In 2008, Doctors Without Borders/Médecins Sans Frontières (MSF) began working in the eastern districts of Jaffarabad and Naseerabad in Pakistan, primarily supporting nutrition programs for children under five years old with a network of mobile clinics and outreach sites. According to the Pakistan Demographic and Health Survey 2012–13, around 45 percent of children under age five show evidence of stunting and 11 percent are wasted and 30 percent are underweight. Malnutrition is a serious concern in the region.
Tufail Ahmad is a Pakistani doctor working in the MSF nutrition program at the District Headquarters Hospital in Dera Murad Jamali, Eastern Baluchistan, Pakistan.
I’ve worked as a doctor with MSF for the past four years. At the MSF clinic in Dera Murad Jamali, I see several malnourished, premature, and sick babies every day. Have you ever seen a newborn baby being given black tea, honey, or herbs right after birth? Have you ever witnessed a mother refusing to breastfeed, convinced the milk could make her child sick? You probably haven’t, but we see such cases all the time in Dera Murad Jamali.
Eastern Baluchistan, where Dera Murad Jamali is located, is an area of Pakistan with dire malnutrition levels. According to Pakistan Demographic and Health Survey 2012–13, around 45 percent of children in the country show evidence of chronic malnutrition or stunting, while 11 percent are acutely malnourished and require urgent treatment. Here in the districts of Naseerabad and Jaffarabad, I would not be surprised if the situation is worse. When I first came to the area to work, I was really shocked.
In an area where there is no food insecurity, it’s surprising to see so many malnourished children. The main reason is the local health practice. Mothers often work in the fields, meaning they can’t invest as much time in the care of their children. Many women experience consecutive pregnancies and are unable to practice birth spacing, and consequently give birth to premature children. After giving birth to a premature baby, a woman is advised to space out her next pregnancy, but generally that does not happen. Many mothers do not breastfeed, or do not know how to do it properly, and often babies are instead fed black tea, herbs, or powdered milk prepared in an unhygienic way.
I hope these practices change one day. There is an immense need to improve the community’s awareness around good health practices. MSF is working very hard on this.
I still remember when my children were born. It was my wife’s first pregnancy and she was carrying triplets. While I was at work, medical complications forced my wife to give birth to triplets in another town after only 31 weeks of pregnancy. She delivered one girl and two boys, who weighed a mere 1.42, 1.26 and 1.13 kilograms [3.1, 2.8, and 2.5 pounds] respectively. As a doctor, I know it’s hard for babies with such low weight to survive. I was afraid they would die.
The hospital where my wife delivered referred the babies to the MSF nursery in Baluchistan, the only medical facility in the area that can take such premature babies. I found myself suddenly treating my own children.
I treated my children for 26 days. There were ups and down. I saw them getting better day by day. Mother’s milk is always our first choice, and breastfeeding really helps children to gain weight. They survived and started getting healthy. They are 16 months old now and still breastfeed. They are just as healthy as other children.
My children are a true example that even if a child is born prematurely, severely malnourished or with a very low birth weight, they can be saved. But parents must protect their children in the first place by taking them to the hospital on time, giving them breast milk and proper weaning after six months, and avoiding unsafe health practices.
Whenever I see a newborn baby fighting for their life, I am reminded of my own three children. It feels like I am treating my own children every single day.
I want to save them all.