'I Grew Up In a Slum, I'm Now a Doctor of Neurology'

I grew up in a very small urban slum, between New Karachi and Gulshan-e-Maymar in Karachi, Pakistan. These slums—called katchi abadis—are areas that are not recognized by the government and so they don't get access to healthcare, education and basic necessities. The houses are small, not well maintained and roads are not constructed properly so public transport doesn't service the area. Electricity is not available on any set schedule and we didn't have addresses to receive mail.

Our house had three rooms for myself and my four siblings, my parents and my grandparents, but there were people living in worse conditions around us. Some of our neighbours had up to 10 children and they lived in one room, all sleeping on the floor.

My father is from a very small village in central Pakistan but he migrated to our katchi abadi to work as a labourer and his monthly income was the equivalent of U.S. $200 a month. Our circumstances were difficult, $200 is nothing, so it was hard to make ends
meet and there was a constant struggle for basic necessities. We would have to think several times before buying a single item, and my family and I only bought new clothes on special occasions, once or twice a year. We never had the chance to dine out or go to malls. The whole world outside our neighborhood was a "different world" to us.

I have two older siblings and when they were at school age, they had to attend the nearest school, which was a few miles away. They didn't have a way to commute there, so my father would take them every day on his bicycle which took him an hour.

I have a vague memory of another school being built when I was 4 or 5 years old, and being aware that other children had begun to attend. All the schools in my area up until that point had been government funded public schools, and the standards of education were typically very low; there were often not enough teachers. My sister was still unable to write out the English alphabet when she was in eighth grade. But this other school, The Citizens Foundation school, was built in 1997 and it was five minutes walk from my house, so I started going there for kindergarten in 1998 and studied there until 10th grade.

We used to go to school at 7:45 a.m. and the day would start with readings from the Quran and prayers, before three or four lessons, break time for lunch and then more lessons in the afternoon. The school day usually ended at 1:30 pm and afterwards I would help my mother make lunch, go to the mosque to read the Quran and help with the cooking, cleaning and laundry.

Because many students' parents weren't educated themselves and because of their financial circumstances, few students were able to get extra tuition, so the teachers often gave us extra help. I remember that we really used to look up to our teachers for everything. They weren't just educating us, they spent time helping us decide what careers to pursue in the future.

1 of 3

As a child, I had always wanted to be a doctor and in 6th grade I made the decision to pursue that goal. However, in the back of my mind I knew that the only way for me would be to get into a government funded medical school. Privately funded schools charged a lot, and I knew I wouldn't be able to afford it. But I knew I could work hard; that was in my hands.

When I was in grade 6 or 7, I also began tutoring other students and I continued doing that all the way through to the end of medical school. I didn't earn much, only $50-100 a month for up to four hours of tutoring a day. By 10th grade, when I was 15, all schools in the education system held exams for students. I was among the very top students, scoring around 90 percent in the exams.

That was one of the happiest days of my childhood, not only for me and my family but also for my teachers. It made all of us realize that I had a bright future ahead. I then received a scholarship from the State Bank of Pakistan and went to an intermediate college. Despite the college being far from my home, there was a contentment from knowing I didn't have to worry about finances.

However, the other students mostly came from very expensive private schools and had their own personal transport and personal tutors. It was difficult, because I was not able to participate in their conversations other than about school. That was the first time I really felt that life is unfair and harder for the poor. I remember I went home to talk with my old school teachers, and they encouraged me to make my comparisons based on intellect and hard work, not money. By the end of Grade 12, I ranked 24th out of over 10,000 students in Karachi.

But there aren't very many medical schools in Pakistan, and entry into them is competitive. And, out of thousands of students who apply, perhaps only a few hundred receive government scholarships. I was fortunate enough to be among the students who received a scholarship.

Medical school was intense initially, but now, I feel like five years passed by in the blink of an eye. In my fourth year I started to get a sense that my speciality would be neurology; it was what I loved. I also had sessions with former students who had moved to the U.S. for medical residencies, they would come back to Pakistan and explain what it was like. At the time, a lot of my colleagues were applying for residencies in the U.S. and so I began to do the same.

Sidra Saleem is now a doctor
Dr Sidra Saleem and her family

I took the necessary exams and was selected, so I travelled to America at 24, two years ago, on a scholarship. Initially, I moved to Chicago and my first experience of America was horrible. Chicago was very cold; the summers were like our winters in Pakistan. I had to spend time learning everything from the food to the healthcare system and even how the buses worked. There weren't many people to guide me. I had friends, but they had their own struggles. Yet, within a few months, the U.S. started to feel like home.

I am now in the second year of my neurology residency and living in Toledo, Ohio. I plan to specialize further in neurology after my residency is complete and I will stay in the U.S. for a while, but then I want to go back and serve my country.

There are two factors that I think have made a huge difference in my career. One was the support from parents; no matter what happened they stood with me and my siblings, even though they had a lot of pressure from society and from relatives. People were not comfortable that they had sent their daughters far away for education. But it didn't matter to them, they just wanted to encourage us. Secondly, The Citizens Foundation school in my area provided me with an education and the guidance I needed. The school gave me the pathway I needed to follow, and I just kept walking.

Pakistan has changed, but there are still a lot of people there who don't like girls going to school and want them to stay at home. When I was growing up I saw a lot of girls who couldn't continue education after 10th grade because of family pressures. Some were married in 7th or 8th grade. There are some who think that if parents send girls to school, they will lose respect in society. I experienced that in my area, especially when I went to medical school. Some people didn't understand that it was a big achievement, they asked my parents why they were sending us so far away and said that if we were
educated we would not find a good man and get married.

In December 2020, I traveled back to Pakistan to get married. My husband is completing his residency here in Toledo and my parents are happy that I am not only settled in my career but also in my life. And, the people in katchi abadi who used to tell my parents not to send us to college, now appreciate what my parents did and even come to me for medical advice. They use our family as an example and are now sending their own girls to school.

Whenever I go back to Pakistan and meet with the children at my old school, I tell them to follow their heart wherever it wants to take them. Nothing is impossible. I tell them that there will be circumstances where they will feel it is not working out but they have to be consistent. Be consistent, hard working and keep trying.

Dr. Sidra Saleem is a second year neurology resident in Toledo, Ohio. She attended The Citizen's Foundation school in Pakistan.

All views expressed in this article are the author's own.

As told to Jenny Haward.