The report, submitted in the Sindh High Court of Pakistan by the chief secretary after the approval of Chief Minister Qaim Ali Shah last week, shows the main causes of death of the children include birth asphyxia, pre-term, low birth weight, respiratory distress syndrome, pneumonia, delivery of babies through traditional birth attendants (Daais)that caused neo-natal sepsis and diarrhoea.
It classifies the casualties of the same children according to their ages, which shows that 118 children who died were newborn babies (one day age), 82 children died were of age two days to one month, 28 children of age 1.5 months to three months and 29 were those whose age ranged between eight months and one year.
The report, however, says Thar, as regards the under five year death rate, was comparatively better than Bahawalpur, Bahawalnagar, Rajanpur, Rahimyarkhan and other neighbouring districts in Punjab. “However the challenges are same.”
The report says that the Thar communities, particularly women, lack awareness of their health concerns.
Majority of the married couple has an average of eight children.
“In view of the aforementioned facts where women is overburdened, takes unbalanced / proteins, fats deficient diet in their meals, shorter birth gaps [deliveries of babies at regular intervals] pose a severe threat for both the newborn as well as the mother,” it says.
The report insisted that the diet of the Thar community today was similar to the one they used to take in the past and the antenatal care was missing.
“The community prefers administration of IV injections over treatment through oral administration of medicines. Simple medicines like Folic Acid, Fefol-Vit beneficial for a pregnant woman, though are available in abundance in the health institutes of the district but despite being provided, their intake is not witnessed as a result of which the pregnant lady and the newborns are at high risk.”
The report claimed that the health department ran health institutes at different tiers across the district besides expanding the network of health centres at micro level, but an extensive awareness programme needed to be launched by all relevant stakeholders such as health, family planning departments, non-governmental organisations, civil society organisations (CSOs) to redress issues such as periodical health care, particularly during pregnancy, use of medicines for increasing the immunity of pregnant women and her child to be born, communication and observance of a normal birth gap between the two children, conduct of day-to-day normal activities, thereby helping in attaining a quality life cycle.
According to the report, the Thar district is a huge district spread over an area of 22,000 square kilometres desert land with scattered settlements and has ever remained vulnerable to drought situation due to the fact that the district has no irrigation infrastructure and it entirely relies on rainfall. This vast distance and tough terrain makes it an uphill task for people to access health and civic facilities, which are present in relatively well-settled cities of Thar.
In 2013, it said, Sindh in general and Thar region in particular did not receive adequate rainfall during the monsoon. During monsoon 2014, only parts of Thar (Mithi and Islamkot) received scattered and somehow heavy rainfall, which minimised the impacts of drought in the region for the time being.
However, the Thar region as a whole did not receive adequate rainfall which was needed. In quantifiable terms, Thar received lesser average rainfalls of 100 millimetres during the monsoon season this year than the last year’s average recorded rain of 189mm, contrary to an average required rainfall of 277mm.
It said due to drought conditions proneness, the district encountered multiple issues that adversely impacted the livelihood of the people.
It counted some key factors for the situation, which included water scarcity resulting in non-maturity of grass and crops, which in turn affected the livelihood of people and posed a threat for the survival of their livestock; overburdened women on account of their involvement in domestic affairs and their contribution in earning of livelihood; reliance on vegetables on account of their religious beliefs by majority due to which lack of requisite calorific/nutritional values; lack of awareness particularly in health issues such as high growth rate due to absence of birth gaps; and scattered settlements.
The report says majority of the people living in Thar are Hindu, who being a strong believer of their religion do not eat red meat, fish, chicken and relies on vegetables and other local products. The vegetables have not requisite energy thus their intake of proteins/energy/fats and other requisite calorific values is relatively lesser to a major extent.
The report examines that the Thari people use chillies and dairy products as their intake for the reasons that they hold huge quantity of livestock and the use of chillies is their traditional pattern. Thus, another factor for weaknesses in women revolves around the non-consumption of proteins-rich diet as well as following their cultural patterns which increase their weakness to a greater extent.
The report mentioned several steps taken by the provincial government to provide relief to the people of Thar, the first and foremost of which was the declaration of the district as calamity affected in February this year which started with focus on free wheat supply, health facilitation, treatment, vaccination of livestock and provision of fodder.
It said the district administration compiled a list of 253,590 families to facilitate with wheat supply of 50-kg bag each, which it completed in three phases of free wheat distribution from March to October.
Regarding complaints pertaining to faulty wheat distribution and favouritism etc, the report claimed that the government provided free wheat relief for 253,580 families in each of the first three phases.
Comparing with the registered head of families data available with the National Database Registration Authority, it said Nadra maintained a record of 237,731 head of families in its database, while the government considered 253,580 families for distribution of wheat in the first three phases.
After the declaration of the district as calamity affected, the provincial government had increased the allocation to 129,973 bags of 100 kg free wheat from 126,790 bags each of the two phases, as a result of which number of families had accordingly increased to 259,946.
It said the question of un-served families with respect to free wheat relief ‘has been satisfactorily catered’.
The report said in addition to this, the government had directed the provincial disaster management authority to engage an independent third-party firm for conducting a door-to-door survey of the district to ensure that the relief measures were effective and efficient.
Courtesy – Dawn News