Critical Care for Mothers and Children in Remote Communities
The anxiety is plain to see on Sadia Bibi’s face. Her two-month-old baby daughter Anisa is covered in an angry red rash, so Sadia has brought her to the rural health center in Danna for an urgent consultation.
Anisa is being examined by Zeenat Begum, the International Rescue Committee’s maternal and child health supervisor. Zeenat is working alongside the health center’s midwives to give them on-the-job training in the basics of reproductive health care, including family planning, understanding risks during pregnancy, and monitoring young children’s growth.
“The problem with this little girl isn’t too serious, thankfully,” says Zeenat, “but it seems to be caused by poor hygiene.” Such skin complaints are fairly common in remote areas like Danna, where education about good personal hygiene is limited and clean water can be scarce. Zeenat adds: “The center also sees a lot of cases of diarrhea, in adults as well as children, and that is also often linked to dirty water.”
This is the second trip to the center in as many months for Sadia and Anisa. In April, they came to get Anisa vaccinated against polio and tuberculosis when she was just five days old. And Sadia was also a regular visitor during her pregnancy, coming in to check her height, weight and blood pressure, as well as learn important information about nutrition and safe delivery.
“We see about 10 to 20 women every day,” says Rukhsana Kazmi, one of the midwives training with Zeenat. “I can now help them fill in their child spacing cards, give them a check-up and talk to them about contraceptives like hormone injections. I’m still in the learning process but it’s been very useful and I hope that when the international agencies go home I will be able to help my people by being a good midwife.”
Rukhsana completed her midwifery degree several years ago but her study was largely theory-based and included little more than a month of hands-on experience. “It’s good to have Zeenat working alongside us as it gives me confidence in what we are doing,” admits Rukhsana. “I’m still nervous when she isn’t here, but I hope to get more and more confident as we go on.”
Rukhsana is new to the Danna health center, but her colleague Sakeena Begum has worked here for 21 years. “Until recently, I was the only midwife,” Sakeena says, “so I had to do everything myself and I have delivered thousands of babies. Obviously I am now very experienced, but I am still learning a lot from Zeenat. She’s not just helping the new staff; she’s also taught me about what types of food are best for young children and how we can encourage mothers to take steps that prevent diarrhea. It’s great working with her.”
This on-the-spot training is just one element of the IRC’s support for health services in Muzzafarabad–one of the areas hit hardest by last October’s earthquake. Paramedics and other health workers are also receiving classroom training from the IRC in subjects ranging from good hygiene and diarrhea prevention to cholera and malaria. And the IRC has hired two additional medical officers to join the Danna clinic staff.
IRC health manager Dr. Muhammed Niaz explains: “Immediately after the quake, IRC staff offered immediate assistance and were examining and treating patients themselves alongside the regular Ministry of Health staff. However, now that the initial emergency is over, our focus is to work with those staff and build their skills, so they can diagnose and treat patients more effectively themselves. We want them to be able to offer a much-improved standard of primary health care to their own communities.”
The IRC is also training staff from 5 other facilities—three first aid centers and two basic health units—scattered throughout Muzzafarabad. The IRC is stocking all of these facilities with furniture, drugs, equipment and other crucial medical supplies.
Five months after the earthquake, all six facilities together had treated more than 18,000 patients, just over half of them women.