Sitting in a small cold room with more than 50 patients waiting outside in a very deprived area of Pakistan, is probably not what most imagine to be an ideal setting for a lifestyle clinic. Yet there I was discussing healthy lifestyle habits with my 9th diabetic patient in row.
I had made the difficult decision to leave my dream job, my own GP surgery and aesthetic clinic in Glasgow to be here. I had my own fair share of fears and apprehensions but few goals and dreams are bigger than our own comfort. I moved to Pakistan in September last year.
Three months after arriving, I started a free clinic with a charity organisation which was working for female empowerment. Within a few days I realised there was a high prevalence of diabetes and IHD in the local community. There was no time in appointments for clinicians to educate them about lifestyle. Clinics are usually busy and patients wait from early morning to see a doctor. It struck me very quickly that system was not working and needed change.
So I took the plunge and started implementing group consultations and lifestyle prescription. I wrote Urdu notes on prescriptions about exact diet plans, exercise plans, sleep plans and discussed stress management with my patients.
With the help of my receptionist and a nurse colleague we set up group consultations fortnightly. We are educating people about lifestyle pillars in the context of chronic diseases.
Within 3-4 months we started seeing improvement in patients’ results and in their satisfaction. Our group consultations are hugely popular - our largest group to date was of 35 patients. I don’t have precise data to share on the effect on patients. But since I introduced our own data register, I found nearly 32.5% improvement in blood sugar and HbA1c with the introduction of lifestyle prescription and group consultation for patients who continued follow up with us. Unfortunately there is no primary care and follow up system so I lost quite a few patients, making data collection bit patchy.
I felt that lifestyle medicine has a huge scope in developing countries. Seeing the response in my clinic, I have conducted lifestyle medicine workshops and video sessions on a couple of local Facebook pages. Recently I created a Facebook group for Pakistani female doctors and have noticed an appetite for lifestyle medicine among them.
My other work is delivering free child abuse prevention workshops in local schools in Pakistan. Child abuse - especially sexual abuse - is a taboo topic in Pakistan. Implementation of law is patchy, so when my kids started going to school, I asked the school about child protection policy. They had a policy but there were clear flaws in it. After discussion with principal we decided to conduct what would be our first child protection workshop at the school. It was very well-attended and as a result I was asked to do more workshops in other local schools. Seeing the response, we made a small team and started workshops in other major cities.
I am really proud of these awareness workshops, the most recent of which was run at a school for street children. I hope in the future, with more support, we can spread the message more widely and can prevent disease and abuse in this world.
I’m a GP, trained and worked in Scotland. I developed an interest in lifestyle medicine during my years as GP partner. Recently I moved to Pakistan and currently I’m working for an NGO voluntarily. I see so many patients with poorly controlled diabetes. Lifestyle medicine is life saver in environment with limited resources as it’s free.