By Ali Nawaz Rahimoo
Tharparkar is the only district in Sindh which does not have fresh water resources, the only source being wells dug into the ground. The
Tharparkar desert in Sindh is the largest desert region of Pakistan and is the 18th largest desert in the world with an area of 22,000 square kilometers. A
population of 1.6 million, distributed in 2880 villages, some of which include
Mithi, Diplo, Chachro, Islamkot, Nangarparkar, Dahli and Kaloi, and 64 Union
Councils, the Tharparkar district was separated from Mirpurkhas in 1990, with
Mithi as its capital. There have been numerous deaths of children due to
malnutrition and the high infant mortality rate has also been the focus of the
media in the past because it is higher as compared to the other districts in
Sindh and malnutrition has been identified as one of the major causes. It has
been observed to be affecting mothers more than infants, as they breastfeed for
as long as six months. However, the health department cannot be solely held
responsible as there is a need for the government of Sindh to look into the
matter and implement long-term reforms. There is also a need to plan for these
reforms ahead of time.
Tharparkar is the
only district in Sindh which does not have fresh water resources, the only
source being wells dug into the ground. However, this water is, in most parts,
brackish and bad for the health and the lack of fresh water does not allow
farming, or healthy living. Personal hygiene and sanitation is also affected
due to the scarcity of water. Thus, providing access to sufficient quantities of
fresh water can reduce the burden of diseases and poverty. The drinking water
in Thar also has dangerously high levels of fluorides whereas the World Health
Organization guideline value for fluorides in drinking water is 1.5mg/l. A high
fluoride intake causes dental and skeletal fluorosis, osteoporosis, thyroid and
kidney problems as well as irreversible chronic bone and joint deformations. So
the availability of safe drinking water has always been a distant dream for the
people of Tharparkar, where over 80 percent of groundwater is unfit for human
consumption.In many families, women and girls fetch water for the family every
day over a long distance, from a communal source. This takes hours, depriving
them of a comfortable working experience as well as education. Constant lifting
and carrying of heavy water pots also causes health problems, particularly
among women who are pregnant. The main crops grown in the area are millet, mung
beans, bulgur wheat, chili and oilseed and they can tolerate dry conditions.
However, in severe drought conditions their yield falls drastically as well. Fresh
fruits and vegetables are scarce due to the lack of fresh water and the
successive years of low rainfall lead to scarcity of food items as well as
poverty. The provision of education is lowest in this region and Female
education in the rural areas is much lower than male education- almost
nonexistent. Another factor that contributes to the low standard of living in
the region is child marriages and it is something the government needs to take
strict actions against as it endangers the lives of both the mother and child. The
concept of family planning is unfamiliar in our country and as a result,
teenage pregnancies are a common occurrence. Overall, health facilities are not
available to the Tharparkar population. Many doctors are available in the area,
but they are either absent from health centres or are unskilled. A total of 84
Community midwives are also present in the Tharparkar District but they are
often not called upon or lack proper skills. The travel-time to the nearest health
facility is about two to four hours and costs from RS 4,000 to RS 6, 000. This
is a huge burden on a poor person, whose average monthly income is less than RS
5, 000.Moreover, there is only one large civil hospital in Mithi. In order to
avoid health tragedies and deaths, the number of civil hospital needs to be
increased. In many families, women and girls fetch water for the family every
day over a long distance, from a communal source. This takes hours, depriving
them of a comfortable working experience as well as education. Constant lifting
and carrying of heavy water pots also causes health problems, particularly
among women who are pregnant. The people of Tharparkar depend on rain for
farming. If it does not rain one year, they suffer from famine, which
aggravates poverty and other existing difficulties. Their staple products are
jowar and bhajra; they store one type of grain and eat that for the entire year
out of fear of a drought occurring. Vegetables and fruits are not part of their
diet which leads to a lack of vitamins and other essential minerals. More than
80 per cent of women in Tharparkar are anemic. The birth-weight of children is
about 1.1 – 1.2 kg- well below the normal weight of 2.5 – 3kg. These facts
contribute to an increased infant mortality rate as well. Due to high levels of
poverty, houses in Tharparkar are not built efficiently either and often cannot
face the drastic weather conditions.
There is a diurnal variation of temperature. Thus, housing
is another aspect that must be looked into, to prevent illnesses caused by
extreme weather. The current livestock population of Tharparkar district is
above six million and most people of the area depend on an agro-pastoral
economy for their livelihood. Livestock, fully or partially, contributes to the
financial resources of every household of about 1.6 million people of the
district so Thar must be given priority in matters of livestock development.
These animals are very precious for them and thus, they keep them near their
homes. As a result, many diseases spread from animals to humans. Newborn babies
are more vulnerable. Thus, the immediate opening of immunization centres for
animals and the availability of veterinary doctors is needed. In conclusion,
the government needs to take immediate remedial measures such as opening
specific hospitals for children and appointing a fixed number of child
specialists, a hospital at each Taluka level with functional wards. It needs to
meet the requirements of Female Medical Officers at Basis Health Centres as
well and allow Lady Heath Visitors. Lady Health workers, also need to organize
Capacity Building of new recruited staff and the government needs to provide
the quality medicines and equipment as well along with the 4×4 ambulance
service Installation of desalination plants, solar water pumps, tube wells for
Agriculture purposes, livestock fodder and medicines is also needed. The
availability of female doctors and specialist doctors, particularly
paediatricians, gynaecologists, and physicians must also be made possible and
programmers of immunization, antenatal care, and child care should be
introduced. Public sector dispensaries and maternity clinics should be set up
to provide easier access. Improved health is tied to public awareness; hence
the importance of antenatal care and complications associated with untrained
deliveries must be explained to the public and. parents must be educated
regarding paediatric nutrition and childcare.
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