Mar 01, 2016

Sindh: Malnutrition and Infant Mortality Remain Problematic in the Region

Weak medical infrastructure, lack of governmental support and erratic rainfall are harming many children in the Sindh region of Pakistan and causing malnutrition and a worrying level of infant mortality. Many structural problems in the region causing this dire situation do not seem likely to improve, mainly due to the government’s lack of action. 


Below is an article by Al-Jazeera English,


The views during the nine-hour drive to Tharparkar, a remote district in southern Pakistan, are stunning but deceptive. 

The long road, the sunflower fields, the camel herders and the desert landscape can make one easily forget the real story of the people who inhabit the region. 

The spell is broken when you enter the poor, dusty town of Mithi, the capital of Tharparkar. And there's a reality check as soon as you cross the gate of the only civil hospital there.

We found some people inside the unfurnished waiting rooms but the stench and unsanitary conditions within the hospital make it almost unbearable just to stand there. Inside the children's ward, there are multiple cases of malnutrition. 

The number of infants and toddlers brought to the nutrition stabilisation centre in January is the highest in the last two years.

Dozens of people - mostly from low-income backgrounds - use the parking area to wait near their loved ones in the hospital.

The hospital seems equipped with incubators and doctors. But that's not the case in other towns like Diplo, Islamkot, Chachro and Nagarparkar.

People from those areas say there are smaller hospitals but they operate with limited facilities and medics. We heard heart-breaking stories of how parents watched their shivering babies. They did not know whether it was disease or malnutrition until children stopped food intake completely, became weak and died within a few days.

Having no means of transport and no money for the journey adds to the number of dead babies.

Many people of Tharparkar still live the way they did hundreds of year ago.

We travelled to Diplo where for centuries mud huts are surrounded by just enough cattle and crop to survive. The simplicity makes these people vulnerable to any change in environment.

Thar - the local name of Tharparkar - has seen drought-like conditions for the last few years but because there has been some rain, technically there isn't a drought. However, for the people here the less-than-normal rainfall means disaster. Less water for people and cattle means less food and increased vulnerability to diseases.

Pregnant women and infants are the worst affected. Then there's the pressure from local traditions 

Women get married at an early age and most have babies every year.

Many of these babies are delivered by untrained nurses and there are a lot of cases of infections - which, when left untreated, become fatal.

The number of deaths has become a contentious issue and there is great discrepancy between the official death toll and that of health workers and non-government organisations.

Provincial leaders have declared a health emergency and issued instructions for round-the-clock monitoring of the situation.

Local government officials offered us tea but wouldn't talk to us on camera until we tracked down the district health officer, who was in the field despite it being his day off 

He admits there are problems but says the government has invested in building hospitals and purchasing equipment.

He also pointed to the fact that the infant mortality rate of his district isn't the worst in Sindh province.

Everyone admits there is a lack of medical staff.

Doctors working on contracts see cronyism, complacency, mismanagement and corruption standing in the way of their hiring by the government as permanent staff.

The government says it's announced full-time vacancies and its hands are tied due to bureaucratic delays and court orders.

Some officials also say it's hard to fill all the vacancies as many doctors don't want to work in remote places and prefer to work in the cities where living standards and incomes are better. 

I've heard them before - the claims and counterclaims. 

The one thing that has remained constant in the last 10 years of covering the interior parts of Sindh province is seeing sick, starving and dying babies.


Photo courtesy of Al Jazeera English