Learn how the World Bank Group is helping countries with COVID-19 (coronavirus). Find Out

FEATURE STORY

Community Medical Center Saves Lives

September 7, 2012

Image

Fareeha Bibi holds her 18-month-old son Faizan, who was born at the facility, as Dr. Surraiya Rashid examines him at the Community Health Centre in Kot Mahmood.

Muzammil Pasha/World Bank

STORY HIGHLIGHTS
  • Death in childbirth and other consequences of inadequate medical care are all too common in rural Pakistan.
  • The Pakistan Poverty Alleviation Fund aims to empower the poor by offering them a variety of services, including the Kot Mahmood medical center, which serves about 21 villages.
  • “We are the lucky ones. All the ladies in my village know it’s safer to come here now. The old way of giving birth isn’t good,” says one mother.

SHEIKHUPURA DISTRICT, Pakistan – Two of Fazeelat Aslam’s childhood friends died having babies at home. “We grew up together, always wishing for marriage and families,” she recalls. “We were excited to be mothers, but when the time came, they were no more.”

“We are the lucky ones,” says the 30-year-old, waiting with her 8-month-old son Asim Ali and other young mothers outside the Kot Mahmood Community Health Centre. “All the ladies in my village know it’s safer to come here now. The old way of giving birth isn’t good.”

Aslam is one of about 12,000 people currently served by the Pakistan Poverty Alleviation Fund-supported center, constructed and operated by partner organization Rural Community Development Society with the financial support of the World Bank.

The PPAF aims to empower the rural and urban poor by offering them a variety of services, including much-needed infrastructure like the Kot Mahmood medical center, which serves about 21 villages in Sheikhupura district of Punjab province, Pakistan.


" Normally, these women would rely on untrained midwives for their deliveries. Also, they would have no pre- or post-natal care, so if there was a problem, it was often too late. "

Rashid Ahmed

Manager, Rural Community Development Society

Quality care at lower cost

The medical center sits in a row of shops along a busy thoroughfare frequented by farmers who tow their produce from surrounding fields. A large metal sign proudly proclaims PPAF support for the medical center, which treats both men and women. But the child and maternal health program probably saves the most lives, says Rashid Ahmed, a manager at RCDS.

“Normally, these women would rely on untrained midwives for their deliveries,” says Ahmed. “Also, they would have no pre- or post-natal care, so if there was a problem, it was often too late.”

Sitting in the center’s flower-filled courtyard that doubles as a ladies’ waiting room, Fareeha Bibi readily recalls four women who died in labor or lost babies in her village before the clinic opened in 2006.

Before the medical center existed, Bibi also had a close call with her first pregnancy. Suspecting her baby was breech, her relatives borrowed from a moneylender and rushed her to a Lahore hospital more than 50 km away for delivery. The family is still struggling to pay back the loan five years later, she says. Her husband is a tenant farmer with only a small guava orchard and vegetable plot.

“Now with this medical center, we are quite comfortable and the cost is much less,” she says, as a doctor examines her third child, 18-month-old, Faizan, who was born at the facility.

The center offers ultrasounds, X-rays, a laboratory, labor room, and small pharmacy at much lower costs than private facilities.

Dangerous old traditions rejected

Dr. Surraiya Rashid says she typically sees about 20 women and their children each day, advising them on everything from proper breastfeeding techniques to nutrition and childhood immunizations. “Before, people were not aware that proper antenatal care was necessary, and there were basic issues that needed to be looked after,” says Rashid.

Childbirth, in particular, was plagued by dangerous old traditions. During deliveries, untrained midwives used unsterilized kitchen knives and scissors and didn’t wear gloves. Intravenous injections might be given without proper sterilization, she says.

Myths, such as sitting a new mother on a pile of wood ash to stop bleeding, were followed. And women were often discouraged from giving babies their first milk, or colostrum, because it was considered useless and dirty, says Rashid. “But now, I hope the old ways are finished. We hardly see any bad cases like that any more.”

Sughran Bibi, 60, says she signed up to be a health center “motivator” after a friend died following the birth of her second baby at home. Bibi now gets a small payment for bringing in village women for their deliveries.

“My friend expired on the second day after giving birth,” she recalls. “No one knew why, maybe it was too much bleeding, maybe an infection, but people didn’t take her to hospital. Back then, they just accepted it as fate.”


Api
Api