Pakistan Flood Relief: Field Notes from Doctors to Sukkur – Day 2

If there is anything the government should learn from this flood, it is to take education and women empowerment more seriously. The enormous task of taking care of so many IDPs iz only magnified many fold by lack of a good base. If these IDPs were a little better educated it would have been so much easier for the govt. to house them. How can a mother take care of 10-15 children? It is simply not possible. Corroborating Dr Nighats experience when told about family planning theyre responses were ‘have you no fear of Allah’ or ‘our husbands want it-they beat us’ Many females do understand but the men dont.

A woman came to one of our camps today asking for birth control pills an amazing happening, to our shame- we had none with us – I wonder if medical teams should carry IM depoprovera-council them and administer?

We went to 3 camps today All of them were tent villages

• it is good that people are being moved from schools, not all of the desks will become firewood
• please make a note that after the floods are over much help will be

Need to refunctionalize the schools

We saw suspected cases of Malaria and Typhoid today -this may be the next major problem.  Conjunctivitis and skin infections account for a great proportion of the complaints. At times these occur simultaneously in the same child.  We went to an army camp today too. It waz well managed, organized clean and ppl were well provided for-all except medical treatment

On the way to Sukkur a mob attacked our pick up truck and stole many boxes of medicines -running alongside our moving vehicle.  People have accumulated along the sides of the highway between sukkur and khairpur- and I cannot curse enough people coming in big cars throwing stuff out of the windows- what are they thinking how is that helping anyone but their own conscious-they are creating serious problems

We met with about 35 lady health care workers today for 2hours

• That is when I realized that my grand idea of an lhw visiting every camp was too Naive – last nights meeting had many false promises lady healthcare workers are a great force- underpaid, exhausted n downsighted by local hospital doctors-this force is only acheiving 25% of its potential

The training session based around teaching them to teach and ensure

• diarrhea prevention
• ors
• malaria prevention
• high risk preg notification
• general hygeine

Feeling a greater need I thought it prudent to turn the training session into a motivational session- we talked interactively abt how they are so important and vital- how they save lives, I told them I respect them much to be working so well with such minimal compensation

We learnt that they do not go to their duties- I hope our exchange atleast made them feel better abt themselves and motivated them to show up at work tomorrow

Many changes are needed- at all levels, the health system 4rm the basic level to the tertiary level is in shambles- this will not change because of a flood

I am confused about training other LHWs here and in sukkur- is it worth it? If they go to every camp it would be but that wont happen There are almost 1500 of them in sukkur and khairpur but why they cant go to the 280 camps is a mathetical conundrum stressing the benefits of handwashing with soap multiple times brought us a promise of adding a bar to their rations.

Speaking of rations we learnt the world food program’s rations consist of wheat and oil – thats it! -I wonder how retarded can one be ‘oh the staple food of pakistan iz wheat so giving them just wheat would be enough’

Meds in need are

• amoxcillin
• augumentin
• eye drops
• zinc syrup
• ors
• multi vit tablets
• skin ointment

Tomorrow we go to kodgi

I strongly maintain that the best thing that any disaster relief cell can do in a developing country is education and women empowerment

Regards

Syed Nabeel Zafar

MBBS, MPH
Instructor (Research)
Department of General Surgery
Aga Khan University.