Changing attitudes: Badin gets 32 new ambulances

People’s Primary Healthcare Initiative lists down all its achievements.

KARACHI:

The people of Badin now have access to 32 ambulances given by the People’s Primary Healthcare Initiative (PPHI), which was given the responsibility of servicing the area by the government. This agreement was made in 2007, prior to which there was no concept of a woman visiting a health facility in the area.

The new ambulances include an advanced cardiac life support vehicle with a doctor and staff for heart patients and pregnant women. Six are advanced cardiac life support ambulances and the remaining 25 are basic life support ambulances.

In a presentation on Monday, PPHI director Dr Riaz Ahmed Memon pointed out a common observation that despite huge investments in primary healthcare, the government was still underperforming. The Sindh government invested billions of rupees in the construction of clinics in rural areas, basic health units and government dispensaries but they were either closed or their doctors were absent. “There were no results even from investments in a number of centrally driven vertical programmes, such as the Expanded Programme of Immunisation, TB Dot, etc., in Pakistan,” he said.

Until 2007, poor patients were charged Rs10 per check-up and Rs50 per intravenous drip even for services provided by the government, said Dr Ayesha Faisal. Today, there are two Basic Health Units in Badin for the 33,000 people. Two female doctors visit each unit and nearly 3,000 patients visit each unit per month. They can get ultrasounds and immunisation.

According to Dr Memon, 61% of these facilities were without doctors at the time of transfer and the PPHI had to hire 523 doctors on contract.  Almost 182 clinics were encroached upon by the police or influential landlords but PPHI managed to vacate nearly 97 per cent of them. The government gave the organisation Rs349 million, of which Rs224 million have been used to build infrastructure at a cost of 35 per cent less than the government’s scheduled rates.

PPHI appointed 410 female doctors, which helped raise the number of family planning clients to 308,907 last year. It now runs 26 mother and child health centres around the clock.

Referring to PPHI’s efforts during flood and cyclone relief, Dr Memon said that they have decided to establish 100 mother and child health centres that will work round the clock. Jamshoro district is also coming under the project soon. Sidat Hyder, a management consultant firm, has evaluated the organisation’s accounts and praised it for its service, he added.

For Dr Samreen, who has been working for a mother and child centre in Tando Allah Yar for four months, the real success is making women come out of their houses. “Now they discuss their complications with the female doctor,” she said. “Our patients have faith in us and like to share their medical conditions, irrespective of any taboos. This gives us an opportunity to advise them on family planning too.”

PPHI is surely beneficial for the patients but, Dr Samreen said, that it offers handsome salaries to the doctors as well. “Our main concern is that wherever we are sent, we should be able to learn something but, with the type of patients we receive, we learn something new every day.” Dr Samreen is in Karachi these days to learn how to do an ultrasound.

Sindh Chief Minister Qaim Ali Shah, who was present during the seminar, explained that the government decided to seek PPHI’s help given the sad state of health affairs.

Controversy

PPHI has its own set of controversies as it was only last month that the organisation was found using sub-standard medicines. According to a Daily Express report, PPHI was found using Paracetamol tablet, which was using only 30 per cent of the required chemicals. The testing report was issued by a federal government analyst of the central testing laboratory.

The clinic in Bhitshah:

31 C-Sections

200 deliveries

90 medicines free-of-charge

60,086 anti-snake, -rabies vaccinations

155 cold chain points for vaccines

With the mobile ultrasound service:

21,178 pregnancies confirmed

7,520 intrauterine deaths diagnosed

3,390 missed abortions detected

657 cases of ectopic pregnancies found

Published in The Express Tribune, June 28^th, 2011.