"Through health education both in our hospital and in the communities, we hope to increase the awareness of the importance of breastfeeding and therefore reduce the likelihood of severe malnutrition. We also spread other health messages and actively screen for malnutrition to improve the overall health situation in this area."
He’s pale and floppy. He’s not moving. His primate reflexes are barely present. This is a case of hypoxic ischaemic encephalopathy - brain damage due to oxygen deprivation at delivery. I’ve seen a lot of it here in Balochistan, where home deliveries are the norm and mothers rarely receive antenatal care.
"I tell all the parents children must be fed enough, so they are strong and don’t succumb to illness"
"Lots of parents fail to start weaning their children. I have tried to understand why. There are multiple reasons. Too many children and not enough food is a reason. Mothers working in the fields all day long, not taking care of their own and their child’s health, is another. Lack of awareness about breastfeeding and good nutrition also contributes to this issue. Last but not the least is the unaffordability of food."
My phone rings one evening - the familiar old Nokia tune. It’s the doctor on call - she tells me a new baby has just come into the nursery. What’s the main problem, I ask. Bleeding, is the unexpected response. Where? Why? I ask. From the mouth, from the nose, in her nappy. There is profuse bleeding, I am told. Can you come now?
We gather around his cot, and it’s clear to us all that this child has severe acute malnutrition. Malnutrition affects different children in different ways. Most become thin and wasted, but some children, when starved, become swollen with excess fluid. Bilal is a very severe case
Health services in Pakistan are often unaffordable and in many regions, conflict and insecurity further restrict access.
In many parts of Pakistan sectarian violence is rife. Government forces are also engaged in military operations against armed opposition groups.
Médecins Sans Frontières/Doctors Without Borders (MSF) programmes focus mainly on meeting urgent needs among communities affected by insecurity.