Balochistan has the highest Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in Pakistan. The main cause behind high rate of MMR and IMR is absence of basic health facilities, illiteracy, poverty lower socio economic status, non availability of doctors, operation theaters, labor rooms, female gynecologists, untrained midwifes, lack of pediatricians, breast feeding centers and vaccinations.
Malnourished child in Chagai District
According to Pakistan Health Demographic Survey (PHDS) Balochistan stands first in terms of high MMR as out of every 100,000 mothers 785 die in Balochistan while 272 mothers die in other provinces of the country. Similarly, when IMR is discussed then Balochistan also leads other provinces as out of every 1000 children 49 children in Balochistan as compared to 49in the rest of the country.
Latifa Bibi hailing from Nushki district located in southwest of Balochistan, gave birth a baby girl but unfortunately her baby could not survive. After two years, she again gave birth to a baby boy but unfortunately the baby is blind from both eyes. Later six children of Latifa Bibi died repeatedly before surviving to their first spring.
Speaking to Monthly Balochi Zind, Latifa Bibi’s husband Sultan said that they live in a remote area of Nushki district which lacks all basic facilities and owing to poverty he could not afford treatment of his children. “I tried my best to take my children to District Headquarter Hospital but my this effort could not help my children survive,” he said with lamenting over his bad luck.
Mah Pari, who also belongs to Nushki district, is a patient of diabetic and had given birth to three children. Due to poor health condition her three children could not survive that inflicted serious shock to her that multiplied her already troubled life.
Atta Muhammad, a husband of Mah Pari and a grower by profession told Balochi Zind that though his wife is a diabetic patient but luckily his first two babies survived, however his three children died very soon after their birth. “When I contacted doctors in Nushki they advised me to move Quetta for further treatment but my economic conditions did not allow me to take my wife and babies to Quetta for treatment,” he said, adding that Nushki lacks specialists due to which a large number of men and women could not move to Quetta for treatment.
Mahjabeen, a midwife says poverty, backwardness particularly lack of awareness amongst women in remote areas of Balochistan the number of MMR and IMR is high. “We witness mothers die on daily basis during delivery cases. What is the main issue is that women keep it secret their pregnancy that further complicate the situation because they don’t take precautions before and after delivery,” she added.
Mahjabeen regrets that living in far-flung areas, dearth of basic facilities in state run hospitals and poor financial condition of people were causes of high MMR in many districts of Balochistan.
Interestingly, the situation of Balochistan is alike Afghanistan which is undergoing a civil war for many decades where MMR is on top of the list in south Asia
Talking to Balochi Zind Head of Department Sandeman Civil Hospital Quetta, Dr. Nahila Ahsan, a renowned Gynecologist said the ratio of MMR in India, Bangladesh and Shrilanka is 150 out of 100000, adding that though these are also developing countries but they have managed to control MMR. “Women in these countries are educated and every woman is aware that hospital is right place for delivery not home. The MMR in Srilanka is 35 out of 100000”, she added.
Professor Dr Naheela Ehsan talking about MMR and IMR in Balochistan
Dr Nahila Ahsan, who has 20 years experience as Gynecologist said the MMR could be reduced if government concentrate on female education which would create awareness among them. “During pregnancy route medical checkups, and proper food should not be missed at all that is essential for every women while getting pregnancy,” he stressed, adding that our midwifes needed proper training who mostly deal delivery cases in ruler areas of Balochistan.
The facility of Caesarean operation in only available in Quetta, however the other districts of Balochistan lack this facility. Before going through any Caesarean operation there must of anesthetist, blood bank in theater in case of emergency which could be tackled properly.
Official data disclose that in two state run hospitals in the provincial capital Quetta Sandeman Civil Hospital and Bolan Medical Complex Hospital each. where 70 delivery cases at labour room and 15 serious cases are reported in operation theaters. If 70 deliveries occur, it means there are 140 patients as mother and child both need much care in initial stage.
Dr. Attaullah Bizenjo, consultant Pediatrician in Bolan Medical Complex Hospital talking to Balochi zind said for healthy baby it is necessary the mother of child should also be healthy. “When a child gets birth in healthy condition it means your society is healthy”, he said.
Dr Attaullah Bezinjo informing causes of increasing IMR in Balochistan
Like MMR the rate of IMR is also high in Balochistan and the causes behind this high rate is lack of basic facilities, awareness, illiteracy, poor vaccination. There are six common but important vaccines which prevent children from diseases such as Tuberculosis, Diphtheria, and Whooping cough, Pertussis, Tetanus, Polio and Measles. If children are timely vaccinated it will help reduce IMR.
Saima Kasi, a NGO worker talking to this scribe said that some NGOs working on MMR and IMR were playing an important role in this connection, however, during past some period many NGOs, including Save The Children have stopped working in Balochistan. “NGOs working in health sector along with government can better play role in controlling MMR and IMR”, she said, adding that there is need of revamping public health system as shortage of essential medicines, equipments and vaccines need prompt redessal.
Saima Kasi said we need to ensure labour rooms, operation theaters, Gynecologist, Anesthetist, trained midwife and nurses in district level besides addressing the issues of poverty, hygiene, nutrition and other basic facilities. “We need capacity building of our paramedical staff and better management and monitoring system to cover up MMR and IMR”, she added.
Peoples Primary Healthcare Initiative (PPHI) is currently working in various districts of Balochistan, including Nushki, Kohlu, Pangour, Zhob, Sibi, Kila Abdullah, Killa Saifullah and Kharan. PPHI has established 653 Basic Health Units and 103 Labour rooms in various districts of Balochistan. Moreover, 148 Pathologist Lab are working while 78 ambulances provide facilities to the masses in various parts of Balochistan.
PPHI’s Chief Executive Officer Aziz Ahmed Jamali told Balochi Zind that PPHI is making all efforts to ensure health facilities to the masses in different parts of Balochistan having only 4 percent from the total budget of health department. “PPHI within its ambit working hard to control MMR and IMR in Balochistan but more resources are needed to curb this high rate,” he said, adding that provincial government along with federal government ought to take this issue seriously and pour more resources to bring down this rate.
CEO PPHI Aziz Jamali informing about activities of PPHI in Balochistan
Hafiz Majid Sectary health Government of Balochistan told Balochi Zind the main reason behind Poverty, low level of literacy, lake of civic facilities, proper sanitation and clean drinking water, shortage of female staff including female doctor, Gynecologist , lady health worker and Nurses ,pediatrician .The Infant Mortality due to birth asphyxia, low wait, acute respiratory. Infections, diarrhea, malnutrition vaccine prevented diseases. Unfortunately the program was failed to achieve their goals and objectives and diverted fund on procurement of Ambulance, physical assets, medicines. Equipments ,not a single DHQ was strengthened to provide MNCH services. Sectary Health Further side All LHW program collapsed due to incapable political posted. There is no fault of LHWs, when nobody will own them they will enjoy to sit at homes.
Contributed by: Asif Ali (Reporter)