ISLAMABAD, Pakistan — One year after Pakistan's worst flooding in decades, UNFPA continues to deliver comprehensive reproductive health care as part of one of its largest-ever humanitarian response efforts.
In August 2010, after the flooding, UNFPA rushed to deliver basic reproductive health services for the displaced. Now, during the recovery phase, the Fund is working to upgrade health facilities to provide comprehensive emergency obstetric care.
The floods highlighted the situation of women living in rural and underprivileged areas of Pakistan, some of whom had never been to a doctor before. Maternal mortality figures show that one out of every 89 Pakistani women will die of maternal causes, and that complications of childbirth still account for one fifth of deaths among women of childbearing age.
Among the 20 million people affected by last year's flash floods were 500,000 pregnant women. Their vulnerability was further exacerbated by malnutrition, trauma and fatigue due to long journeys to safer areas or camps, and by subsequent poor hygiene.
Given the immense needs, UNFPA in collaboration with the Government and civil society partners started to deliver urgently needed maternal health services through mobile service units as part of an outreach programme for areas that had no functional health facilities.
Refurbishing health facilities and distributing basic supplies
Damaged health facilities were refurbished and female health care providers were recruited to restart basic services. The Fund provided personal hygiene supplies and newborn and clean delivery kits to tens of thousands of women. Reproductive health equipment and supplies sufficient to cover an estimated population of 6 million were distributed within the past year.
Today, the emphasis is on helping flood-affected people rebuild their lives. "A vast majority of people have gone back but some are still here and are in need of services. Those who have gone back are more aware of their health needs," says Ceemab, a Community Health Worker from Khairpur. "Women who come to see us are very scared that there will be another flood this year, and they will again lose the little that they have managed to build back in a year," she adds.
"The buying capacity of the flood-affected people who have returned to their areas has decreased significantly," says Dr. Jameel Chaudhry, UNFPA Provincial Coordination Officer in Punjab. "There is a need to provide services at minimal or no cost, as the returnees cannot afford out-of-pocket health expenses."
Working to improve the quality and accessibility of services
The Fund is now working to provide, where possible, free reproductive health services in Government-owned health facilities. The focus is to strengthen quality and improve the accessibility of services. However, sustainability of services remains the biggest challenge as it requires support and commitment from the Government at district and provincial levels.
A programme aimed at protecting displaced women and girls from violence was also initiated last year. Coordination mechanisms, co-led by the Department of Social Welfare, were set up both at the federal and provincial level. Referral systems were established for the survivors to receive medical, legal, and psychosocial support. Twelve women-friendly spaces were also set up to reach women in affected communities.
"UNFPA will continue to provide humanitarian assistance in reproductive health and gender-based violence programmes for flood-affected communities as well as for people internally displaced as a result of conflict," said Rabbi Royan, UNFPA Representative in Pakistan.