Zeenat’s father narrates his family’s ordeal.—White Star

KARACHI: Despite being the largest (area-wise) town of Karachi, Gadap is the least developed and most backward part of the city; poverty is rampant and life’s basic facilities are non-existent.

Recently buried in the graveyard of Gadap town’s Qadir Jokhio village is a young mother, 25-year-old Zeenat, who now rests in peace with her baby. Both graves are unmarked.

“Their lives could have been saved if the private hospital she was initially taken to in Gadap had provided her with the right treatment,” Dur Mohammad, Zeenat’s grieving father, says as the Dawn team stand by quietly in the graveyard.

According to him, Zeenat in her last stages of pregnancy started having labour pains and vaginal bleeding around 8pm on April 14 when she was taken to a private hospital, situated more than 20 kilometres from the village, part of union council-three of Gadap.

“About half an hour was wasted in arranging a vehicle to shift her to the hospital where doctors first administered her some kind of injection and, then, blood, as they found her hemoglobin (HB) level too low (that was three while a pregnant woman’s HB level should be at least 10, according to doctors),” Mohammad recalls.

These efforts, however, couldn’t help Zeenat and she started vomiting upon which the family was asked to take her to the Civil Hospital Karachi, about 40km from the private hospital.

The poor family once again pleaded the driver to show some mercy and help them take their patient battling for life to the hospital. The driver agreed and the family finally reached the CHK around 11pm.

Zeenat, the family narrates, was immediately admitted and operated upon but the doctors could neither save her nor the baby. The family was told that excessive blood loss proved fatal for Zeenat and the child.

“It was a baby girl. I held her in my arms for a while but didn’t have the courage to see her face,” Mohammad says.

At the village, Zeenat’s blind mother is still struggling to accept the death of her only daughter. Sitting in her one-room house, she doesn’t reply to any question posed to her.

“She has become too quiet after Zeenat’s death,” Jannat, their daughter-in-law, says.

The 50-bed government hospital in Gadap City, which has been lying closed for many years.—White Star

According to the family, it was Zeenat’s fourth pregnancy in eight years’ of married life. Two of her children had died earlier within the first week of their birth and only a girl survived. She is looked after by her father that lives in a nearby village.

No functional hospital

It might be the first maternal death of this year in Gadap town but, according to residents, such deaths are common in the area that has no functional government hospital while facilities at primary healthcare centres are inadequate.

Spread over 1,200 square kilometers, Gadap town is divided into eight union councils and, according to old estimates, is said to have a population of about 550,000.

The Dawn team visited a 50-bed government hospital located in Gadap town that has been lying closed since its inauguration in 2009.

“It was started in 1990s and was made in bits and pieces by different governments. The basic health units operating in the area are often without a doctor and medicines and are closed down by 2pm.

“We want a female doctor in our area so that women feel comfortable discussing with her their health issues,” says Nasima, a teacher running a private school near Qadir Jokhio village.

Residents of the town recall the good old days when the area was famous for its agricultural produces and was a major source of supply of vegetables and fruits to the city. But, now it’s fast turning into a desert with depleting water resources aggravated by an acute lack of rain.

“There is no supply of piped water and people have boring system in place to meet their water demands. This widespread practice has also led to a steep decline in underground water level, along with excavation activities to remove sand and gravel from Malir riverbed over the years,” said Munawar Hussain Jokhio, a social activist.

Most parts of Gadap are also deprived of piped gas supply that, residents say, has also caused deforestation. Educational facilities exist but they are without teachers in most cases.

“Lack of clean water is the major reason behind poor public health. A few years ago, we did a survey and found that 20pc of about 5,500 people tested were suffering from hepatitis,” said Dr Moula Bux Abbasi, a senior retired government official.

On women’s health, he said that since most people lived in abject poverty they couldn’t spend enough on their health.

“When I ask them to drink milk, they reply that they don’t even have enough milk to make tea. Most women are acutely anemic that makes them vulnerable to have heavy vaginal bleeding in pregnancy. If immediate and proper medical help is not provided, the condition could be life-threatening,” he said.

Sharing her concerns on women’s health, Dr Nusrat Shah who heads a gynecology ward at CHK said that women having HB level less than three reported at the hospital that was risky both for the mother and the child.

“I can’t offer an immediate explanation to what exactly happened to the mother on that night without going into details about her case. What I could say, however, is that vaginal bleeding before delivery was not normal and required careful patient treatment,” she said.

Pregnant women, she said, must have at least HB level 10 at the time of delivery and that could be done only if they were provided with proper antenatal care and iron supplements.

EDO Dr Zafar Ijaz said that the health department was working on a plan to make the 50-bed hospital functional and upgrade a rural health centre (located in Gadap’s Murad Memon Goth) to a hospital.

“The hospital is not functional because the human resource required to run the health facility hasn’t been approved by the government yet,” he explained, adding that health camps were set up in the town to cater to residents’ medical needs.

Published in Dawn, May 5th, 2015

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