A Report by RAWA* , November 2005.
Malalai Hospital Reopens as Malalai Clinic in Khewa Camp
In July 2005 RAWA was forced to relocate its flagship health care project, Malalai Hospital, from the Pakistani city of Rawalpindi to Khewa refugee camp. Khewa camp is located about 30 miles from Peshawar.
RAWA originally established Malalai Hospital in Rawalpindi to help over 20,000 Afghan refugees living in a refugee camp called Kacha Abadi, located between Islamabad and Rawalpindi. But in May 2005 the government of Pakistan forced the refugees to leave, threatening to destroy all the mud huts if necessary. The government also pressured Malalai Hospital and other aid groups to stop their services in order to pressure the refugees to leave. Finally the Pakistani police bulldozed all the houses and the refugees were told to relocate to camps closer to Afghan border.
With the removal of Kacha Abadi, the existence of Malalai Hospital in Rawalpindi was no longer beneficial so instead we decided to provide medical services to people in Khewa camp. There, the refugees were in grave need of healthcare after a small clinic run by an NGO was closed down a year ago.
Currently Malalai Clinic is being run by a team of a female medical doctor, a child specialist, a gynecologist, 3 nurses, a lab technician, a pharmacist, a registrar, a service worker, a driver and a security guard, 4 days a week, 9 am to 2 pm.
The clinic is equipped with a medical laboratory including superior equipment to treat eye health, and an ambulance to transport patients to Peshawar in case of emergency. But unfortunately due to a lack of funds we cannot as yet open the In-patient department to admit patients and carry out surgeries. However, the OPD is running to its full capacity.
In Rawalpindi, Malalai Hospital was serving only Afghan women and children but in Khewa camp, due to the lack of any other medical facility, we have decided to provide medical services to Afghan men also.
There are about 5000 refugees living in Khewa camp and 25,000 in the surrounding camps and brick factories for whom Malalai Clinic also provides medical care. Each day, 120-180 patients from Khewa or the neighboring camps and factory workers come to the clinic. Among them at least 100-120 are women who have gynecological problems and children who have diseases such as diarrhea, dehydration, skin infections, pneumonia, flu, malnutrition, etc.
The nearest medical facility is a Pakistani private hospital about 25 km away and it is nearly impossible for the refugees to pay the high costs of transportation. By moving Malalai Clinic to this area, the local Afghan refugee population has been relieved of one of it’s biggest problems.
Most of the refugees in the camp live and work under terrible conditions. The most common health problems result from a lack of food, vitamins, unsuitable environment and very heavy and non stop work. There have been several cases where a mother or her new born baby have lost their life due to unsafe methods used by untrained midwives or lack of access to a medical center.
Patients of Malalai Clinic pay a small fee of 10 rupees (= 16 US cents) to get registered. After that, all medical check ups, tests and prescribed medicines are provided free of charge. Common medical tests such as typhoid, malaria, hepatitis B & C, and other routine tests are carried out in the clinic.
If any patient suffers from a serious medical condition that cannot be treated at the clinic, we immediately send the patient to a well-equipped hospital in Peshawar city. The ambulance formerly used by Malalai Hospital is available 24 hours a day for transporting patients.
Malalai Hospital has been downsized to create Malalai Clinic by reducing the number of staff, being far away from the city, operating in a smaller building in a remote area and with limited facilities (such as electricity and water). While this obviously causes difficulties, the number of patients and diseases that Malalai Clinic personnel face daily remains nearly the same as the hospital faced in the city.
Despite the problems, the most needy families are being reached and treated by the responsive staff of Malalai Clinic. The clinic has even employed some local widows who now have a source of income for their desperate families.
Additionally, because the atmosphere at Khewa camp is safe, most women can come to Malalai Clinic without facing any trouble. Most of the clinic staff personally know the families and ethnic groups settled in the area and are able to speak with their language with the same accents. As the people of Khewa camp and the surrounding area are from different provinces of Afghanistan the clinic is an opportunity for us to be in touch with Afghanistan’s different ethnic groups and better understand their needs, wishes and problems.
The clinic also has a Mobile Health Team composed of two doctors, a nurse and a pharmacist. The team visits neighboring camps and especially families who live and work in brick factories, and provides them with free health care services. There are several poor families who are suffering from various illnesses but cannot spare the time to visit a doctor as they are struggling to spend each hour working to support their families. Or some women and children are simply not allowed by their families to leave home.
Visiting such families not provides support to the women and children, it also enables Malalai Clinic staff to be aware of living and working conditions, the problems of local people, their needs, and ways they can be helped.
Malalai Clinic’s reputation is growing by the day – visitors have never witnessed discriminating or immoral behavior by the clinic staff.
The clinic personnel have learned not only to act as health workers but as a sincere human beings who listen to the sorrowful stories of the people and share their pain. That is why most of the female patients talk about their problems and miseries with confidence and ask for guidance and help.
Aside from providing medical treatment, Malalai Clinic has regular programs of health education for women to educate them about the importance of hygiene, how to acquire healthier food, and how to look after babies and children. The programs also educate them about different vaccinations, serious illnesses, etc.
With the help of FemAid, RAWA has also started a course for midwives to train women who can provide First-Aid in situations where there is no doctor. Currently 15 women are being trained who will graduate in three months after which they will be provided with a First-Aid kit and other equipment and medicines.
* Edited for grammar