By Midhat Ali Zaidi
Swat, Khyber Pakhtunkhwa – May 2016: “UNICEF truly appreciates the efforts being made by medical professionals working to improve heath care facilities for the mothers and children of Swat valley,” says Ms. Karin Hulshof UNICEF Regional Director for South Asia. Ms. Hulshof was visiting various projects working under UNICEF’s Maternal and Newborn Child Health (MNCH) programme in the Swat district, of Khyber Pakhtunkhwa province. “Pakistan is very close to my heart and I am glad that UNICEF’s contributions have helped in training and the establishing facilities to save and improve the lives of mothers and children in this beautiful valley.”
estled deep within the majestic Hindukush range, the valley of Swat was once known as ‘Switzerland of the East’. However, during the past decade or so, it has made headlines for entirely different reasons. The beauty and serenity of the valley were tarnished by massive floods and insecurity, which led to large-scale displacement during 2009-10. Nearly 3 million people, including 400,000 children had to leave their homes to take shelter in nearby areas.
During her farewell mission to Pakistan, in her capacity of Regional Director for South Asia, Ms. Karin Hulshof, along with UNICEF Representative in Pakistan Ms. Angela Kearney, visited Swat valley to witness the development and rehabilitation work being done by UNICEF. Since 2012, UNICEF has worked to help the people of Swat, rebuild their lives and strengthened social and health care services for the wellbeing of women and children within the district.
Establishment of Sick New-Born Care Unit at Saidu Teaching Hospital
The highlight of her mission was a visit to Saidu Teaching Hospital, where UNICEF has helped to establish the Sick New-Born Care Unit (SNCU). In line with Every Newborn Action Plan endorsed by World Health Assembly in 2014, UNICEF is assisting the government of Pakistan in developing a Newborn Survival Strategy. Work is being done to scale up evidence based newborn care interventions in selected districts of Khyber Pakhtunkhwa. By building capacity for Essential Newborn Care (ENC) and basic Emergency Obstetric and Neonatal Care (EmONC), the subject is quickly becoming a reality.
Due to unavailability of neonatal services in the surrounding areas, this unit receives sick newborns from all over Swat and adjacent districts, catering to a population of nearly 5 million. UNICEF has provided support to the hospital’s paediatric unit by renovating existing infrastructure of the nursery and fulfilling critical equipment gaps with provision of incubators and phototherapy units. It has also helped in building capacity of health care providers by training Medical Officers, Community Midwives and Lady Health Workers and Lady Health Visitors for improved care and timely referrals.
“Our unit is receiving about twenty five new cases every day, as we have gained the population’s trust with our new facilities. Now we do not have to refer children to Peshawar for something as simple as a blood transfusion,” says Doctor Fazl-e-Rabi, in-charge of the nursery unit at Saidu Teaching Hospital.
The unit receives a bulk of cases for birth asphyxia and prematurity with children born at home without proper care. Dr. Fazl maintains that the new facilities have enhanced their live saving capacity by 95 per cent. “Our staff is not only providing care to the newborns and their mothers but also counselling patients to challenge societal norms which can be injurious to their children. We are educating them about breastfeeding techniques and the necessity of proper care and hygiene for a newborn.”
Asma (30), a mother of four, has brought her 8-month premature baby Faiz, for treatment at the Saidu Teaching Hospital. Her last baby was still born, but she has confidence in the care providers and facilities here to save her baby.
“My son was unable to breathe properly until I brought him here. But the doctors and staff saved his life by initiating treatment as soon as we brought him in,” says Asma, who gave birth to Faiz at a privately run hospital, which did not have such facilities. “The staff are very competent and treatment is provided to every mother and child who comes in, no matter if they are rich or poor.”
Improving the Expanded Programme on Immunisation
Another important aspect of the MNCH programme is the training and capacity building of community health workers to support Pakistan’s Expanded Programme on Immunisation (EPI). UNICEF has provided continued support to train community health workers to reach every child in the country by providing necessary vaccines at the doorstep. So far, over ten thousand LHWs have been trained under the programme.
At the Basic Health Unit (BHU) in Union Council Manyar, Doctor Mohsin Sami Khan is conducting an EPI training session for LHWs from the catchment areas. The six month course trains community health workers in vaccine administration, referrals and monitoring the community for vaccine defaulters through door-to-door marking. He informed the delegation that his area has a very low refusal rate, with people bringing children from miles up in the mountains.
“We go to every house in the community, while maintaining a relationship with the BHU,” says Shameem Akhtar, an LHW receiving the EPI training here, while explaining the nature of her work for the visiting dignitaries. “An important part of our work is the community health sessions, where we educate the mothers about family planning, nutrition, hygiene and importance of breast feeding. Any problems that come up during the session are referred to the BHU.”
Ms. Karin Hulshof was also briefed on the preparations of the up-coming Mother and Child Week, which are held biannually in April and November every year. The April round will be focused on creating awareness about diseases which spread during the summer season, while the one in November educates mothers about acute respiratory infections and other common ailments during winter. The BHU staff also demonstrated and briefed her about the procedure for administering the Inactive Polio Vaccine (IPV), which has been recently introduced as part of the routine immunisation programme to aid in Pakistan’s fight against Polio.
"Community health workers are the backbone of EPI,” says Ms. Karin Hulshof while speaking at the training session at BHU Manyar. “Your efforts have been exponential in reaching every child and creating awareness on the importance of vaccines in the community. Every one of you is our partner in delivering health care to women and children of Pakistan, which could not have been possible without the efforts you make.”