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Displacement Traumatic for Pregnant Women

 IPS 11 June 2019

(Originally published: 07/2009) Pregnant women uprooted by the violence in the Malakand region, northwest Pakistan, have suffered acutely in refugee camps for the internally displaced. Displaced women from Swat, Buner and Dir - the three affected districts - have critical health needs that relief operations must urgently address, says UNFPA, the United Nations Population Fund. According to its estimates, some 69,000 pregnant women have been displaced since the start of military operations on Apr. 27 in the three adjoining districts of the North West Frontier Province (NWFP). There were nearly 6,000 new births in June, of which at least 900 required surgery because of complications, the U.N. agency reports. (846 words) - By Ashfaq Yusufzai

PESHAWAR, Pakistan - Pregnant women uprooted by the violence in the Malakand region, northwest Pakistan, have suffered acutely in refugee camps for the internally displaced.

Displaced women from Swat, Buner and Dir - the three affected districts - have critical health needs that relief operations must urgently address, says UNFPA, the United Nations Population Fund.

According to its estimates, some 69,000 pregnant women have been displaced since the start of military operations on Apr. 27 in the three adjoining districts of the North West Frontier Province (NWFP).

There were nearly 6,000 new births in June, of which at least 900 required surgery because of complications, the U.N. agency reports.

Peshawar-based gynecologist, Prof. Anjum Wakeel, who has helped establish clinics for women in the IDP camps, says everywhere the new mothers and their infants are facing severe health and nutritional problems because of the overall poor food, sanitation and medical conditions.

The Pakistan Pediatrics Association (PPA) has set up a special 20-bed ward for newborn babies in Mardan and Swabi district hospitals, especially for IDPs. But this is like a drop in the ocean.

Yet the PPA-run wards had admitted 6,075 patients in June. According to the records, 1,391 were admitted for diarrhoea, 288 for dysentery, 276 Urinary Tract Infections (UTI) and 122 for meningitis.

"Our doctors had examined about 191 newborn children of whom 144 were underweight and 125 severely malnourished," says Dr Abdul Hameed, PPA president. There is severe overcrowding, he confirms. Two or three children can be admitted on each bed. Neither are there labour rooms to handle delivery-related complications, he adds.

"The situation could slip out of control if immediate measures regarding strengthening of childcare in the camps aren't initiated," he told IPS.

UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, John Holmes, who is on a visit to Pakistan, is reported saying, "We still need to do more to help (internally displaced) people both now and in the coming months." Holmes who has visited refugees in camps in Peshawar, Mardan and Swabi, has traveled to Buner district, Thursday.

Antonio Guterres, U.N. High Commissioner for Refugees, has described the massive displacement of Pakistani civilians because of the escalating fighting between Pakistani forces and Taliban militants as "the most challenging protection crisis since Rwanda [in the mid-1990s]."

"My son has severe diarrhoea. There is no improvement. He is pale, and not responding to breastfeeding," Jamala Bibi of Buner in the Shah Mansoor camp, Swabi, told this reporter on May 20.

Pakistan has a population of 160.9 million, which is growing at a rate of 1.8 percent. According to observers, the country is unlikely to meet goal 4 and 5 of the Millennium Development Goals (MDGs), which calls for reducing child mortality and improving maternal health respectively, by 15 to 50 percent by 2015.

Every family in the Malakand region has at least five or more children. The conservative Islamic groups allied to the Taliban, who made Dir, Swat and Buner their stronghold two years ago, targeted non governmental organisations (NGOs) working with the community on reproductive health goals. Their field workers were kidnapped and the NGOs threatened with dire consequences if they did not pull out of these districts.

A worried Ajmal Khan, 40, is unable to express his feelings over the birth of a daughter - his sixth child - at the Jalozai camp, near Peshawar, on Jul. 3. The camp, which had sheltered Afghan refugees till last year, was opened for Pakistani IDPs. "Under normal circumstances I would have been happy. But not this time, because my daughter is very sick," he says.

His wife, just 25 years old, had screamed in pain all night till the baby was born, he adds. In the end, an elderly traditional birth attendent from a nearby camp was brought to help her, he says. In the morning she was seen by Prof. Wakeel, the doctor confirmed to IPS.

Most pregnant women among the IDPs need antenatal care which is not available, the doctor says.

"We have tasked the Lady Health Workers to compile data about pregnant and lactating women, and provide them medical assistance, so they could deliver in normal circumstances and avoid complications," says Zahir Ali Shah, NWFP's health minister.

Now, the UNFPA has scaled up its support for reproductive health care for the displaced population, and has launched a 3.9 million dollar global appeal to provide comprehensive maternal, neonatal and child health care and psychosocial support, both in camps and nearby medical facilities, in 2009. According to officials,

Thoraya Ahmed Obaid, UNFPA's executive director, told IPS in May that the agency was working with partners to provide life-saving services to pregnant women, and psychosocial support and basic hygiene facilities for displaced families. "We are basing our help on the specific needs of women and families, with a focus on safeguarding human dignity," he said.

Shah, the provincial health minister promised his government was assessing the reproductive health needs of IDPs, and apart from establishing health services in the camps, nearby hospitals would also be provided with the means to support the needs of displaced women.

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