Pakistan: First time in the field

Nathalia is in Pakistan, where she and the rest of the pharmacy team work to ensure that all our medics have the right drugs available to give patients the best possible care. Today she visits one of the clinics for the first time, and sees the impact of the work first hand...

So, after writing about the fun side of being in Pakistan (and all my coffee adventures), it’s time to talk about the work. Well, we can start by going a little deeper into what I actually do here: I’m a Support Pharmacist based in MSF’s coordination office for Pakistan - located in Islamabad, the capital city. I work closely with the Medical Coordinator, head of medical activities in the country, and the Country Pharmacy Manager, who is the person responsible for the whole pharmaceutical side of MSF’s work in Pakistan.

Our cure rate in the project is heading to around 94%

My key roles while I’m working at the office are: designing pharmacy-related standard operating procedures based on the MSF guidelines; following up and updating clinical protocols – especially when they are drug-related; planning and implementing a stock strategy, including for emergency scenarios, like flood, earthquake or heat wave (all common in Pakistan); and being a backup for the Country Pharmacist Manager whenever and wherever it’s needed. And this is the best part of my position, because it involves visiting the projects constantly.

I recently came back from my first ever field visit. I spent two weeks in Karachi, the biggest city in Pakistan (and 6th of the world). There, MSF has a clinic located inside Machar Colony – an area densely populated with people of different ethnicities, including Bengalis: Bangladeshi migrants who came to Pakistan decades ago. A large number of them still have very limited access to public medical care.

I am extremely touched by the chance to work on something that impacts other people’s lives in such a positive way

At the clinic, run in partnership with a local (non-governmental) organisation, we have several departments providing basic healthcare, including outpatient consultations, stabilisation and referrals for emergencies, delivery unit, mental health / health promotion activities, and a Hepatitis C project – an important part of the activities.

Pakistan is the country with the second highest prevalence of Hepatitis C in the world, after Egypt. The prevalence of Hepatitis C in Karachi has been estimated to be between 5 and 10%. And Karachi, having such a large number of inhabitants, and other big city factors that contribute to a higher spread of the virus, was the perfect entry point for a project focused on this disease.

The MSF medical warehouse in Karachi. Photo: Nathalia Peixoto de Oliveira / MSF. 

Although I’ve been following many advocacy campaigns that try to raise awareness of Hepatitis C drugs, this project has been my first time working with these types of treatments, which are relatively new. During my visit, one of my main tasks was to discuss the newly implemented protocol for Hep C treatment with the doctor responsible for the department. MSF now offers the ‘first line’ drugs, recommended by the most recent studies, to a bigger number of patients - and our cure rate in the project is heading to around 94%.

Ensuring that every patient gets all the drugs needed during the entire treatment is the responsibility of the pharmacy department. While in Machar Colony, together with the  Pharmacy Supervisor, I went through our stocks of the Hep C drugs, trained him on the new protocol and the new tool for the estimating the needs for next year, while trying to make sure that the whole pharmacy chain is working in synch.

After two weeks in the project, I came back to Islamabad not only with more knowledge of Hepatitis C, of our project in Machar Colony, and the local pharmaceutical activities there, but also extremely touched by the chance to work on something that impacts other people’s lives in such a positive way. This, for sure, is the main reason why I joined MSF. Working from afar is part of my role, but nothing beats the experience of being on the field. And now I only have one more week to go before I get to visit another project, Timergara. Can’t wait for it!