Pakistan

Fourth Quarter Summary

Real Medicine Foundation joined hands with Pakistan Health Foundation UK to provide comprehensive primary healthcare to the people of Union Council Agra, District Charsadda of Province KPK. From September 1^stto December 31^st, 2012,5,157patients were diagnosed and treated at the PHF-RMF Hospital Agra for a variety of medical conditions. 64.2% of patients during this period were female, 35.8% were male, and 17.9% were children.

Female cases include general medical cases as well as antenatal, postnatal and gynecological patients.During this reporting period, 250 women came for antenatal visits, 377 women visited the hospital for gynecological problems and 153 women visited to discuss family planning demonstrating the local demand for MCH services and the rapport the hospital has already established with the local community.

Most of the diseases diagnosed and treated resulted from poor living conditions of the patients living in this community which is still recovering from the floods of 2010:

· Acute Respiratory Tract Infections (ARI): 30.0%

· Gynecological and Obstetric Cases: 15.1%

· Diarrhea (bloody and non-bloody): 11.0%

· Dyspepsia: 11.2%

· Scabies: 7.3%

· Hypertension: 8.7%

· Urinary Tract Infections: 4.7%

· Constipation: 1.5%

· General Body Aches and Weaknesses: 2.7%

The above graph indicates the top ten diagnoses (diseases) seen at the clinic in the Fourth Quarter. In the left corner the ARIs (Acute Respiratory Tract Infections) on the graph bar reflect high numbers of patients were checked and cured but the reason for the high numbers is due to the high population of the area. Contrary to the diagnosis of ARIs, the number diagnoses of Hypertension and UTIs (Urinary Tract Infections) was lower compared to the last quarter. The reason for these findings is that the patients have been frequently educated by RMF’s team on diet, proper nutrition and self-hygiene and the results are starting to show. The ratio of curing these patients remains the same.

164 cases were seen and subsequently referred to secondary and tertiary care hospitals such as Lady Reading Hospital (LRH) and Khyber Teaching Hospital (KTH) in Peshawar for further treatment. The PHF-RMF Hospital has not only served the patients of Union Council Agra but also serves the underserved patients from non-flood affected areas of other adjacent Union Councils of District Charsadda.

Polio Eradication and Advocacy activities

The PHF-RMF Hospital also interacts and coordinates with local health authorities at the district and provincial levels.  Recognizing the strength of our hospital, local authorities have selected the facility as a provider for polio vaccinations.  521 children were vaccinated against polio during this quarter; see Success Stories.

The polio campaign is run every month by the Government and partner organizations like Rotary International, who help with Rotary Polio teams.  The hospital also aims to provide women and children in the area access to vaccinations against infectious diseases including polio, tuberculosis, MMR, Hib, tetanus, diphtheria, measles, and hepatitis B.

For details of patient flow during these three months please find attached the Morbidity Matrix as Annex 1.

Success Stories:

521 children were vaccinated against polio during the months of September through December 2012. For a more in depth blog coverage by Dr. Rubina Mumtaz of our Polio Program and it's challenges please visit this link:

http://www.realmedicineblog.com/2013/03/14/rmf-pakistan-we-will-eradicate-polio-even-in-the-face-of-violence/

PHF-RMF Hospital Agra is doing well and has started taking steps of involving the general public in our polio awareness and eradication campaigns. Our community outreach component "Make Pakistan Polio Free" is getting popular in the rural communities of District Charsadda and the locals showed immense pleasure about the provision of these outreach and preventative services.  The current initiatives by the Government and the continued involvement of Rotary clubs are starting to bear fruits, and we anticipate achieving our goal of complete polio eradication in the regions we are working in soon.

The PHF-RMF Hospital vaccinated 521 children from various Union Councils of District Charsadda during 9 campaign days from September through December 2012. As usual, the hospital provided space and access to children for the Government/Rotary polio teams.

Relieving the pain of deprived communities (Case study)

This is a short story about a little baby girl called "Mashal" (which means 'Light") who  was brought to our clinic in Union Council Agra, Charsadda by her panic-stricken parents.

Mashal was born premature and her weakened state was added by the fact that she was not breastfed by her mother who had been misled into believing that bottled milk was a better option. A weak baby, at nearly one year of age, she looked 6-7 months old and could not sit unsupported.  Mashal had contracted measles from her older siblings and cousins living in the extended family set-up. Within a few days, spots were erupting over her body, and she quickly slipped into respiratory complications, including pneumonia. She was exhibiting a very high fever and rapid shallow breathing with bluish pallor. The child immediately received urgent medical care and within a few days was on the road to recovery. Even in previously healthy children, measles can be a serious illness and as many as 1 out of 20 children under five with measles develop pneumonia. In developing countries where malnutrition and Vitamin A deficiency are common, measles kill 1 out of 5 children. Mashal, with her weak nutritional status, stood a reduced chance of recovery but with the quick support from all the hospital staff she was lucky to have survived this episode. 

Mashal is the youngest of 6 children borne to Sakeena and Amjad whose only source of income is his daily laborer wages and according to her mother, she had not received any vaccinations since her birth (Sakeena had all her children delivered at home at the hands of traditional birth attendants called ‘dais' ). Mashal is now registered with our EPI team and we will ensure that her vaccinations are up-to-date as we educate her mother on the importance of this aspect of all her children’s health.