KARACHI, Dec 13: The maternal mortality rate in remote areas is very high, as doctors generally do not go there to serve people. The services of midwives, who are more likely to head to rural areas, should be utilized to bridge this gap.

About 85 per cent of the pregnancies culminate in natural deliveries, which may easily be supervised and handled by trained midwives. These views were expressed at the launching ceremony of a textbook in Urdu for students of midwifery, entitled "Hamal aur zatchgi ki paicheedgion ka ilaaj" (Treatment of pregnancy and childbirth complications) on Saturday.

The 400-page book provides clear guidelines for major complications and has been translated from English by Sarwar Sultana under the supervision of Dr Shershah Syed and Dr Hamid Manzoor.

The launching ceremony was presided over by Prof Anita Ghulamali, former education minister. Dr Gaynor Maclean, who voluntarily conducted a one-week course for midwives at Sindh Government Qatar Hospital, was the guest of honour. Hayther Bull, a consultant midwife, also spoke on the occasion.

Dr Maclean, who is among a few dozen midwives with doctorates in the world, said that she could not imagine a world without books in her own language. She pointed out that midwifery was fast turning into an evidence-based discipline and expressed hope that some Pakistani midwives would soon start producing books and papers in Urdu because failure to do so would augur ill for the profession.

Dr Maclean, who speaks Urdu quite well, said that women's lives could not be saved merely through the knowledge that some midwives might have, but rather through the skills that were acquired in the light of this information. She advised the midwives present to acquire skills. "Do not just use your brain but also your hands," she remarked.

Dr Maclean said in many countries where the MMR was on the higher side textbooks were not available in local languages. Pakistan was, therefore, fortunate in that sense as it had at least two textbooks in Urdu on the very subject.

Speaking on the occasion, Hayther Bull said the book was recognized by the international representative bodies of midwives as well as gynaecologists. She spoke of the need to improver care at all levels of society. Health education should be taken as an important part of healthcare, as without it the attitudes of families, and the society at large, could not be altered much.

In her presidential address, Prof Anita Ghulamali said the doctors could not discharge their duties properly without the support of nurses and midwives. She pointed out that Ms Maclean, by advocating the publication of textbooks in local languages, had said what she herself had been saying for long.

The former education minister said the policymakers in Islamabad did not like it whenever the idea of publishing textbooks in Urdu was put forward. "The reason for this is that they do not understand the issues well," she added.

If it was decided that the services of midwives would be utilized to reduce MMR in the rural areas, she said that the policymakers should also ensure that adequate resources were provided to them.