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Drought or not, children are dying in Tharparkar, Qaim Ali Shah

The infants may not be dying of hunger, but they have no immunity to fight back any attack of weather and disease, as they are given birth by weak mothers. PHOTO: AFP

Death is a regular visitor at the doors of Tharparkar’s mothers. Within the first 10 days of 2016, 17 children died in just the Mithi area of district Tharparkar in Sindh.

Nothing new.

Between December 2013 and early March 2014, at least 124 lives were lost in Tharparkar, 67 of them at the Civil Hospital Mithi alone. These are just some registered deaths in the most (relatively) developed area of the 20,000 sq km desert comprising the district. And once again, Sindh’s Chief Minister (CM) says these deaths are being exaggerated.

This feels like Déjà vu.

Part of the statement of saeen, as CM Qaim Ali Shah is popularly known as, is probably true – the part that says that the drought is not causing these deaths.

That, Mr CM, should be cause for more concern.

It’s not that the CM and his team are doing nothing about Tharparkar. They form inquiry commissions, send trucks full of wheat, food supplies and medicines, and I am sure they sack a few officials here and there. While all of this can and does help, that help is very temporary.Saeen continues to apply band aid on the wounds of Tharparkar. The wounds inside continue to fester. None of the measures being taken for Tharparkar seem satisfactory and sustainable.

For those who know even a little about the beautiful but desolate Tharparkar know that if at all, the district were in a state of drought, that would be just a miniscule part of its issues.

Consider this.

In March 2014, many reasons for the deaths of the ill-fated children were stated by medical officials at Civil Hospital Mithi. Reasons like sepsis, blood infections, pneumonia, premature births and asphyxia. Why did these children not have even basic medical assistance is the question. Where were the first aid and the tetanus shots that could have helped the kids who died of sepsis? Why were the children not clad warmly enough, and pneumonia killed them? If according to the Provincial Disaster Management Authority (PDMA) director general, the newborns carried infections due to deliveries in unhygienic conditions at their home, why are mothers in Tharparkar still giving births at home? Why are there so many premature births in the first place?

Quoting people working on ground level in Tharparkar, open defecation is one of the major problems that causes up to 80 per cent of diseases reported in the rural areas of Tharparkar. This was shared by social activist Mohammed Siddique Rahimon in December 2015, at an event in Umerkot district where local experts discussed how poor infrastructure, a thin network of basic facilities and open defecation are among the major causes of endemic diseases. Umerkot faces the same predicaments as Tharparkar.

Purchasing substandard and expired medicines and supplying these to patients is another cause of death, according to information shared by Association for Water, Applied Education & Renewable Energy (AWARE) that works at grass root level in Tharparkar.

It is no secret that a large proportion of the population in Tharparkar does not have access to clean, uncontaminated and enough water. Water with high levels of arsenic among other contaminants in the merciless desert of Thar, when used for drinking, preparing food and irrigation of crops, cripples and kills those who consume it over long periods of time.

Is that too not the government’s responsibility?

But perhaps the biggest reason of disease and death in Tharparkar is malnourishment of its mothers. CM sahib says that if there was drought and lack of healthcare facilities, then men and women would also have suffered equally. Sir, your team is aware that mothers in Tharparkar give births while their haemoglobin level is as low as four. When the mothers are so anaemic and undernourished, what hope do the children they give birth to have to survive?

The CM is right when he says that the death of these children are largely on account of maternity-related complications and not from hunger or lack of food. But who, I respectfully ask those in-charge of governing Tharparkar, will make sure that maternal mortality is controlled in Tharparkar, and the mother is healthy and strong enough to bear a child? The infants may not be dying of hunger, but they have no immunity to fight back any attack of weather and disease, as they are given birth by weak mothers.

The first step towards solving a problem is recognising it. The problem lies in bad governance and the government not taking ownership of the painful condition of areas that come in its domain. We request those responsible to take note and step up their game for a holistic solution to the problems of Tharparkar and similar areas in Pakistan before more innocent lives are lost.

An open letter to the Sindh Chief Minister: Tharparkar needs you, Sir

By Farahnaz Zahidi Published: March 12, 2014

http://blogs.tribune.com.pk/story/21399/an-open-letter-to-the-sindh-chief-minister-tharparkar-needs-you-sir/

Thar babies

Politicians will go back to their comfortable homes and mothers in Thar will continue to mourn over their dead babies. PHOTO: FARAHNAZ ZAHIDI

Dear Sir,

I wonder how you sleep at night, because I am, honestly, having a tough time sleeping peacefully these days.

I have visited Tharparkar a few times. And every time I came back, it took me a long time to get the images of Tharparkar out of my system. You and your government, Sir, have visited one too many times. These people have voted for you and trusted you. I wonder how you get those images out of your system.

I will not be unfair. So I have to say that visits to interior Sindh have told me enough to say that yes, you and your government did try to make things better for these people at some levels. There is the Benazir Income Support Programme (BISP), the Lady Health Workers (LHW) program, a more women-friendly legislation and a few scattered silver linings. But were they really enough? And in particular, for Tharparkar which was already a ticking time bomb of impending doom due to food insecurity and lack of water, did you all do enough?

Travelling to Tharparkar, one sight that was amazing was seeing flags of the political party they all love on their small, circular homes. Inside the circular homes, there would mostly be pictures of their local leaders from the same party, bleached out due to the intense Thari heat.

Last year, before the May 11, 2013 elections, in a small village near Islamkot, I asked a few of the women whom they would vote for. They giggled, covering their beautiful but weather-beaten faces with colourful chunnis (dupatta), and replied

“For the same people.”

“But are you satisfied with the work they have done?” I had asked.

“No. Not really. Par Adi, aseen ghareeb marhoon aahiyoon. Hee asaan ja wadda aahin. We cannot vote for anyone else.”

(But sister, we are poor people. They are our elders.)

The loyalty was something I couldn’t fathom with my city-centric sensibilities. But they did vote for their elders. Are their children paying a price for that loyalty? Perhaps the answer is, yes.

Listening to the breaking news about the many lives of little children snuffed out before their time, I have those images in my head again. Because I know that these children did not die in a day… they were dying all along. Even the new born ones.

They were dying because their mothers have a history of weak bones and malnourishment, because they get to drink brackish water laden with fluoride and their average meal is sun-dried red chillies crushed to a paste with roti that is not enough.

These children, who are dying, are born to mothers who have mostly lost more than one baby because they have to travel on camel backs in full term pregnancy if they need a caesarean section delivery. The nearest hospitals, Sir, are too far.

The vaccinators who are unsung heroes carry the vaccines on foot in the unbearable heat, but mostly the ice that keeps the vaccines fresh melts by the time they reach their destination. So the mothers mostly do not get tetanus vaccines on time and die from septicaemia because they have contracted infections by delivering children on the sand which is a Thari tradition. The children do not get vaccinated for deadly but preventable diseases.

The NGOs struggle to make things better in Tharparkar but they do not have enough support from the government.

You, Sir, and your government have known this all along, haven’t you?

This wave of donations is only reaching Mithi which is like a model town at the minute. The real issues are still prevalent in the small villages. Who will solve their problems, Sir? Visiting politicians in Mithi for whom lavish meals are lined up do not know the pain of someone in small villages like Maghoo Bheel where donations may never reach. These politicians also do not know how those standing in queues for hours to be handed a bag of grains are beaten with sticks or ridiculed by those distributing the donations.

You do know that what is being called a ‘drought’ or ‘famine’ is no doubt a natural calamity. But it is not like the floods or an earthquake. This is a natural disaster of which the death toll can be mitigated. But sadly no one takes notice. This disaster is related to lack of clean drinking water, Sir. I wrote a story last year about just one such village where the entire population walks with spines bent or crawls on the floor because the water they consume is too little and unfit for human consumption.

Without a word of exaggeration Sir, I called your office every day for months to get a single 15 minute appointment with you, so that this issue could be brought to your notice; all that village needed was an electricity line that could run a water filtration plant that someone had donated to them. The people of the village kept writing to you. Promises were made. In protests. On Twitter. But it was not taken seriously enough.

You must have seen Thari children, Sir, running barefoot in the desert sand or sitting in a weak looking mother’s lap. They are stunted, mostly, and look much younger than their years. Their Body Mass Index (BMI) is clearly under the required level. Their hair is brittle and their skin is parched. They cry in weak voices for no reason. Their bellies are too large for their body. Their Mid-Upper Arm Circumference (MUAC) when measured tells health officials they are at a risk of dying.

The NGOs give the extremely malnourished ones high-energy food supplement biscuits. But because the entire family is so poor and food insecure, they all end up sharing it. And so, that malnourished child never regains health because his supplement is shared, morsel by morsel, by the entire famished family.

Some of these malnourished children will grow up to be mothers. They will give birth to weak, sick children. And unless someone steps up, this cycle will go on. The donors who are donating excitedly right now will soon get exhausted after media stories die out. Donor fatigue will set in. Politicians will go back to their comfortable homes. And mothers in Tharparkar will continue to mourn over their dead babies.

Just this once, can we do something lasting, Sir?