Health woes of Shimshal Valley

G. Mussa Shimshali

In April 2010, I visited my native village Shimshal after a long time with a research team to conduct a poverty assessment, which was conducted in the entire disaster hit area of Gojal.

Our team conducted a focused group discussion with members of local institutions in Shimshal to know about the causes of deteriorating economy situation in the village. It was found that about 50% households are cash starved. The major reasons were found that a large part of the income (including income in kind) is spent on accessing health facility.

For minor health cases, which are not very expensive, cost a lot when women and children travel a long way to reach Hunza, where the hospitals have been constructed, in search of cure.

Some of the factors adding to increased health cost are;

• High transportation costs, almost increased five times after the damming of Hunza river
• The Shimshal road is highly dangerous and jumpy. That badly affects’ health of pregnant women and that turns the minor cases into sever one
• It takes at-least a full day to travel from Shimshal to Hunza, if boat/chopper services are available, otherwise it takes several days and the patients have to stay in hotels at either side of the lake, while, residential expenses and food at hotels in the disaster area almost became double due to disaster in the area  and high food inflation in Pakistan
• Women and children do not travel alone, they need special care of a man, that means expenses become double
• Boat and chopper services do not remain smooth due to appalling frozen lack in the winter and windy weather and people trap in one or other side of the lack for several days and spent their budget on an unplanned stay

These factors evidently increase the expenditure and their common repercussion on the lives of people in the current scenario evolves in the following;

• Huge expenditure on health do not allow people to meet their children’s educational expenses (especially higher education).people are snooping to educate their children and a huge trend of education is also found in the village in spite of being situated in the far flung area, but many talented students discontinue their education just due to unwelcoming financial position of their parents
• Economic position of people is getting worse as the community members sale out their livelihood resources( cattle, livestock and agricultural resources) in an emergency situation to meet health expenses
• People are apprehensive about their future and trauma-subject is budding in the community

However, every problem has a solution.

In the context of shimshal, the only solution that possibly will cater the health related need of the inhabitants on sustainable bases is establishment of a primary health care center.

Initiative regarding catering this most important need has been already taken through construction of a basic health care center funded by MISEREOR, representing the community of shimshal in Germany by Gesündheit Für shimshal.eV and administering the project in shimshal by Nowbahar Welfare Organization Shimshal(Reg.) NEWDO, but delay in the construction process due to dilate in release of fund has affixed the difficulties of community in shimshal.

This basic health care project was initiated in 2008 by some philanthropists from Germany who were on a trekking tour to Shimshal and during their tourthey realized the extreme need of basic health care center in Shimshal, where at least minor and normal cases (including pregnancy cases) could be treated.

Names of the philanthropists are Mrs. Elisabeth Buschmann, Mr. Horst Buschmann, Uschi Szes and Monika Blum. To access the fund for the project, these philanthropists formed an organization in Germany, namely Gesündheit Für shimshal.eV.

Members of Gesündheit Für shimshal.eV put their effort together to access fund for establishment of the health care center and in this regard they hold several meetings with the community of Shishal. This organization also prearranged a medical camp in shimshal in 2009 as a first step toward its contribution to the community of shimshal, organize and funded by Gesündheit Für shimshal.eV.)

Objectives of the medical camp were to cater the immediate health needs of the inhabitants. Medical specialist, surgical specialist and a gynaecologist, along with  three nursing staff, ware taken to Shimshal who checked up  hundreds of women, children and aged people and provided free of cost medicine. The medical camp proved successful, as appreciated by the community itself.

Initiation of BHCC project gave a sign of hope for the deprived community of shimhsal to reduce their problems related to lake of medical facilities. It is the community of shimshal who can better realize the  importance and need of this project because they know well that what sort of problem they have faced in the past and currently facing. It is also worth mentioning here that the desired health care center is the first ever community based health care center initiated in Hunza/Nager District, which would be operated and managed by the organized community itself (revealed by a socio-economic survey conducted in May 2010).

The construction phase of BHCC is in process under supervision of an experienced contractor, who work with zeal and Zest in collaboration with the project committee (consist of foremost responsible community activists, Construction experts and representatives from all segments of the community, selected by the community itself) under supervision of NEWDO. The major part of construction has been almost completed (wall construction is about to complete) and the contractor and Gesündheit Für shimshal.eV have used their own resources up to now. However, construction had been stopped for several months due to two reasons, (i) sever cold weather condition in the winter and (ii) delay in release of fund by the major donor agency.

The community of Shimshal is of the view that delay in release of fund is consequence of some management and project coordination issues within the partner organizations in Shimshal and donor agency due to communication gape. The issue should be resolved on acute bases so that construction phase could be completed and the BHCC could be putted on running, as staff for the center has been already trained in basic nursing and will be soon trained at advance level. The community assumes any further delay in the project as a gigantic loss for the socio-economic resources of the area and its repercussion would result in a poor health, wastage of time and resources of the poor community.

Some people are of the view that if delay in project is due to management issues, representatives of all stakeholders should come around the table to fetch out a solution for it. After analyzing the situation, visit of the project side should be made by all stake holder to see that what progress exist on the ground.  It is also strongly recommended that the responsible organizations should coordinate with one another rather then depend on individuals. Meetings with community should organized, who are the direct beneficiaries and also the flagrant witness for the progress and transparency of the project. They should also be consulted and investigated that have they been involved in the project committee or not? This will be an authentic way to know about the progress of project and ground realities.

Nature has already posed toughest challenges to the far-flung mountain communities, like Shimshal. Survival in shimsahl is extremely difficult due to being cold weather, mountainous geographical location and lack of easy access to other parts of the countries. The disaster of Atta-Abad Lake added to their issues and created a huge economic rescission in the area. Increased transportation cost, hyper food Inflation Lake of basic health facilities and deteriorating income created an issue of survival.

All these elements are evidently adding to the difficulties of the community and if the project, which I must say “God gifted one to the community of Shimshal” will be delayed or postponed by the responsible organization that would be likely a human made disaster by the people; who actually want to reduce the difficulties of the community but due to communication gape, they will unwillingly create a human made disaster for the marginalized community.