November 17, 2022
Environmental Health Risks in the Philippines
Doctors of the World has been active in Pakistan since 1996 with the aim of strengthening the country’s health infrastructure
In many parts of Pakistan, vulnerable communities are not able to access the healthcare they need
This is especially true for women and children. 1 in every 11 children dies before their 5th birthday, and maternal mortality is very high due to complications during labour such as hemorrhages and eclampsia. An estimated 14,000 women die every year during childbirth in Pakistan, which means 1 woman dies in childbirth every 37 minutes.
Doctors of the World has been working in Pakistan since 1996 in order to strengthen the country’s health infrastructure, especially in the provision of sexual and reproductive care for young women and girls.
In August, 2022 a 30- years record-breaking monsoon has led to severe floods affecting over 80% of Pakistan. Its impact has been devastating: 33 millions people have been affected including 7.6 million estimated people displaced. Pakistan is facing a massive humanitarian crisis that unfortunately won’t be resolved quickly. The flooding has not only taken thousands of lives and damaged billions of dollars in homes and infrastructure, but its repercussions are only just beginning. The floods have destroyed thousands of crops and have greatly impacted Pakistan’s food security, the risk for malnutrition and even starvation is on high alert according to the international community.
20.6 million
need humanitarian assistance
2 million
homes fully or partially damaged from the 2022 floods
1,400
public health facilities have been affected by the floods
In the province of Khyber-Pakhtunkhwa access to healthcare is often disrupted by instability caused by terrorism and natural disasters such as earthquakes, landslides, and floods. As a result, many communities in the province have become displaced and there are also a high number of refugees from Afghanistan residing in the region.
Since 2009, Doctors of the World has supported 7 healthcare facilities in Khyber-Pakhtunkhwa through mobile medical teams and the organization of informational workshops. Our teams provide primary healthcare and sexual and reproductive healthcare, and raise awareness on the importance of immunizing children.
Between 2020 and 2021, the 4 health structures supported by Doctors of the World have all been successfully transferred to local health authorities: thanks to coordination and advocacy efforts with the authorities, sufficient public resources have been allocated, within the framework of ‘a large provincial development plan, allowing us to sustain our action over the long term.
Following this intervention, Doctors of the World turned to the former tribal areas bordering Afghanistan, where years of conflict and the lack of development of public infrastructure have left the health system in an extremely precarious state. In December 2021, we started providing primary health care in a health facility in Khyber District, a geographical area to which access has long been restricted for security and administrative reasons: this is a first step in responding to the needs of a largely underprivileged population. Our focus that year was largely on COVID-19, preparing healthcare staff and the public on how to prevent and treat coronavirus.
In 2021, we have:
- Supported 41 health centers in 4 districts of KP with personal protective equipment, medical and non-medical equipment, and water and hygiene infrastructure, benefiting 70,223 people,
- Distributed 6,000 antigen test kits and 1,700 personal protective equipment kits to health centers,
- Trained 36 health personnel in the prevention and reduction of risks in the face of Covid-19,
- Educated 105,950 people about Covid-19 and barrier gestures.
Responding to the Floods in Pakistan:
Doctors of the World (DotW) has mobilized its team of over 100 staff in Pakistan to respond to this crisis from August 28th, through integrated outreach healthcare and reproductive health services with mobile clinics in the Khyber Pakhtunkhwa province, including the Nowshera, Charsadda and Chitral districts. DotW is in close coordination with the district health department, and other stakeholders to ensure coordinated efforts.
As of February 2023, Doctors of the World has
- Provided 12,340 medical consultations,
- 1,373 women have benefited from ANC consultations
- 273 women received PNC within 48 hours of delivery
- 1,185 women got access to family planning through the 4 mobile clinics deployed
- 1,593 persons, including 860 mothers and 733 caregivers received counseling sessions on infant and young child feeding to prevent malnutrition.
- The teams conducted 462 health education and awareness sessions for a total of 7,311 participants.
In the province of Punjab, women marry very young and often have early pregnancies
17% of women are married before the age of 17, and cultural and religious practices prevent young women and girls from gaining access to or learning about family planning. Since 2015, in order to improve access to quality sexual and reproductive health (SRH) services in the Punjab region, Doctors of the World has partnered with the Population Welfare Department (PWD) staff to improve access to family planning and capacity building of treatment centres.
One aspect of the program is creating a pre-marital counseling manual aimed at improving access to SRH and family planning services, particularly for young people. This manual provides guidelines for staff to raise awareness and improve communication between young couples about sexual and reproductive health issues and services, to enable them to make informed choices, together, about their future life as a couple. couple and family.
In 2021, this manual was tested in Lahore to assess the potential of this new tool: PWD staff were trained and communities in the intervention area were sensitized on the definition, objective and content of the pre-marital counseling manual. The perception by these different actors of SRH issues as well as the introduction of the manual have been evaluated within the framework of a study, the results of which are encouraging. Pre-marital counseling could be a key factor in improving the contraceptive prevalence rate, the use of SRH services or even strengthening women’s decision-making power, thus becoming a tool in the service of equality.
In 2021, we have:
- Made 7,503 people aware of the pre-marital counseling manual,
- Trained 24 PWD staff on the pre-marital counseling manual.