Health services in Pakistan are often unaffordable and in many regions, conflict and insecurity further restrict access.
In many parts of Pakistan sectarian violence is rife. Government forces are also engaged in military operations against armed opposition groups. Médecins Sans Frontières programmes focus mainly on meeting urgent needs among communities affected by insecurity.
In Hangu, Khyber Pakhtunkhwa, where many Afghan refugees and displaced people have settled, Médecins Sans Frontières works in the hospital’s emergency department and operating theatre, and a midwife supports maternity services. The team also organises patient referral to facilities in the provincial capital Peshawar.
In Timergara, Médecins Sans Frontières provides full support to the emergency department and mother and child health centre, and a new building was constructed at the centre to accommodate growth in patient numbers. After more than five years supporting emergency, maternal and child healthcare in Dargai hospital, services were handed over to the Ministry of Health in August.
In Peshawar, Médecins Sans Frontières runs a 30-bed hospital specialising in obstetrics and gynaecology, and also conducts antenatal and postnatal consultations in 11 health centres in the district. Staff at the health centres were able to identify and refer high-risk pregnancies or obstetric emergencies to the hospital.
Médecins Sans Frontières programmes in Kurram Agency in the Federally Administered Tribal Areas (FATA) are staffed by Pakistani personnel, while management is based in Peshawar, with regular visits. The team provides paediatric services at hospitals in both the Shia community of Alizai and the Sunni enclave of Sadda.
Balochistan has some of the worst health indicators in Pakistan. It is frequently affected by sectarian and interethnic violence and natural disasters. Médecins Sans Frontières is mainly focused on the needs of pregnant women and children, and at all programmes in Balochistan, carries out nutrition and health promotion activities.
Médecins Sans Frontières first worked in Pakistan in 1986
Dr Alan Hughes spends his semi-retirement in some of the world’s most under resourced health hot-spots, delivering babies, repairing fistulas and saving the lives of women giving birth in the most difficult of conditions.
The call came out of the blue. Having only recently been accepted into Médecins Sans Frontières, I was expecting to wait a few weeks until I was placed.
It is only now David McGuinness is home that he realises how the past nine months working with sick children in Pakistan has changed his life.
While the world’s media focuses on stories of violence and drone attacks in north-west Pakistan, local families struggle through another bitter winter in the mountains, with little or no access to healthcare.
Despite the need for humanitarian assistance, Médecins Sans Frontières has not been given permission to work in Pakistan's earthquake-affected area, writes Chris Lockyear.