The Health Care Center located in Shimshal,, my native village, is one of the finest examples of exemplary community effort for self-development. They call it a Health Care Center for the community, by the community”, and rightly so.
The Health Care Center (HCC) is an achievement of the community of Shimshal accomplished in collaboration with philanthropist organizations from Germany, which constructed and made operational during the Attabad Disaster. The project was implemented by the community itself, and they are the ones managing it.
I visited Shimshal in August 2011 for one week and while i was at the village the construction work was finalized. I was lucky enough to also participate in the inauguration ceremony. It taught me a new lesson, “if truth be told”, and I am much impressed that such exceptionally sensitized, mobilized and self-reliant communities exist in Gilgit-Baltistan.
The inaugural ceremony was attended by a number of people, including representatives of the donor agency, representative of Gesundheit fur Shimshal e.V. (a club formed by German friends of Shimshalies in Germany, who bridge the gap between the community and the donors), representatives of other NGOs and foreign friends of Shimshal. The day of opening ceremony, in a way, looked like a forum, where stakeholders celebrated their success, assessed their weakness and generated ideas for doing more. It was an idyllic feeling for me and I think, it is an innovative model for the rural development specialist, as a best example of participatory approach.
The community described that the Health care center is a 95000 Euro Project, funded by MISEREOR Germany and completed in a short period of time under tough circumstances by the community. During the project implementation period, the Attabad disaster posed toughest challenges to any project implanter in the area to survive with a project, designed prior to the disaster scenario. High transportation cost, blockage of infrastructure communication and hyper inflation almost put a full stop on the mobility of an individual and the effected people of the disaster area had a question in their minds that “how to survive”? Access to health facilities was about in a halt but establishing a health facility in such a scenario by the victims themselves was almost impossible. During those days I was myself in the area as representative of my organization for emergency relief and I saw the throbbing situation of the victims regarding health; where sickly women and children were pleading for health facilities in hopelessness. It took a long time for government and NGOs to streamline the health facilities, but still the health facility is restricted to the central place of the valley (Gulmit), not to the far-flung areas, like Shimshal and Chipurson. Women and children from those areas had to travel a long way to access health facility in the centrally established emergency health relief service and still from many parts of the valley people have the same practice.
In a state like this, it was the community of Shimshal who assessed the pace and quality of relief by the outsiders and felt to pace up the construction process of their
own community health care center. It was much interesting and more worthy to notice that the project implementation team members worked voluntarily. The project implementation team managed the resources on the pre-design with further alterations of surrounding walls (not funded) and built a standard seismic-resistant building, fully equipped with modern medical gears. In this process the community were blessed enough with friends of Shimshal, who have a contiouse help to the community and extended cooperation in terms of time and resources are member of Gesundheit fur Shimshal e.V. (Host, Liza, Usche and monika including other 71 lifetime members).they have marvelous contribution in the establishment of the HCC as the success was impossible without them.
The center is now operational with trained nursing staff and two supporting staff, equipped with necessary required modern machines and all other basic health facilities. After putting the health center on running, a considerable decline in the number of patient travelling in the down country is reported by the community. recently, I visited the village again and interviewed the community members and they describe that establishment of the center has have an ultimate impact on their live. They reported that even minor diseases used to very costly for them in the past, when children and pregnant women travelled transversely a long way through the Attabad Lake to access health facility; but now those are dealt in the center.
The center is also linked with the Aga Khan Health Services, Pakistan (AKHSS), which plays a greater role in developing the technical and management capacities of the staff. In partnership with AKHSS and Gesundheit fur Shimshal e.V, HCC has currently sent local nurses for training in AKU for an intensive nursing training. This Step will prove a milestone for the sustainability of the HCC and capacity building of the rural educated women.
A similar programme regarding capacity building has already been initiated in partnership with the government health departments and trained nurses and midwifery staff, now serving in HCC. Another practical step taken by the community to boost the institutionalization process by accessing resources through linkage and partnership with NGOs and government departments, which is works out, designed, planed and implemented by the community. During the construction of HCC building, several awareness programme on “Health and Hygiene“ have already organized by the management and will continue the process in the future as well. Two time’s emergency medical help through medical camps have also provided provided, which helped the entire inhabitants of Shismshal to access free medical treatments and such programmes will be considered crucial from now to strengthen the future sustainability of the center.
It is a model of its own kind and the only Health Care Center of Gilgit-Baltistan, which is designed, established and managed by the community. It also gives a massage to the development practitioners, and communities across Gilgit Baltistan that if the community is empowered and sense of voluntarism is promoted the rural development can be enabled in line with its fundamental nature.