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Natural disaster | Refugees | Endemic/Epidemic disease | Healthcare exclusion

Access to healthcare remains a challenge in Pakistan, especially for people in isolated rural communities, urban slums, and areas affected by conflict. 

Figures

Healthcare for women and children is a serious concern: women in rural areas die from preventable complications during pregnancy and delivery, and neonatal care is unavailable in many areas: according to the Pakistan Democratic and Health Survey, one in every 11 children dies before the age of five.

Doctors Without Borders continues to support health authorities in responding to urgent needs.

Mother and child health

Mother and child health in Balochistan

MSF runs a 60-bed paediatric hospital in Quetta, with a neonatal unit, an inpatient therapeutic feeding centre for children under five years with severe acute malnutrition, and an isolation ward.

In 2016, 800 patients were admitted to the hospital and 2,385 malnourished children received treatment. Until April, the hospital also operated a paediatric ward.

In Kuchlak, 20 kilometres north of Quetta, MSF manages a mother and child health centre offering outpatient treatment and nutritional support for children under five and 24-hour emergency obstetric care.

Patients with emergency obstetric complications are referred to Quetta. Psychosocial counselling is also available in the clinic.

Until July, MSF offered outpatient services for reproductive health and children. In 2016, MSF staff carried out 39,527 outpatient consultations and assisted 4,989 births.

In Kuchlak and Benazir Bhutto hospital in Mari Abad, MSF treated 2,555 patients for cutaneous leishmaniasis.

Near the Afghan border, MSF works with Ministry of Health at Chaman district headquarter hospital, providing reproductive, neonatal and paediatric healthcare, and inpatient and outpatient nutritional support for malnourished children under five.

These services are available to local residents, Afghan refugees and people who cross the border seeking medical assistance. In 2016, 1,060 patients were admitted to the neonatal and paediatric wards, 4,080 births were assisted, including 248 caesarean sections, and 1,321 malnourished children received treatment.

MSF supports Ministry of Health in emergency room for trauma cases and treated 6,971 patients in 2016.

MSF continues to work in the eastern districts of Jaffarabad and Naseerabad, supporting inpatient therapeutic feeding for severely malnourished children, and general paediatric and neonatal wards in Dera Murad Jamali district headquarters hospital.

Teams also run an outpatient therapeutic feeding programme through a network of mobile clinics and outreach sites. In 2016, MSF reopened mother and child health unit in collaboration with the health authorities.

In 2016, 11,474 malnourished children received treatment under therapeutic feeding programme, 821 patients were admitted to the neonatal and paediatric wards, and 484 births were assisted.

Mother and child health

Federally Administered Tribal Areas (FATA)

MSF provides medical care to vulnerable communities in Bajaur, the northernmost tribal agency. At Nawagai civil hospital, teams work in the outpatient department, stabilisation room and mother and child health unit,  while providing treatment for cutaneous leishmaniasis, endemic in Bajaur.

In 2016, 31,069 outpatient and 8,152 emergency consultations were conducted. In addition, MSF supports Khar Agency headquarters hospital in the event of a large influx of casualties.

At Sadda Tehsil headquarters hospital in Kurram Agency, MSF provides outpatient care for children up to 5 years, inpatient care for children under 12 years; treatment for cutaneous leishmaniasis; antenatal care and obstetric and emergency referrals; and support Ministry of Health in emergencies.

In 2016, staff on average carried out 3,000 outpatient consultations per month. At the smaller Alizai hospital, they conducted an average of 120 paediatric outpatient consultations each week. MSF temporarily opened a medical point at New Durrani camp in May to assist displaced people.

Emergency and maternal care in Khyber Pakhtunkhwa (KPK)

MSF offers comprehensive 24-hour emergency obstetric care at Women’s Hospital in Peshawar for patients referred from surrounding districts and FATA.

The hospital has 24 obstetric beds and an 18bed neonatal unit for specialised care for premature and severely ill newborns. In January, the new outreach team started working to improve liaison between patients, hospital and the community. In 2016, 4,906 deliveries were assisted, including 479 caesarean sections.

In Timurgara, around 200 kilometres north of Peshawar, MSF supports district headquarters hospital’s emergency, resuscitation and observation rooms, as well as the neonatal unit. Teams provide comprehensive emergency obstetric care, including surgery, and assisted 9,627 births.

The ‘cardiac corner unit’ treated 2,667 patients with acute coronary syndrome, and the mental health team carried out 3,987 consultations.

Staff also ran community health awareness-raising activities and conducted a total of 7,713 sessions. In December, MSF added a new digital X-Ray facility to its services.

Healthcare for Machar Colony

In Karachi’s Machar Colony slum, MSF provided 107,397 outpatient consultations at the clinic run in collaboration with SINA Health Education & Welfare Trust. Machar Colony is densely populated with around 200,000 people, living in polluted, unsanitary conditions.

The programme includes primary healthcare, basic emergency treatment, obstetric care and mental health support, as well as educational sessions on hygiene and health.

In addition, MSF provides diagnosis and high-quality treatment for hepatitis C, highly prevalent in this area. In 2016, 412 patients were started on treatment for the disease and 301 completed the course.        

Emergency response

In April, heavy rains led to flooding in KPK. Alongside with Provincial Disaster Management Authority, MSF distributed 1,659 emergency kits to affected people in Swat, Kohistan and Shangla.

MSF ran a dengue prevention campaign in Timurgara, Balambat and a camp for Afghan refugees, reaching 4,219 households.

During the summer, a team set up 10 heat stroke prevention points across Machar Colony providing drinking water and first aid. A total of 23,000 people benefited from the activity.

No. staff in 2016: 1,649 | Expenditure: €22.9 million | Year MSF first worked in the country: 1986 | msf.org/pakistan blogs.msf.org/pakistan | @MSF_Pakistan

Staff Story

Working under pressure,

It's very hard because we have no news from patients who used to come regularly for care. Or we see patients that tell us terrible stories like this little girl of seven who has burns to her face, caused by an explosion. She came for treatment. But when I asked her where her father and mother were, she said they died. There is also this 32-year-old woman who was slightly injured by shrapnel and was pretty good physically. But she was very shaken by the loss of her four brothers. Two of them just got married and all died in recent weeks. We listen to patients, they need to talk but they do not understand what happened to them.

We really go through a lot of emotions. Sometimes incredible things happen also. A patient we follow up for a while is in a wheelchair … When I learned that the city of Shujahia where he lives was under heavy shelling and that everybody was fleeing, I wondered how he would do. How to escape in a wheelchair? And then one night I was watching television that showed refugee families in a school and I saw him on TV! He was alive. It was great.

To read more, visit blogs.msf.org/hazem