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Pregnant women struggle to find care after Pakistan’s floods



RAJANPUR, Pakistan – The first five months of Shakeela Bibi’s pregnancy went smoothly. She chose a name, Uthman, to make clothes and furniture for him. She had regular home health checks and access to medication. Later, an ultrasound showed the baby was upside down. The doctor told Bibi to take care and rest more.

And then there was the great flood this summer. Bibi’s house in Rajanpur city, southern Pakistan was flooded.

When she spoke to the Associated Press last month, she was living in a camp for displaced families. As her due date approached, she feared the possibility of a breech delivery with almost no healthcare.

“What if my health suddenly deteriorates?” Shakeela said. She is anemic and sometimes has low blood pressure, but she says she cannot have a proper diet in the camp. “I’ve been in a camp for two months, sleeping on the ground, and this is making my situation worse.”

Pregnant women are struggling to get care after unprecedented flooding in Pakistan, which has flooded a third of the country and displaced millions from their homes. According to the Population Council, a reproductive health organization based in the United States, there are at least 610,000 pregnant women in flood-affected areas.

Many live in camps for displaced people, or try to make a living with their families on their own in flood-ravaged villages and towns. Women were denied access to health services after more than 1,500 medical facilities and major roads were destroyed. More than 130,000 pregnant women need urgent care, with around 2,000 women giving birth each day mostly in unsafe conditions, according to the United Nations.

Experts fear an increase in infant mortality or health complications for mothers or children in a country that already has the highest maternal mortality rate in Asia. They also warn of dangerous, long-term consequences for women, such as an increase in child marriage and unwanted pregnancies as a result of disrupted families’ lives and livelihoods.

Rasheed Ahmed, a humanitarian analyst at the United Nations Population Fund, said previously the health system was poor and he now warns of “death, disability and disease” if women’s health brings pregnancy is missed.

“The biggest shortages are female health workers, medical supplies and medicines,” he said. “Resources are another challenge. What are the government’s priorities? Are they willing to spend money? “

At camps in the flooded towns of Fazilpur and Rajanpur, pregnant women told the AP they had not received any treatment or services during their pregnancy since arriving at the camp nearly two months ago. Clinics dispense medicine for minor ailments, but nothing for expectant mothers. The next day, after AP visited a local medical center to inform them of their plight, female paramedics checked on the women and distributed packets of calcium and iron supplements. .

In the end, Shakeela Bibi and her family left the camp, took their tent, and set it up near their wrecked home. The authorities gave them a month of flour, buffalo milk and lentils. She is now past her due date, but doctors have assured her that her baby is fine and do not think she will need Caesarian.

Perveen Bibi, an 18-year-old who is five months pregnant and unrelated to Shakeela, said the lack of medical facilities in the camp forced her to go to a private clinic and pay for an ultrasound and check-up. But she was prescribed medicine that she couldn’t afford.

She said: “I used to have a good diet, with dairy products from our livestock. The family had to sell their cattle after the flood because there was no place to raise them and no way to raise them.

Bibi, who has a daughter and is expecting a baby boy, said: “We need female doctors, female nurses, gynecologists. She had a son about a year ago, but he passed away a few days after giving birth. “We don’t have ultrasound or IV capabilities. We are just passing through. “

In the camps, families of five, seven or more people eat, sleep and spend the night in a tent, sometimes with only a bed between them. Most sleep on carpets. Some of the survivors had only the clothes they fled and relied on donations for.

Outdoor faucet for washing clothes, washing dishes, bathing. Pregnant women said they are lacking clean water and soap. They are afraid of infection because of defecation in the camps. A bathroom was set up, but it had no roof and tents around it.

Amid the devastation, organizations and individuals are doing what they can – UNFPA is delivering safe newborn supplies and birthing kits to four flood-hit provinces.

A Karachi-based NGO, the Mama Baby Foundation, has provided 9,000 safe delivery kits, including supplies for newborns, across the provinces of Sindh and Baluchistan, as well as antenatal care. and antenatal care for 1,000 women. The Association of Mothers and Newborns, also based in Karachi, has provided more than 1,500 safe delivery kits, mainly in Sindh.

Ahmed from UNFPA said pregnant women have needs that are different from the rest of the displaced population, needs that are not being met by the state.

“The reaction of the government is very general, it is for the masses. It’s about shelter, resettlement,” said Ahmed. “I have heard of women who have had a miscarriage because of the emotional stress, the physical stress of moving and moving,”

According to Saima Bashir from Pakistan Institute of Development Economics, the health crisis caused by floods will affect women as it will take a long time to rebuild health facilities and restore family planning. .

“Women and girls are very vulnerable in this situation,” said Bashir. She points out that there are more and more reports of child marriage.

Even before the floods, 21% of Pakistani girls were married before the age of 18 and 4% before the age of 15, according to UN data.

This rate is increasing for a number of reasons. Some parents marry their daughter as a way to get financial support from the boy’s family so they can rebuild their house. Others fear for the safety of their girls in displacement camps and believe that marrying them will protect them from abuse or secure their future. In addition, the destruction of schools during the floods also closed other options; instead, some girls who have already attended school or are able to work will stay at home.

In the next few years, those girls will become pregnant, Bashir says, especially with limited access to contraceptives.

“There will be many unintended pregnancies,” she said. “This … is amplifying this crisis, and it is increasing the population.”

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