12 November 2004	Friday	28 Ramazan 1425

KARACHI, Nov 11: Hundreds of expecting mothers in suburban areas of the city have to rely on traditional birth attendants (TBAs) for medical assistance at the time of delivery, because the government, despite its tall claims, could not establish well-equipped health centres for emergency needs of the residents.

Women living in the remote areas of Keamari, Gadap and Bin Qasim towns, and parts of Baldia Town, are at a great risk during their pregnancies due to nonexistence of relevant medical facilities there, PPI learnt on Thursday.

There are only five Rural Health Centres (RHCs) for 104 villages of Gabopat Union Council, Keamari Town, with more than 80,000 residents,

Reportedly, 2-8 TBAs are available in each village in the area but they are not properly trained nor able to deal with complicated cases.

Owing to illiteracy, the residents most of the time fail to realize the emergency, and fail to shift patients to major hospitals in time. They also have to face the problem of non-availability of transport in night hours.

A TBA, Masi Rukan, 74, resident of Ibrahim Haidri has been in this field since last 40 years. "I do not remember how many births I have assisted, but I know that I have got a lot of experience through practice and I once helped eight mothers on the same day," she said.

"My grandmother was a renowned midwife in the entire area, and was able to deal most complicated delivery-related cases. I inherited this profession from my mother. Headache is major problem for expectant mothers, and I always advise them to be admitted at a major hospital," she added.

Though Rukan has also got training from two non-government organizations but she said that she did not understand their techniques and only practised the traditional methods of childbirth.

Dr Abdul Razzak Lasi, engaged in the Aga Khan Mother-care Project in coastal areas, said response from the villagers was not encouraging as they did not like to go to main hospitals for treatment, and as a result many lives were lost.

We provided them vehicles free of cost and assured them that proper medical care would be provided to both mother and newborn at hospital, but they felt reluctant to follow the advice, Dr Lasi said.

Saeeda Ramzan, 30, having some experience as a nurse, and now working with the Fisherfolk Forum, said that it was difficult to describe the real situation in the rural areas of Karachi.

"Poor people depend on the government-run rural health centres, which are without basic facilities, and even doctors do not spent their duty hours there," she deplored.

Talking about TBAs' training, she said it was not satisfactory because they did not have equipment to note weight of a baby at the delivery time. These illiterate women needed proper facilities, so that they might be able to help mothers with confidence.

Murad Bibi, 53, a resident of Hawkesbay said, "I have become a midwife because the community required somebody to help mothers during delivery. This is not my occupation and i have only 8-year experience.

"I have helped more than 100 mothers, including eight mothers, who gave birth to twins," she added.

Kulsoom Dablo, 58, from Rehri, has helped more than 200 mothers in her 34-year-long career as a midwife.

According to a report, on an average, 4 million births occur every year in the country. About 80 per cent of deliveries take place at homes, and 95 per cent of the deliveries are handled by TBAs.

Doctors believe that deaths occurring due to complications in pregnancy and childbirth are strongly associated with inadequate medical care and professional assistance at the delivery time.-PPI