BOOK EXCERPT

Jane Austen in Pakistan: A new book of short stories brings together two unlikely themes

From ‘Pride and Prejudice’ to ‘Emma’, the aptly titled ‘Austenistan’ relocates Austen’s classics in modern-day Pakistan through a series of short stories.

On Javed’s retirement, the Baigs moved to a rented house in Garden Town, a once-up-and-coming Lahore neighbourhood which the property boom had passed by. Once well-maintained, and as green as its name suggested, Garden Town had since grown decrepit with cobwebs of electric wires hanging from poles and old houses with peeling paint lining the potholed streets. Inside, the drawing room was still decorated with the good furniture she’d brought in her dowry – heavy, carved woods that lasted, along with some crystal objets she’d bought over the years.

The part of the house reserved for the family’s own use had cheaper furniture they’d bought more recently, ranging from modest pieces in less expensive wood to imitation wood. Javed’s salary, and now his pension from the civil service, was a joke, so piece by piece, over the years, they’d sold off all his family land. With all the bills, tuitions and expenses of a family of six depending on a single income, their household budget was too tight to spend on interior decor, let alone buying somewhere new to live.

They’d have had their own property if they’d thought to buy one while Javed was still living in government housing. But property prices in the city were too high now, especially in the affluent new neighbourhood of Defence where their friends lived, with all the modern luxuries of underground wiring, regular garbage pickup, well-designed bungalows, and perfectly paved roads.

The girls’ weddings still had to be paid for and their trousseaus purchased. Times had drastically changed since their own wedding when one could get away with dinner for a couple of hundred people and dressing the bride in a gold-thread-embroidered bridal outfit and gold jewellery.

Nowadays, every component of a wedding was a Bollywood production

They could barely afford their daughters’ school and college tuition. The girls’ private schooling was the one luxury that Jameela and Javed both insisted on for their daughters – Javed because the idea of stupid children filled him with horror, and Jamila because she knew that if they were to make good matches, they must rub shoulders with the daughters of affluent families like the ones that went to the all girls’ Grammar School. It was a necessary expense and one which their birth entitled them to.

No matter, they are pretty girls, like I was, and vivacious, she sighed. We will manage something, InshAllah.

She gazed at the four bent heads poring over their smartphones. Twenty-year-old Jahan was angelic in looks and temperament, docile and good-natured, full of the sort of sweetness that men found appealing. Then came Elisha, her father’s pet, with bucket-loads of independence, spirit, and strong personality. No man likes a headstrong and blunt wife, she thought. However, she had to admit that the girl knew her own mind and wasn’t needy. I must teach her to at least appear more subservient and pliant.

Her youngest two – Khadija and the sixteen-year-old baby of the family, Leena – were shrieking.

“Give me back my phone,” screamed Leena, clawing the air as Khadija held the phone high over her head “Mama! Tell her to give me back my phone!”

Spoilt by her parents and looked after by her older sisters, Leena wasn’t the most mature 16-year-old.

Curvy, fashion-conscious, and skilled with makeup, even on her limited budget, she looked older when she dressed up. It was proving to be a dangerous combination.

“She’s texting a boy again, Mama. That Dilawar.” Khadija said, referring to a good-looking and thoroughly spoilt young man who had been making his interest in her known recently. A few years older than Leena and the scion of a rich political family, Dilawar drove around town in a brand new Porsche Panamera and had just been expelled from an American college for cocaine possession. His parents, insisting the university had cooked up the charges, felt that it was just as well that he was back since he had to learn the ropes of the family business anyway. In reality, learning the family business meant he had nothing to do and money to burn, so, he spent his time throwing parties and chatting up whichever pretty girl caught his eye. There were lots of takers.

The glowing message read: “What’s the plan? Want to do lunch at Cosa Nostra?”

Hmmm, the catty aunties will see her, assume the worst and she will get a ‘fast’ reputation, thought Jameela. Not one for letting an opportunity slip though, she hit on a compromise.

“Take your sisters with you and you can go.”

Elisha looked coolly at her mother. “You know we can’t control Leena, Mama. She’ll want to take off with Dilawar for a spin after lunch. You know how persuasive he can be and she doesn’t listen to us when she’s all goo-goo-eyed. You need to be stricter with her.”

“Oh, hush,” said Jahan, the family peacekeeper. “We’ll take care of her, Mama.”

“Thank you, Mama, you are the best and the coolest!” Leena purred, throwing her arms around her mother and giving her a resounding kiss on the cheek.

I am cool, Jameela thought, heading towards the kitchen to order tea, when her own phone started ringing. It was nowhere near as sleek as her friends’ latest smartphones but it had been bedazzled by her younger daughters. She heard her sister Aneela’s high-pitched voice at the other end.

“Jameela? Did you get your cards for Momo Mirza’s daughter’s wedding?” Aneela said, not bothering with a preamble. “You must go. There are going to be so many boys there for your girls, those Mirzas know everyone!

I’ve already heard about two eligible men who are coming from Dubai. One is the son of the Dars who live in that big 12 kanal house in GOR and is visiting from Dubai. The other is related to the Corps Commander of Lahore, General Humbhi, and they’re both bankers. Have you heard?”

“Apa, that’s very exciting, you know I don’t sleep at night, worrying about what will happen to my girls I had to take an Ativan every night this week. We haven’t had any invitations yet because you know what Javed is like. Day and night, I tell him to be more sociable, to make friends who might be useful to the rest of us, but does he listen? No! You know how stubborn he is.”

“Well, my nieces are such pretty girls that they will easily get good marriage proposals, but do try and get invited to the Mirza wedding. I have to go now. Anwar is calling me,” and she hung up abruptly. Anwar, Aneela’s lord and master, owned a supermarket known for its array of imported, or smuggled (depending on who you asked), goods. The whole fashionable world bought its supply of smoked salmon, brie and Dove soap there, but the society set still turned up their nose at him for being a glorified shopkeeper He was doing very well off their money though, and Aneela was more than satisfied.

“Javed, sweetie,” Jameela cooed, sounding quite like Leena, “such eligible boys have arrived from Dubai for the Mirza wedding! You must make sure we are invited so they have a chance to meet our girls.”

Javed was sitting in his study clicking on his massive, outdated desktop computer. He hastily minimised his browser window to conceal the pornographic site he had been on. Jameela knew about his pastime, but shrugged it off. She had far too many things to worry about.

“Why must I get us invited?” he asked wearily. “These boys are here to attend a wedding, not to meet our daughters.”

“Jaadu, how can they like our daughters if they don’t get to see them? I’ll bet all the other women have had designer ensembles made for their girls for this wedding. It’s so competitive nowadays. Never mind, I know we can’t afford that, I’ll take something old from my trousseau and reapply the embroidery on new fabric.”

Javed winced at being reminded of their straitened circumstances, but Jameela rattled on.

“They are such lovely girls,” she continued, “that they will stand out from the others You must go and meet Mirza and congratulate him. He will definitely invite us then.”

Javed held his ground, “I don’t want to cosy up to him just for an invitation. If only you were as interested in the girls doing well in their studies as you are in them getting married, they would not need to depend on finding husbands to provide for them....” His voice trailed off as his irritated wife slammed the door shut in exasperation.

The next day, Javed returned from his Friday prayers as chicken qorma and chappatis were being brought to the table for lunch.

“Guess who I just met?” Javed said, coming into the room with a spring in his step, clearly feeling quite pleased with himself.

“How do I know?” muttered Jameela, still sulking from the night before.

“Jehangir Mirza with the two boys from Dubai, they were at the mosque for Juma prayers. I went to the mosque in his neighbourhood, hoping to run into him. Aren’t you pleased?”

“Hmmm, did you congratulate him?” Jameela said, not daring to hope.

“Not only did I congratulate him, but he also asked me if we received our wedding invitation He gave it to our neighbours, the Laeeqs, to pass on to us.”

“Those Laeeqs! Always so sneaky, I’m sure they kept it on purpose Their daughter Shazia, bechari, is so plain compared to our girls.” Jameela said. “Even though she’s the only daughter and will inherit property,” she added with a tinge of resentment.

He produced a thick cream envelope containing a stack of gilt-edged invitation cards from behind his back with a flourish.

“Oh, Jaadu, you’re the best,” squealed Jameela. “Girls, girls, look what your father has brought!”

The girls trailed into the room The youngest two were giddy with excitement, and immediately started discussing potential outfits. Their mehndi outfits must be particularly eye-catching. It would be so much fun. They would dance the night away and take a million selfies! Jahan also looked pleased, but Elisha acted cool though she was also excited to be going to one of the year’s biggest society weddings. While they would always have some cachet as a former landowning family, they couldn’t afford to repay anyone’s lavish hospitality, and invitations had dwindled. Jameela was going to make sure this wedding wasn’t a wasted opportunity.

Excerpted with permission from ‘The Fabulous Banker Boys’, by Mahlia S Lone, from Austenistan, edited by Laleen Sukhera, Bloomsbury.

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What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.

Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.