In Pakistans Swat \valley, health workers reach out to women and children already struggling

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SWAT VALLEY, Pakistan, 28 September 2010 - The scenic Swat valley in Pakistan's northwest Khyber Pakhtunkhwa province is facing a complex emergency situation. Since May 2009 military operations and conflict have ravaged the area and in July 2010 floods came, affecting some 3.8 million people in the province and devastating thousands. The impact on the health and nutritional status of families has been severe, especially for children and women. "Children and women were badly affected by the conflict and we had not yet completed the early recovery work when the worst floods hit us," said Javed Afridi, Project Coordinator for the Abaseen Foundation, a non-governmental UNICEF partner in Pakistan. With partners like Abaseen, UNICEF is conducting social mobilization activities for 'Mother and Child Days' and other health and vaccination campaigns in the Swat valley. Community mobilization Mr. Afridi said that the floods have exacerbated the health challenges facing women and children in remote areas as bridges and roads have been washed away, limiting access to services. "With winter's approach, we will have another nightmare as more areas will be cut off due to snow," he added. To address the lack of access to basic health services for mothers, last year UNICEF began supporting the 'Mother and Child Days' campaign, which is conducted by non-governmental partners to enable the delivery of a package of high-impact, low-cost child survival interventions. During the campaign, children – especially in rural areas – receive immunizations and de-worming medicines. Mothers are counseled on household practices like breastfeeding and basic hygiene, and on how to identify and treat diseases like pneumonia and diarrhoea. UNICEF and its partners are working rapidly to reach the most vulnerable in Khyber Pakhtunkhwa and other flood-affected provinces. In Kot Naway Kaley village, for example, teams of vaccinators from the area's Basic Health Unit are going door-to-door, identifying and registering children for measles vaccines and administering on-the-spot polio vaccinations. In addition, community mobilization activities – including meeting with village elders – ensures that vaccination teams operate smoothly and that all eligible children are immunized against preventable, life-threatening diseases. Improvements for women and children Major strides have been made to date. Last month in severely affected districts in Khyber Pakhtunkhwa, including Swat valley, large percentages of children were reached with polio vaccinations, measles vaccinations and vitamin A supplementation. Under the Mother Child Days package in Swat valley, some 32,000 families have been reached, nearly 5,000 pregnant women have been registered and provided with clean delivery kits and 129 high-risk pregnancies were referred to hospitals or other health facilities. Of those affected by flooding in Pakistan's Khyber Pakhtunkhwa province, hundreds of thousands are women and children. The devastating floods have hit children and women the hardest, as both are already vulnerable across Pakistan. Neo-natal and maternal mortality rates are high, especially in Pakistan's more remote provinces. According to UNICEF's Multiple Indicator Cluster Report on Pakistan (2008), 100 of every 1,000 children in Khyber Pakhtunkhwa province die before their fifth birthday. Of these, many die in the first year of life due to preventable diseases like diarrhoea and pneumonia. The floods have worsened the situation, and reports from health authorities show continuously increasing cases of acute respiratory infections, acute diarrhoea, malaria and skin infections. The way forward includes scaling up community-based health campaigns in partnership with UNICEF's 'Lady Health Work¬ers' programme, the national Maternal Neo-natal and Child Health programme as well as NGO partners and institutions. UNICEF will also expand efforts to provide medicine, equipment, other supplies to resume and to restore com¬munity-based basic maternal, neonatal and child health services. Compounded devastation Aside from door-to-door outreach, the Mother Child Days campaign also provides services and health education at 'delivery point' locations. There, health workers conduct intensive health, hygiene and nutrition promotion activities through counselling sessions; provide demonstrations on using oral rehydration salts (ORS) for the treatment of diarrhoea; and deliver critical, life-saving messages about prevention of communicable diseases like diarrhoea, pneumonia, skin infections and malaria. Simultaneously, ante-natal and post-natal check-ups for pregnant women and new mothers are being conducted by trained midwives. Hyat BiBi, a community midwife from the Swat valley town of Mingora, is working as a Community Health Worker for the Abaseen Foundation. She is advising women on pregnancies and related health issues, she says, during what is one of the most difficult moments her community has ever witnessed. "We have not yet recovered from the ravages of war, and now this calamity has befallen our province," said Ms. BiBi. "I have never seen such flooding in my life."