HEALTH-PAKISTAN: ‘War on Terror’ Cripples Border Hospitals

By IPS Correspondents Reprint | | Print |

Ashfaq Yusufzai

PESHAWAR, Jun 5 2007 (IPS) - Pakistan’s Federally Administered Tribal Area (FATA) extends 27,220 sq km along the Afghanistan border and has been the target of a series of debilitating U.S. missile attacks since 2005.

Believed to be hiding amongst its 3.5 million Pashtuns are several top al-Qaeda, flushed out of Afghanistan along with the country’s former Taliban rulers, by the U.S., and its allies.

Aerial attacks have crippled FATA’s once well-organised health delivery network. Government-run hospitals are exposed to U.S. air attacks from across the border in Afghanistan, and the retaliatory fire by Taliban and pro-Taliban groups.

The seriously ill are taken by road to overcrowded hospitals in the neighbouring North West Frontier Province (NWFP). According to guesstimates, 20 percent of hospital beds in the NWFP’s capital city, Peshawar, are occupied by patients from FATA.

“We live very close to the agency headquarters hospital, in Miramshah, North Waziristan Agency, but due to the nonavailability of doctors and staff, we brought our brother here,” said Wajid Khan outside the Khyber Teaching Hospital in Peshawar. His brother, Sajid Khan, was operated upon for appendicitis.

“We had a full fledged government hospital in Bajaur Agency. But we transported our mother to Peshawar because of the non-availability of a specialist there,” said Gul Khan. He said he paid 1,000 rupees (16 US dollars)for the three-hour taxi ride from Bajaur to Peshawar. The stress of travel has worsened his mother’s persistent hypertension, he worriedly confided.

Since 2002, the number of admissions in hospital and out patient departments (OPDs) in FATA has decreased. The tribal areas comprise seven agencies.

“We saw only 50,000 patients in 2006. There were 200,000 or more patients before the ‘war on terror’,” said Dr Ajmad Ali, who works as a government medical officer in FATA. The number of surgeries have also dropped from 32,000 in 2001 to only 13,000 in 2006, he added.

Medical staff are not willing to work in FATA. “Several doctors and health professionals have got themselves transferred from FATA because of the looming danger there,” said a health official in Peshawar, who did not want to be named.

Two years ago, Dr Bakth Sarwar, 48, was critically injured when his hospital in Miramshah was hit by a missile. The doctor has refused to go back to work, and is on indefinite leave in Peshawar.

On Feb. 15 this year, Bajaur agency surgeon, Dr Abdul Ghani Khan, was killed and three health department officials were injured in a bomb attack by pro-Taliban militants on a meeting to promote the anti-polio campaign.

In May, nine health workers, including three females, who were part of a survey were kidnapped in North Waziristan Agency. They were released after a week on May 25.

Governed directly by the federal government, FATA has well-equipped facilities. But an acute shortage of medical professionals has paralysed the roughly 26 hospitals and eight rural health centres, and over 400 community health centres.

Dr. Zubair Khan, director-general, FATA Health, told IPS that he had directed all surgeons to increase admission and OPDs. According to him, the NWFP governor Ali Mohammad Jan Aurakzai was “angry” that health facilities were not being used in FATA.

Prior to the launch of the U.S.-led ‘war on terror’, Afghan patients would come to FATA-based hospitals for treatment. FATA had 66 government-appointed specialists, 435 medical officers, 48 female doctors and 182 nurses apart from non-technical staff, according to official records.

“Most of them prefer to stay away from their duty places for fear of lack of security there,” said a doctor, who insisted his identity should be protected. “Lady health workers, nurses and doctors in North and South Waziristan, Bajaur and Khyber Agencies have been approaching us to get themselves transferred to the NWFP. Some of them have either taken long leave of absence or were staying home,” he said.

Health authorities admitted that basic health indicators like infant and maternal mortality rates have worsened in FATA and questioned the Pakistan government’s commitment to meet Millennium Development Goals (MDGs) by 2015.

For instance, the government was required to bring down the infant mortality rate from the present 116 to 44 in a population of 1,000 and maternal mortality ratio from 600 per 100,000 live births to 140 in FATA.

“Compared to the rest of the country, the health indicators for FATA are poor,” the senior doctor who granted IPS an interview only on condition that his identity be protected. The infant mortality rate for Pakistan was 103 per 1,000 live births and maternal mortality ratio 350 per 100,000 live births.

Director-general Dr. Khan blamed the heightened threat of militancy for the poor health services. “Health workers face problems in North and South Waziristan and Khyber agencies. They are told not to wear pants and shirts, not to carry cellphones or shave their beards,” he said. He said he had appealed to the authorities to provide security to his staff.