Death by design: malnutrition and health crisis in Tharparkar

Karachi

Most remote and rural areas of the country have similar conditions to Tharparkar, but since the area has been marred with poor availability of basic resources and opportunities, besides a lack of job opportunities, the role of private sector has become even more significant than before.

This was pointed out that panellists speaking during “Death by Design: Malnutrition and Health Crisis in Tharparkar” organised by the Habib University on Saturday.

The panel comprised special secretary health Dr Shereen Narejo, community development expert Dr Sonu Khanagarani and HANDS chief Dr Shaikh Tanveer Ahmed. Senator Taj Haider of Pakistan People's Party could not make it to the event.

The panellists emphasised that there were many Thars in the country with similar fates, and all of them were waiting for a miracle.

They were of the view that a large number of deaths of infants and women during childbirth were not due to natural disasters, but on account of poor political leadership, family pressures, lack of professional commitment and dedication towards the benefit of human kind.

They informed the audience that it was necessary to understand that lack of clean drinking water, sanitation, food supply, access to education, transportation and basic health facilities were also equal factors that had spurred the deaths of children in Thar and nearby localities.

“Pakistanis living in urban centres know the region through the colourful dresses of Thari women, its distinct music and dance, and its unique handicrafts with their unique patterns,” they said. “However, they remain largely unaware of the difficult lives that residents of Thar live and constant struggles they must wage to be able to earn a living.”

Dr Sonu Khanagarani mentioned that Thar had around seven million cattle population, one of the largest in Sindh, and the locals bartered it for food water, transportation and other purposes. Their sole possession was their cattle. Another source of income for some people was renting out agricultural lands.

He said there were two sources of water in the region, rain and wells. However, rains were not a regular feature in Thar while the subsoil water drawn from wells was unhealthy for consumption. However, said Dr Khanagarani, 97 percent of the water used by people of Thar came from beneath the soil.

“In the past, over 80 percent of the population were Hindus but now the ratio has changed to 60 percent Muslims and 40 percent Hindus, due to mass emigration non-Muslims to the other side of the border on account of the prevailing social insecurities.”

He claimed that after both wars with India, in 1065 and 1971 respectively, one major change in the desert was the establishment of madressahs near the border run by outsiders.

“Thar is the most peaceful region in the country. But it remained isolated from other parts of the province till 2000 after which the operation of FM radio channels, construction of a road and availability of mobile networks provided some relief to the desert dwellers,” he said.

HANDS chief Dr Shaikh Tanveer Ahmed while citing figures of the health department stated that 481 children under five years of age had died from December 1, 2013 to March 14, 2015 and all the deaths were reported at district headquarter hospital Mithi that was supposed to be equipped with most of the basic treatment facilities.

He said about 326 deaths were reported from the region in the year 2015 alone. Meanwhile, he pointed out, national figures showed that about 67 children out of 1000 infants born every year died before the age of five while 83 out of 1000 infants passed away before their first birthday.

According to the Pakistan Health Survey, 270 women out of 100, 000 lost their lives during childbirth in Pakistan. In Sindh, the average ratio was 370/100, 000 while in rural localities of the province it was actually 450 deaths per 100, 000 childbirths.

He said more than 50 percent of the deaths occurred due to involvement of unskilled persons in childbirth. He said the Sindh government had begun a program for midwives and after receiving between 18 to 24 months of training, these women were adeptly handling delivery cases in their areas.

Dr Ahmed also said that hardly 33 percent children in the province were vaccinated and that was another major reason for such a large number of deaths in Thar and surrounding areas.

Food insecurity, he said, was another rising concern and malnutrition was closely linked to the state of mental and physical health of families, and especially mothers.

Special secretary health Dr Shereen Narejo urged the private sector to help. Expanding on a lack of human resource, she said the high dropout rate of women was a big challenge for the government because roughly 30 percent of students of government medical or nursing institutions never stepped into the professional world.

She urged everyone to do their bit and be a bit more proactive to be able help build the country.

The session ended with a sublime reminder of apathy when moderator for the event, the interim dean of the School of Arts, Humanities and Social Sciences at Habib University, Dr Asif Aslam, informed the audience that a collective prayer was recently organised at a temple in Mithi to mark the death of more than 200 new-borns and infants in Tharparkar district.