Center for Research and Security Studies
Series: Da Aman Awaz
Program: Zamung Awaz
Topic: Health problems in FATA
Guest # 1: Mustaram Khan, Journalist
Guest #2: Dr. Nadir, ENT specialist and Registrar in LRH
Report# 1: Aftab Mohmand, Mohmand Agency.
Report # 2: Azeem bangash, Hangu
Anchor Person: Asma Ali.
Asma Ali: Assalam u Alekum dear listeners. As you know we discuss matters of public interest in this segment and try to convey your voice to the concerned people. Today we have selected a very important topic which is a matter of grave concern for millions of people. We have to discuss the health problems in our FATA region. Our valued guests are with us and first I would like to ask Mr. Mustaram Khan to brief us about this issue according to your personal experience.
Mustaram khan: I would like to share my experience in Mohmand Agency that can apply to other Agencies as well. Health situation is very precarious there. The administration in the health sector is very loose there. The meager staff that is present there does not do their duty well. Almost 15 BHU’s and health installations have been destroyed and people are left at the mercy of local Atai doctors or they have to move to Peshawar.
Asma: According to a NNICEF report, Polio, Hepatitis, Cancer and TB are the top diseases in upper Dir and most of our tribal region. Although the government is making great efforts even then why they can’t control polio?
Dr. Nadir: I can’t challenge the validity of this report because Upper Dir is such a far flung area that people are mostly ignorant about health hazards. The use of injection is the main cause for the spread of several fatal diseases. Common local Atai doctors made use of injection on such a large scale that people consider it as a must for the treatment of every minor or major illness. One injection is employed for many patients. As a result the disease spread from one to many. These simple people do not know that the use of injection has been abandoned all over the world and virtually every disease is now treated with medicine that is orally taken. Other reasons are toothbrush and proximity with patients. Main cause is still ignorance then.
Asma: why polio could not be contained in spite of so much effort by the government?
Dr. Nadir: FATA is the most backward area in the whole world. The vaccine for polio needs to be preserved at a low temperature. But there are no such facilities or equipments to keep that vaccine active in the far flung areas of FATA. Then there is so widespread corruption in the whole campaign that many things are only present in papers. Then unfortunately the people in FATA have false believes about the vaccine. They think it may make their children unfit fir reproduction when they grow up. I just want to say why these Western countries do not mix such ingredients in common medicines like paracetamol and other medicines that we daily use. I want to assure them that these medicines are properly checked by our local Muslim doctors and do not contain any such thing.
Asma: There was a demonstration the other day by polio teams’ members. What was their demand?
Mustaram: These people were demanding to be paid because they have worked for many months but have not been paid. While the WHO authorities said that they have already disbursed their salary. The problem then lies in the agency surgeon office. There is acute corruption in that department. It is really unjust not to pay those workers who work in the most difficult situation. These workers are often very poor people and had to work in the most hostile and difficult circumstances.
Asma: If government has failed in the case of Polio for which funds are available from donors then what to talk of other diseases. Has government failed in this field?
Mustaram: The problem is that no one does his duty well here. There is corruption at higher level and the employees also shirk their duty. Food distribution project in FATA has also failed badly.
Dr. Nadir: I would like to add that Polio is a disease to which all the children are prone while other fatal diseases Like TB and hepatitis are rare. Unfortunately when there was a demand for inquiry about the corruption in the polio campaign, the government about the same Agency Surgeon as head of inquiry committee. Now it is stupid to appoint a person to get inquiry about his own office. What I mean to say is that we have too much funds for FATA but FATA secretariat is the most corrupt department in our country. All the high officials are political appointees there and do not belong to FATA. The whole system should be scrutinized.
Caller: I am Hussein Afridi. Too much effort is required in FATA in health sector. There are no health facilities for people here. Every Agency should have at least some laboratories to cure common diseases.
REPORT; Aftab Mohmand, Mohmand Agency.
Polio Campaign is faced with immense problems in Mohmand Agency. The staff in the campaign comprises of 68 areas in charge, 408 teams and a host of social workers and other related staff who are responsible to vaccinate almost 80 thousand children here. But all of them are not paid for many months and they also face security problems as well. The API head Aftab says about this situation… “we had several trainings in 2012 ND 13 BUT ARE NOT PAID SO FAR. WE ARE FACED WITH SERIOUS FINENCIAL PROBLEMS AND WE AY REFUSE TO CARRY ON THE CAMPAIGN.” Jehanzeb, who is a worker, says …. “we have to walk for miles on food in the mountainous region and had to carry water cooler and vaccine with us as well. Sometime we have to stay for night and had to make our own arrangements. But even then we are not paid for all our hard labour. People are also hostile and a few days back one of our friend was seriously injured by people.” Another worker in the polio campaign Sayaro says… “We are mostly poor people and have several economic constraints but we are not paid. We have some female staff members with us as LHW who are also not paid. We are disgusted about this situation.” While Amir Nawaz, who is a social organizer, says… “Since 2010 we have four rounds of campaign but are not paid yet. Now the boys have refused to go with us and the whole campaign is in serious jeopardy.” But on the other hand a senior official of WHO Abdul Aziz says… “It is wrong to say that we have not paid the workers. Although it was a little delayed but we have paid it in full to the concerned department. Now the workers are demanding to be paid by secretariat.” Whatever the reason may be, these deserving people must be paid otherwise the whole campaign would fail.
Asma; You heard the report. WHO says we have paid the money. Then the problem must be in our own people?
Mustaram; The problem lies in the Agency Surgeon office and health department. They are consuming everything. These workers are very poor and needy people.
Asma: What are those health problems which require immediate reprisal?
Mustaram; The very first requisite is that the Agency surgeon should be immediately transferred or deposed. Some officials of good repute may be appointed in the agency. Political appointments in FATA Secretariat are the root cause of so many problems. We demand that local people from tribal region should be appointed in the secretariat. The situation is so bad at present that honest employees are teased to either leave the job or bow to their demands.
Asma: another problem in FATA is that no doctor wants to perform his duty there even if he is from the same area.
Dr. Nadir: It is due to the bad policies of our rulers. No hard area allowance is paid to such doctors who perform in tribal area. Naturally a person serving in hilly area where all the facilities are so scarce should be paid higher than in the cities. But in our country the reverse is done.
Asma: But it is also a fact that many doctors run private clinics in Peshawar and earn a lot.
Dr. Nadir: I assure you that the income from private practice in FATA would earn double the income in Peshawar. But the problem is that FATA is so persistently neglected that there are virtually no facilities at all. The Secretariat is replete with corrupt people.
Caller: Yousaf from Khyber Agency; I think you should do something about the fake medicine which are in vogue in tribal area. And secondly I want to say that if this polio virus was sleeping earlier because we had never been vaccinated but nobody in our family is handicapped or ever suffered from polio.
Dr. Nadir: Such is the ignorant attitude of our people as displayed by this worthy caller. There are no fake medicines in the market. There are medicines from good companies and bad companies. One is cheap and less effective while the other is expensive but effective. Secondly polio virus does not spread through water and dust but through urine, stool or saliva of the infected child. If we could control this virus for five years then there would be no case of polio.
Asma: When there are no health facilities in FATA then there must be greater number of deaths during delivery for these poor women?
Mustaram: Yes there are so many unfortunate deaths for babies and women during delivery because such cases need immediate treatment which is never there for these women.
Asma: Most of these people are so poor and if somehow they manage to come to Peshawar then how can they afford the expenses here?
Dr. Nadir: Tribal peoples have their own strict customs when we talk of women. Only serious and complicated cases are brought to Peshawar. But here there problems are not solved immediately. As they are mostly ignorant people, they are often misguided and exploited to draw out money from them. They are so poor that most of them cannot afford private treatment.
REPORT; Azeem Bangash, Hangu.
“ I have come early in the morning at 7 am but I am still waiting to be seen by a doctor. We are sent here and there but am unable to see a doctor” these are the words of a female patient who has come at 7 am in the morning and now when it is 11.30 am she is still waiting to be seen by a doctor. In Hangu District Hospital, which was provided with all kinds of facilities at the start, there are only 8 doctors on duty out of 28 allotted posts. Patients are faced with real problems as one of the patients Muhammad Naseem bangash tells us… “I am standing in a long line for my turn to be allowed to see the doctor. We are pushed like animals here and there and we are in great trouble” another patient Faisal Nadeem says.. “ I had pain in my stomach. The doctor on duty saw me and prescribed some medicine for me without bothering to know what kind of pain I have” In Hangu 51 doctors are needed to be enough for the population. But at present there are only 25 doctors present. MSF is an NGO who is working with the government in health sector in Hangu. Professor Dr. Ishaq bangash says about the present situation… “we have demanded again and again for more doctors to be appointed here but our demand is not fulfilled. Posts are vacant here but not many doctors would accept the post here.” In fact there are several vacant posts here in health department but the government is not serious to solve this problem. MSF is one organization which is trying hard to provide some facility to the people in health sector in Hangu.
Asma: As you heard the report, there are 50% vacant posts in Hangu.
Mustaram: I think in the whole of FATA almost 60% posts are vacant. I know many cases where a health employee is working privately in Afghanistan while drawing salary from Pakistan. We demand from our new provincial governor, who also belongs to tribal area, to address this serious problem of health in the whole of FATA.
Caller: I am kiran from Hangu and I am also a doctor. It is very sad to know that many of our doctors say that we are in the profession only to earn many. I think it is a sacred job and it is our duty to help the people.
Dr. Nadir: Yes such should be the spirit of all doctors. But it should also be born in mind that doctors are also human beings and have many needs. In a government hospital a doctor cannot get any money from the patient but it is his duty to serve the patients there.
Asma: It is said that many doctors do not do well their duty in hospital but all their focus is on their private clinics?
Dr. Nadir: it is a wrong generalization. Only a few doctors are involved in such practice and majority are doing government job only. It is the duty of the government to compel doctors to do their duty properly. A good system of check and balance is needed for doctors. There are many doctors who if go to Europe and Middle East can earn a lot more but they have preferred to stay here.
Asma; when there is emergency situation on FATA, what does these people do?
Mustaram: I myself have witnessed such an emergency when there was a huge bomb explosion. There is no facility whatsoever for such casualties. People are rushed to Peshawar in private vehicles without any life saving equipments. No ambulance is available in FATA although in papers they have plenty.
Asma: So what are your suggestions for improvement?
Mustaram: I suggest that good and local people should be appointed in FATA secretariat and in the health installations in FATA. We are patriotic people and our plight must be redressed.
Dr.Nadir: I personally appeal to the new governor on behlf of FATA people to please expel corrupt people from the department and have pity on us. Our coming generations will also pray for you.
Asma: thank you all.
- Radio Show