Collapsing medical facilities in conflict-ridden northwest


Peshawar: For the last three years or so, doctors and nurses at the sprawling Lady Reading Hospital in the north-western Pakistan city of Peshawar have been especially busy.

The hospital, one of the largest in the country, treats people across Khyber Pakhtunkhwa Province (KP), but lately demands on it have grown.

“Since the conflict began in the tribal areas and elsewhere, around three years ago, we have a 20-25 percent increase in patient load. We now see 5,500-6,000 patients daily in the outpatient and emergency departments. I cannot give a precise figure but there were significantly fewer patients previously,” hospital chief executive Hamid Afridi told IRIN.

He agreed one reason for this was the collapse of medical facilities as a result of fighting in many areas.

“There are simply no doctors, and especially no female doctors, left in South Waziristan [one of the tribal agencies in north-western Pakistan] – not even in the principal city, Wana. Most have got jobs in other places and moved away since the conflict began there,” Haroon Wazir, 25, told IRIN in a waiting area at Lady Reading.

He described a harrowing journey, over rough roads, he had made with his six-month pregnant, and sick, wife. “We travelled nearly 400km [from the tribal agency on the Pakistan-Afghan border] over two days in my brother’s van. We found a female doctor along the way but she said my wife, who is only 18 and pregnant for the first time, must be brought here, to a big hospital. The doctors are trying to save her and our baby.”

The situation is especially difficult for women in conflict areas, who are often reluctant to see male doctors. Many refuse to do so altogether.

Women doctors threatened

The Taliban’s discouragement of women in employment has meant women doctors and nurses have often fled areas under militant control, or stopped working. Those who refused to do so have sometimes suffered terrible punishment, as happened to Shahida Bibi, a “lady health visitor” working under a government scheme in the small town of Shabqadar in the Charsadda District of KP, close to the Mohmand tribal agency, after it was taken over by the Taliban between 2008 and 2009. Despite threats she refused to quit her work.

“Shahida lived in the bazaar area. She was kidnapped by the Taliban. And after a couple of days her mutilated body was found under the Subhan Khwar bridge, near the Shabqadar bazaar. Her crime was that she worked,” Sher Ali, president of the Shabqadar Press Club, told the media.

Given such reports, it is understandable why women who can offer medical help are reluctant to return to work even in areas that have been freed of militants, such as Swat Valley in KP, where a military offensive drove out militants in the middle of 2009, allowing displaced people to return.

“Things are much better now. Many of us no longer wear burkas but just our traditional shawls. However, even though I am a qualified doctor I remain fearful of resuming work – though I feel very guilty because I see all around me women and children who need help. Not all can afford to travel elsewhere for assistance,” said Asma Khan, in Mingora, the main city in Swat. She had received threats for working during the Taliban insurgency.

Among those who need help are women like Hamida, who has heart problems. “We cannot afford to go elsewhere for medical help. Good women doctors are hard to find in Mingora, and my husband refuses to let me see a male doctor,” she told IRIN.”I often fear for the future of my children,” she said.

Kurram

Things are tougher still in areas like the Kurram Agency where conflict has continued since 2007 and has recently intensified.

Humanitarian agencies, since the conflict began in earnest in 2008, have also expressed growing concern over the situation and the lack of access to health care.