MITHI: Not many people are around as I make my way inside the Civil Hospital in Mithi. Once again, Thar is making the headlines as multiple deaths of newborns are being reported largely by the Sindhi-language news channels and newspapers. Unlike a year back, the hospital staff is quite defiant when asked about reports in the media regarding the growing death toll. The district newspapers are reporting 67 deaths across Thar, while the official figure given by the civil surgeon, Dr Iqbal Ahmed Bhurgri, speaks of 20 deaths that occurred in the first 16 days of January. The hospital staff in Mithi refuses to admit the toll even as three more deaths are reported by the spokesperson for the provincial health department on Jan 17.

Despite the contradictory figures, the question is why so many deaths occur in a short period of time every year. And why, after the initial ruckus, is Thar forgotten?

The answer lies in Mithi, which has been in the news for the past three years for various reasons. Topping the list of issues are the deaths of newborns. On entering Mithi, one can see that it has a long line of NGO offices. It is the headquarters of Tharparkar (which has a predominantly Hindu population) and is more developed than the other five talukas.

A senior paediatrician at the hospital, Dr Sahib Dino, says having a secondary-care hospital, with a paved road leading to Karachi, Mithi receives “a lot of referrals from Islamkot, Umerkot, Diplo and Nagarparkar”. These cases, he adds, involve prolonged labour, premature births and lack of neonatal care. “Apart from that, there are child marriages happening by the dozen, leading to unplanned and frequent pregnancies that result in sepsis in the mother’s womb. In most cases, it causes the death of the unborn child. If the child survives, his or her growth is stunted,” he explains.

A staff doctor says the children who are admitted to the ICU or nursery unit in Mithi have ailments as varied as pneumonia, diarrhoea, heart infections, diabetes and thalassaemia. “You name it and the children who are admitted here have that disease. We try our best to accommodate them and help, but there are times when the children don’t survive.”

A few blocks away from his office, Dr Bhurgri, who took over from another medical superintendent in March last year, is not happy with the rising death toll and grumbles constantly about the reportage. “We are a 174-bed hospital and we get a budget for 74 of those beds. We recently got 13 incubators installed and yet we are referred to as killers in the newspapers,” he says, pointing to a leading newspaper’s front-page headline.

In another block, where the nursery unit for newborns is situated, 25-year-old Zohra stands outside with her husband Khaliq. Residents of Diplo, they travelled for hours to get their son treated at the hospital. Zohra says in her first three pregnancies the babies didn’t survive. “I have three children now and this one gets fits whenever I breastfeed him. This is the only hospital we know of,” she says in Sindhi. “The doctors helped us too,” she adds as an afterthought.

Grateful for the ‘help’ they are receiving at the hospital, Zohra asks me to come to the nursery unit where her child is being treated. A male nurse, however, refuses to let us in asking for a letter from the civil surgeon before shutting the door.

The CEO of Hisaar Foundation, Dr Sono Khangharani, says matters are getting aggravated by climatic changes. He says that between May and June several deaths were reported from heatstroke. Similarly, by the end of November and December last year, there was a cold wave for a week which caused multiple deaths. “Sixteen hundred deaths have been recorded in the past three years. I’m not making this up. It is from the record of hospitals in the six districts of Tharparkar. Keeping in mind the seasonal calendar of Thar, the government should devise a yearly policy in which these deaths can be controlled. But so far the response of the government is reactive rather than aimed at better planning.”

He also points to the lack of crisis management. “There are very few Basic Health Units, and where there does exist a BHU it works only as a dispensary. The staff hands out a tablet with a receipt to the people from 10am till 2pm before referring them to another district. They have to come to the main districts anyway for treatment.”

As a solution to the persisting problems of Tharparkar, Dr Khangharani says: “Governance needs to get better. The timely release of the budget is necessary to keep overall development in the area going. Taking away medicines from the hospitals needs to stop. Often, medicines available in the markets are of no use. So, it is a matter of overall management, keeping the nutritional, maternal, and climatic issues of Thar in mind.”

Until these issues get fixed, the season of death, it seems, is set to continue in Thar.

Published in Dawn, January 19th, 2016