Pakistan: Female Medical Teams Reach More Women Post Earthquake
Up to 200 people gather each day to receive mobile clinic services in a tent in Mastana Gali, a village in Pakistan-administered Kashmir, where last year’s earthquake wrecked 80% of homes. Today, nearly everyone lives in tents or corrugated iron shacks. Reconstruction of some homes is under way, but only barely. Exposure, crowding, weak diets and bad water compound health problems that existed in this poor region before the earthquake, including those related to pregnancy and childbirth.
Five hundred health facilities were destroyed. At least 5,000 women give birth each month in the affected areas, where mothers often already have six or seven children. Most deliver at home, and maternal mortality is high. Post-earthquake stress and rough living conditions have increased the risks for women.
In a region where cultural norms do not allow women to be examined by male physicians, the all-female mobile clinics provide primary care, prenatal checkups, and skilled deliveries round the clock. These services are supported by UNFPA, the United Nations Population Fund.
At the same time, health workers report that, as more and more women learn that comprehensive reproductive health care is available, with women providers, increasing numbers are coming for family planning services. Indications are that more women are accessing health care than before the earthquake and that in some places level of care exceeds what was previously available.
Among those who come to the clinic is Naseema, two months pregnant. Dr. Nawaz gives her a prenatal exam and guidance on nutrition and health, and advises her to go down to the nearest health center to deliver her baby safely when it comes.
Post-traumatic stress and poor diets contribute to a high rate of pregnancy complications and miscarriages among the earthquake survivors. “Nine out of every ten pregnant women we see are anemic,” reports Dr. Fouzia Shakeel, a female physician in the UNFPA-supported maternity center at Battal Civil Hospital. This leads to low-weight infants and an elevated risk of miscarriage or haemorrhage during delivery. Dr. Shakeel and her team deliver 30-45 babies each month.
At the Battal centre, two or three patients each month undergo lifesaving procedures after suffering incomplete miscarriages. Up to five women per month have convulsions or obstructed labour and must be sent by ambulance to a hospital in Mansehra or Abbotabad. Before the earthquake, such women would have been more likely to die.
Patients who are likely to require surgery can be referred to one of two hospitals where UNFPA has provided equipment and staff for maternity wards.
“Last month we had 406 deliveries including 76 C-sections,” says Dr. Miriam Zubair at the AIMS Hospital. “Every day we see one or two patients with eclampsia or hypertension. We need more beds and equipment, but patients are being managed well. No one has died.”
UNFPA’s work to help Pakistan restore maternal and health services is part of a joint Early Recovery Plan, developed in collaboration among the Government’s Earthquake Reconstruction and Rehabilitation Authority, UN agencies and civil society partners. Funding has come from Norway, Germany, Kuwait, the United Kingdom, Japan, the Republic of Koreaand the European Commission’s Humanitarian Aid department (ECHO).
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