GILGIT/ JAGLOTE: “Hassan’s wife has died while giving birth to a baby this morning. She died due to excessive bleeding. The baby has survived.” Those words hit Azeema so hard that she sat down as her husband Manzoor Khan uttered them on entering his house in Jaglote Valley, about 60 kilometers from Gilgit. Azeema, 26, has herself been in the clutches of death twice during childbirth. She knows what Hassan’s wife would have gone through in those last few moments as she bled to death. Out of the four babies Azeema has given birth to, two died in the course of delivery, and she almost never made it.
“Azeema’s delivery became complicated when initially the midwife assured the family wrongly that everything was under control, but after wasting considerable time, she expressed her inability and advised us to take her to a specialist doctor. We rushed her to Gilgit but it was too late,” says Khan. The experience taught Khan better, but not many get second chances. If her husband had not put in extra efforts to save her life and get her treated in time, Azeema, like her friend would today be just a statistic, a story.
In such remote rural areas, every mother has a story to tell – stories of deaths that could have been prevented.
Bleeding to death
Azeema’s unnamed friend is one of Pakistan’s 16,000 women who die annually during childbirth. Out of these, some 5,000 die due to Postpartum Hemorrhage (PPH), the leading cause of mothers dying. If the woman needs emergency surgical delivery, in most cases she never makes it to the nearest hospital in time and bleeds out and dies at home or on way.
Hope in a miracle drug
It’s inexpensive and almost free of side-effects. Helping the uterus to contract after childbirth and therefore reducing blood loss, Misoprostol can save lives. It has been included in World Health Organisation’s (WHO) model list of essential medicines. The National Committee for Maternal and Neonatal Health (NCMNH) has been advocating for the inclusion of Misoprostol in the national essential medicines list of Pakistan. “I instruct doctors and midwives attending childbirth to carry these tablets in their purse at all times to save lives of their patients,” says Dr Sadia Ahsan Pal, gynaecologist and obstetrician.
“If the mothers have regular checkups the complexities could timely be addressed,” says Dr Shujaat Ali of City Hospital Gilgit. “In most cases, they come to doctors at the 11th hour when things have already deteriorated.” “We are trying to address issues within the given resources but it’s really a tough job,” said Gulbar Khan, health minister in Gilgit-Baltistan.
Published in The Express Tribune, May 27th, 2013.