Lack of hospitals and female doctors in Kashmir: every second child dies at birth

In the valley of Neelum there is only one medical clinic without specialist equipment. Only one doctor visits 17 thousand patients, but can not touch women. Pregnant women are forced to travel hours to give birth at the nearest hospital. They are often exhausted by pain and die. The territory is impassable, the doctors have no incentive to pursue the profession in the area.

Islamabad (AsiaNews / Agencies) – One child dies every two that are born on the first day of life or they are born dead. This is the case in the Neelum Valley in Pakistan's Kashmir region, a mountainous and impervious land where doctors and hospital equipment is lacking. Throughout the region, 54 children per 1,000 births die after birth or are born lifeless. The percentage of maternal deaths is very high, because the only doctor in the valley is a man and expectant mothers cannot be touched by male strangers to the family. This is why pregnant women face long hours of travel (even up to eight) before reaching the nearest hospital, but often arrive exhausted by pain and do not survive labor.

The Neelum valley is located in the extreme northern part of the country, at about 4 thousand meters above sea level. The thick blanket of snow covering the ground for most of the year, does not encourage the arrival of new doctors and makes it difficult for women who have to give birth to move.

About 17 thousand inhabitants live in the village of Sharda, and there is only one doctor working in a Basic Health Unit, a kind of medical surgery without specialized equipment. Because of the local tradition (Muslim) that prevents him from visiting pregnant women and helping them at delivery, he is helped by three "Lady Health Visitors", that is, women with  some health education, but with no medical training, who try to spread basic knowledge of hygiene and health.

Asmat Nisa, a pregnant woman who lives in the village of Kel Arang, already the mother of five children, says: "We are afraid to die. There is no hospital and I've never seen a woman doctor. " Shaheen Farhat, director of the Reproductive, Maternal, Newborn, and Child Health Program (Rmnch) in Pakistani Kashmir, reports that the major cause of maternal and child deaths is the lack of "trained midwives and specialists, who can assist women in labor."

According to a study by Save the Children published in 2014, Pakistan has a very high proportion of deaths in childbirth or children born dead, that is 40.7 per 1,000 births. In Europe, only 5.9 children do not survive the first four weeks of life. Even Afghanistan, torn by years of war, has a lower percentage: 29 per 1,000 births.

Dr. Sardar Mahmood Ahmed Khan, director general of the health service of the Kashmir region, argues that a key factor to the shortage of doctors is the harshness of the territory and the lack of electricity. "The small turbines – he says – are only enough for home lighting, but not for everything else. The Basic Health Union is also without energy”.

Dr. Khan adds that the Rmnch program launched in 2007 provides for increased salaries for doctors who choose to work in rural areas of Kashmir: 80 thousand rupees (690 euro) per month for doctors and 150 thousand (EUR 1,295) for specialists, against a wage of 65 thousand (EUR 590) and 100 thousand (EUR 863) for those who decide to practice the profession in the cities.

Nevertheless, doctors are scarce and the 500 million rupees (4.3 million euro) allocated to the program ran out earlier this year. Throughout the region of Kashmir, inhabited by 4.4 million people, they work just 1,050 doctors. In the area there are 758 medical centers (including clinics, hospitals, clinics), where there are 3 thousand Lady Health Visitors.

• Pakistan kashmir children deaths Neelum surgery