Munira Borhany shares her journey as a change-maker in Pakistan’s hematology field
Hematologist, ISTH leader and women’s health advocate
Munira Borhany’s career aspirations were clear from a young age. As a child, Borhany dreamed of becoming a doctor. Through hard work and tireless ambition, her dreams came true.
Today, Munira Borhany, MBBS, FCPS, FRCPath, is a well-respected consultant hematologist in Karachi, Pakistan. She is an active ISTH member holding a variety of leadership positions, as well as a strong advocate for women’s health and patients with bleeding disorders.
The early days of her medical career
Looking back, Borhany recalls that she never doubted her desire to pursue a career in medicine. “I had this clarity from the very beginning. I didn’t want to do anything else,” she said.
After graduating from medical college and embarking on a residency in internal medicine, Borhany was confronted with the reality that too many patients were suffering from bleeding and thrombotic disorders. Equally alarming, there was a shortage of specialist doctors equipped to address their needs. At that time, the field of hematology was still new in Pakistan; not many people knew about it or pursued it as a specialty.
“I originally wanted to be a pediatrician, but since I enjoyed the space and saw a dire need for competent hematologists in my country, I decided that was the field for me and also completed a residency in hematology,” she said.
Today, she specializes in both malignant and non-malignant hematology. She has worked in all areas, from blood film, bone marrow reporting and blood banking to performing bone marrow transplants. She is particularly interested in treating blood cancer patients, along with congenital blood disorders, as they are common in Pakistan due to a culture of family marriages, she noted.
Pursuing leadership opportunities at the ISTH
Borhany initially learned about the ISTH after reading literature about hemophilia and rare bleeding disorders. In 2008, she joined the ISTH as a Reach-the-World member. The ISTH Reach-the-World program provides access to thrombosis and hemostasis related knowledge and education to healthcare professionals from selected countries based on World Bank classification.
“After joining and coming to ISTH meetings, it seemed like a treasure trove where the experts gathered to share their knowledge,” she shared. “I wanted to connect with colleagues and mentors who shared similar interests, and this seemed like the perfect place.”
Borhany sought out every new opportunity in the field and within the ISTH’s many programs and offerings. In 2011, she was the first Pakistani recipient of the ISTH Reach-the-World Fellowship, which offers junior clinicians and researchers from developing countries the opportunity to study at host institutes known for their expertise in thrombosis and hemostasis.
For her fellowship, Borhany was trained in the hemophilia and thrombosis department at the Angelo Bianchi Bonomi Centre at the University of Milan in Italy. Her training focused on clinical evaluation, phenotype correlation with genotype and the treatment and management of bleeding and thrombotic disorder patients, among other projects.
Next, Borhany took on a new leadership role as a Co-Chair of the former ISTH Scientific and Standardization Committee (SSC) Subcommittee on FXIII and Fibrinogen, and now as a Co-Chair of the ISTH SSC Subcommittee on Women’s Health.
She has also been a facilitator for an ISTH team-based learning course, which offered her an opportunity to mentor others. She highlighted the ISTH team-based learning course as distinct for its innovative approach to collaboration and learning.
“Unlike traditional lecture-based formats, the ISTH team-based learning course emphasizes active engagement, teamwork and problem-solving among the students. It focuses on promoting critical thinking and an application of knowledge in a collaborative setting,” Borhany said. “By working closely with peers in small groups, participants have the opportunity to exchange ideas, debate concepts, and tackle real-world scenarios, fostering a deeper understanding of the subject matter.”
Taking on new research endeavors
Most recently, Borhany was a recipient of an ISTH SSC 2024 small grant award, which is an annual program that provides funding to support and advance state-of-the-art projects from the subcommittees of the ISTH SSC.
The SSC small grant is for a project focused on fibrin clot structure and function in patients with congenital FXIII deficiency. The goal is that she and her team will provide, for the first time, a detailed picture of the structure and function of fibrin clots in a large group of patients with congenital FXIII deficiency who are not on prophylaxis treatment.
“The grant was a pivotal moment in my career, empowering me to pursue my research interests, expand my impact within the field and contribute to the collective effort to improve patient care and outcomes,” she remarked.
Advocacy for women's health and improving education globally
Borhany is a dedicated advocate for women's health and patients with bleeding disorders, especially in underserved regions worldwide. In Pakistan, she highlights the pervasive issue of underdiagnosing or misdiagnosing bleeding disorders in women, often due to the misconception that these conditions primarily affect men. Additionally, societal norms and cultural barriers contribute to women's reluctance to disclose such health concerns, presenting further challenges.
“Increased education and outreach efforts are needed to ensure women are aware of the signs, symptoms and risks associated with thrombosis and hemostasis disorders,” she said. “In the future, I would like to see improved access to diagnostic facilities, specialized healthcare services and educational programs tailored to address the unique needs of women in Pakistan.”
She is involved in the Hemophilia Foundation of Pakistan, and currently serves as the Medical Director of the Karachi chapter. In this role, she helps lobby the provincial government to allocate separate funds for bleeding disorder patients.
Looking toward the future
Outside of her professional work, Borhany enjoys spending quality time with her children and family. In her free time, she can be found cooking or watching a movie (her favorite movies are thrillers!). She is passionate about traveling and exploring nature, and often carves out time to explore the local area when traveling internationally for work commitments and scientific conferences.
What is next for Borhany? In addition to her clinical work in Karachi, she looks forward to continued leadership opportunities with the ISTH and participating in upcoming programs and meetings.
“Involvement in the ISTH has significantly shaped and strengthened my career,” she noted. “It has provided invaluable networking opportunities, access to cutting-edge research and mentorship from seasoned professionals.
She is optimistic about the future of thrombosis and hemostasis, and as such, she hopes to inspire the next generation of ISTH members to take advantages of new opportunities, too.
“I encourage early career professionals to actively participating in ISTH events, seek mentorship and consistently attempt to better themselves,” she said. “Collaboration and teamwork are key, so seize opportunities to work with others to drive positive change in healthcare.”