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Pakistani Mothers, Babies Face Health Risks

October 27, 2010 at 12:00 AM EDT
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Special correspondent Saima Mohsin reports from Pakistan, where pregnant women and infants who survived the floods often lack sufficient nutrition and access to health care.
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GWEN IFILL: Next: the youngest victims of the Pakistan floods. We have a report on maternal health from special correspondent Saima Mohsin.

SAIMA MOHSIN: Today and every day, 1,700 babies are born in the flood-affected areas. Around 250 of them will experience complications.

The U.N. estimates half-a-million women will give birth in the flood-affected zones in the next six months. Those that make it to the camps are relatively lucky. They should get some medical assistance. Others are still wading in the water, with no access to even basic health care, the unseen and the unlucky.

Our cameras followed the Pakistan Medical Association, which has set up tents in the camps they can get to. A midwife monitors the pregnancies and keeps a check on the women.

Ameera Un Nisa is having her seventh child. She’s anemic and a high-risk patient.

NAGINA ILYAS, midwife (through translator): Our concern is that Ameera lost a lot of blood during her last delivery and had to be rushed to hospital. On top of that, she has conceived very quickly again, and she’s very anemic yet again.

WOMAN (through translator): I have been very upset. I was crying when the floods came, worried about my unborn baby. We’re very uncomfortable here. It’s very hard. We don’t always get clean drinking water. There aren’t any facilities. We’re sleeping on the ground. My children are repeatedly getting sick. I get them medicines, but they don’t work.

SAIMA MOHSIN: Nadia (ph) is refusing to drink milk.

NAGINA ILYAS (through translator): When you are pregnant, it’s essential you drink milk. You and your baby really need those nutrients.

SAIMA MOHSIN: The midwife struggles to convince her that it’s good for her health and her babies.

NAGINA ILYAS (through translator): You can add any flavoring or just add sugar to taste, but you must drink milk.

SAIMA MOHSIN: We found that language is a huge problem in the camps. Pakistan’s diverse populations speak many different languages and dialects. Children often bridge the communication gap.

This woman had had a high temperature for days, but had not alerted the midwife. Some women are scared they will have to pay for the treatment. Others, like this one, had not thought it necessary.

One of the major problems affecting safe childbirth in Pakistan is the delay in calling for medical help. Women and young girls deliver at home. The doctor is often only called once a situation is life-threatening or it’s too late.

DR. SHERSHAH SYED, Pakistan Medical Association: The main risk is hemorrhage, bleeding. It is the biggest risk, because these women are already weak. When you say a hemoglobin six, this woman — if this woman was in England and America, she would be admitted into hospital and will be having intensive care.

FATIMA ALLAHDITTA, Pakistan (through translator): Water was up to here. We all rushed to the roof to save ourselves and spent 24 hours there. Then the military rescue finally came, and I passed out. They carried me to safety. It’s been very hard being pregnant through all this.

SAIMA MOHSIN: While we were filming, Fatima was taken to hospital. A high-risk patient, she gave birth to a healthy baby girl. Had she still been in her village, things may have been different.

FATIMA ALLAHDITTA (through translator): Now we don’t have anything, no home, no clothes to wear, nothing to eat or drink, worried about my baby’s future. You have to have something to give your children, and I have eight children.

SAIMA MOHSIN: Maternal mortality is still high in Pakistan, far from the millennium development goals. Even before the flooding, for every 100,000 births, an estimated 500 women die.

The flooding has only added to this grim situation. Trauma, lack of hygiene and sanitation, little food leading to malnutrition make women and their newborn babies more vulnerable.

DR. SHERSHAH SYED: These conditions are totally unhygienic. The water is not there. And whatever water they — they have is totally polluted and dirty water, and that will give you infection.

SAIMA MOHSIN: The camps are dirty and dusty. Many women give birth on the hot sandy earth. The discomfort is secondary to the grime and dirt around them. People from rural communities, many illiterate or unschooled, have little or no training in hygiene. We found feces and urine just outside tents and even in the hallways of schools converted into camps.

DR. SHERSHAH SYED: There’s no hygiene. There’s no sanitation. There’s no clean water. And in this situation, managing a pregnant woman is — is really difficult.

NAGINA ILYAS (through translator): They’re sitting on the soil. The water isn’t clean. Now they’re telling me they haven’t even had any water for two days to wash. I look at little kids touching the ground and then eating with the same hands, putting all that dirt into their mouths. Inevitably, the next day, they come to me suffering from diarrhea.

SAIMA MOHSIN: Nagina holds a regular clinic, often crammed and overwhelmed. Midwives end up having to treat women and children for all kinds of problems, coughs and colds, diarrhea, fever, breast lumps, and sexually transmitted infections.

Medicines are rationed and limited to one or two days worth of doses. The lack of literacy and understanding means patients can’t treat themselves. Perpetually pregnant, women are having one birth after another, some giving birth to up 10 children or more. In a few years’ time, the midwife told me, this young girl will be pregnant, too.

But women have little knowledge of how best to feed their babies and protect them from disease. Babies lie in the hot sun with little shelter. The tents, hotter than an incubator, become unbearable. This woman had had twins. She was struggling to breast-feed them. Their sallow and sunken faces revealed the onset of malnutrition.

Many of these women have never seen a doctor. The Pakistan Medical Association says there is a positive side to this disaster.

DR. SHERSHAH SYED: Suddenly, there is a flood, so they all have to leave their village and come to the different camps in cities. And, in cities, they’re having far better care, as far as their pregnancy is concerned, because some midwives are there; doctors are there.

SAIMA MOHSIN: The flooding has brought to light many issues Pakistan’s people were already facing, now exacerbated by the dire situation.

At least 20 million people have been affected by the flooding. Another half-a-million newborns will be added on to that number in the next six months. The plight of Pakistan’s flood victims, old, young and new, is far from over.