Russian-held nuclear plant surveillance system

The UN atomic watchdog said on Wednesday it had again lost its connection to its surveillance systems keeping track of nuclear material at the Russian-held Zaporizhzhia nuclear power plant in Ukraine, Europe’s largest, which the watchdog wants to inspect.
“The fact that our remote safeguards data transmission is down again –- for the second time in the past month –- only adds to the urgency to dispatch this mission (to Zaporizhzhia),” the
International Atomic Energy Agency said in a statement.

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The connection was lost on Saturday “due to a disruption of the facility’s communication systems,” it added.

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Anti-coup protesters in Sudan shot dead: Report

Four protesters were killed in Sudan on Thursday, medics said, as large crowds took to the streets despite heavy security and a communications blackout to rally against the military leadership that seized power eight months ago.

In central Khartoum, security forces fired tear gas and water cannon as they tried to prevent swelling crowds from marching towards the presidential palace, witnesses said.

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They estimated the crowds in Khartoum and its twin cities of Omdurman and Bahri to be in the tens of thousands. In Omdurman witnesses reported tear gas and gunfire as security forces prevented protesters from crossing into Khartoum.

The protests mark the third anniversary of huge demonstrations during the uprising that overthrew long-time ruler Omar al-Bashir and led to a power-sharing arrangement between civilian groups and the military.

Last October, the military led by General Abdel Fattah al-Burhan toppled the transitional government, triggering rallies that have called on the army to quit politics.

Some protesters carried banners calling for justice for those killed in previous demonstrations. Others chanted, “Burhan, Burhan, back to the barracks and hand over your companies,” a reference to the Sudanese military’s economic holdings.

Earlier, protesters barricaded some of the capital’s main thoroughfares with stones and burning tires.

It was the first time in months of protests against the October coup that internet and phone services had been cut. After the military takeover, extended internet blackouts were imposed in an apparent effort to hamper the protest movement.

Staff at Sudan’s two private sector telecoms companies, speaking on condition of anonymity, said authorities had ordered them to shut down the internet once again on Thursday.

Bridges shut

Phone calls within Sudan were also cut and security forces closed bridges over the Nile linking Khartoum, Omdurman and Bahri – another step typically taken on big protest days to limit the movement of marchers.

In recent days there have been daily neighborhood protests in the build-up to Thursday’s rallies.

On Wednesday, medics aligned with the protest movement said security forces shot dead a child during protests in Bahri. Thursday’s four deaths, all in Omdurman, brought the number of protesters killed since the coup to 107.

There was no immediate comment from Sudanese authorities.

The United Nations envoy in Sudan, Volker Perthes, called this week on authorities to abide by a pledge to protect the right of peaceful assembly. “Violence against protesters will not be tolerated,” he said.

Military leaders said they dissolved the government in October because of political paralysis. As a result, however, international financial support agreed with the transitional government was frozen and an economic crisis has deepened.

Burhan said on Wednesday the armed forces were looking forward to the day when an elected government could take over, but this could only be done through consensus or elections, not protests.

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UN: Almost 16 million people in Ukraine need humanitarian aid

As Russia presses on with its invasion of Ukraine, some 16 million people inside the country need humanitarian aid, the UN humanitarian coordinator in Ukraine said Thursday.

“Almost 16 million people in Ukraine today need humanitarian assistance: water food, health services,” Osnat Lubrani told a press briefing.

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Six million Ukrainians have been forced to flee their homes for other parts of the country since the war started, though around 5 million have since returned, she said.

But “many know that they might be forced to flee again,” she added.

Over 5.3 million more Ukrainians have fled abroad, Lubrani said.

She said the UN tally of casualties since Russia invaded Ukraine on February 24 was likely much higher.

“The number we have of almost 5,000 civilians killed and more than 5,000 injured is just a fraction of the frightening reality,” she said.

She also said it was “extremely difficult if not… impossible” for humanitarian groups to access areas that are no longer under Kyiv’s control.

Lubrani called on Russia and Ukraine “to do more to protect the people of this country and to make our work possible.”

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