KARACHI: Efforts urged to check maternal mortality
KARACHI, May 22: A symposium on “Contemporary Issues on Reproductive Health”, held on Wednesday, urged concerted efforts to address the fast growing incidence of cervix cancer, urine incontinence and high maternal mortality, besides other reproductive health-related complications among local women
The symposium was jointly organised by the Pakistan Medical Association (PMA) and Greenstar.
Speakers on the occasion included Dr Sadqa Jaffery, Dr Shershah Syed, Dr Kauser Nazir, Dr Aziz Abdullah, Dr Sharaf Ali Shah, Dr Rehana Ahmed and Dimitri Prybylski, an epidemiologist. They stressed the need for meaningful involvement of family physicians as the first line of health care providers, for timely diagnosis and proper medical intervention.
Prof Sadqa Jaffery of Ziauddin Medical University said that the high incidence of maternal mortality and morbidity in the country could not be attributed to lack of resources, but to sheer apathy and negligence towards would be mothers and their requirements.
Pointing out that 80 per cent of deliveries were conducted at homes, she said that the major causes of maternal mortality such as haemorrhage, excessive bleeding and hyper glycemia in almost all cases were related to repeated pregnancies.
She referred to three delays leading to maternal deaths; these were delayed decision to seek proper medical care, delay in reaching emergency obstetric care, delayed referral on the part of doctors themselves.
Dr Kauser Nazir, head of the OB/GYN department of the Jinnah Medical College, said that the Human Papilloma Virus was linked with 95% of all cervix cancers, commonly noticed among women belonging to lower socio-economic strata of the society.
She suggested improved diagnostic skills on the part of local family physicians as well as gynaecologists with regard to the visual inspection of the cervix with or without acetic acid to gauge the problem. The gynaecologist also referred to the WHO recommendation seeking a single life time Pap Smear Test to prevent the disease.
Dr Sher Shah Syed, regretting the lack of political will to raise women’s social and health status in the country, referred to the issue of fistula, an outcome of improper delivery practices.
Citing several cases in which a women was made to suffer either due to negligence of the doctor or for arriving late at the hospitals, he suggested that available options to treat the condition must be adequately projected and carefully applied.
Citing obstructed labour as major cause followed by mismanagement of the second stage of labour and termination pregnancy for urinary incontinence among women in the reproductive age group, the doctor said reconstruction was possible, although in certain cases it was said to cause cancer within a period of 15 years. “However, since it provides a woman in miserable condition a relief for considerable time, it cannot be ignored,” he said.
Dimitri Prybylski, an epidemiologist associated with the Population Services International, discussing HIV/AIDS in global perspective, said the condition had wreaked havoc across the globe, and while 40 million people worldwide were believed to carry HIV, 95% were not officially diagnosed.
With regard to Pakistan, he said the country was on the high- risk list due to its weak medical infrastructure and lack of awareness about the gravity of the issue.
Dr Rehana Ahmed urged medical professionals of to acquire skills in their respective fields. She said that more than a third of Pakistanis lived below the poverty line and the situation was compounded by high birth rates.
“The Total Fertility Rate (TFR) is at 5.5 children per married woman of reproductive age through her child bearing years,” she said. —APP
