Esther Park, Edinburgh University medic, writes on her time at Women’s Christian Hospital, Multan, Pakistan.
“Sheer medicine.” If I were to recall what it felt like to be involved in medical care in Pakistan, that’s the phrase I would use. It was a basic, down-to-earth medicine. There weren’t many complicated tests you could do, no multidisciplinary team to have extensive discussions with, no fancy equipment to use in the operating theatres. But everything you did was necessary.
People had limited contact with healthcare professionals, and so everything you did with them and every piece of advice you gave made a big difference.
For example, there was very little awareness about healthy eating and exercise. Telling prospective mothers with type 2 diabetes (there were many) that parathas, biriyanis and ice-cream are not good for them was often met with surprise and some remorse!
Simple medications, such as aspirin, could make a big difference in helping women who have had multiple miscarriages to have healthy babies. It was exhilarating when a mother with a history of multiple stillbirths and miscarriages went home with a healthy little baby after being managed carefully in the hospital.
There were also moments when we wished there was more we could do. A baby was born prematurely at 31 weeks. He had a very low heart rate and wasn’t breathing well by himself. We gave medication to mature the baby’s lungs and carried out resuscitation straight after birth. But, without an incubator or ventilator, there was little more we could do to support the fragile life and the baby passed away at about 20 minutes of life. If the baby had been in the UK, he would very likely have lived.
Another patient, in her early 20s, presented with excessive bleeding at around 24 weeks pregnant. Four of her previous pregnancies had been lost around the same time. Tests done so far revealed no obvious cause. Genetic abnormality was a likely cause, but the patient could not afford expensive tests. Her husband was growing impatient and threatening her that if she doesn’t give him a living child soon, he will get a second wife.
This was sadly a common scenario. Infertility is often attributed to some physical or spiritual defect on the woman’s side and women with bad obstetric history are said to have “atra”, a local ‘disease’ that spreads by contact with shadows. Such women are isolated from communities and even in hospitals, avoided by other women in fear of catching the disease of infertility.
In situations like these, where we could offer little more, we told the patients that God loves them and we would pray in the name of Isa (Jesus), the prophet of healing, as He is known in Islam. I observed with surprise and joy that this was often accepted with gratitude. In the many cases when our skills and technologies were at their end, prayer was the only place to which we could go, and it was a good place to go.
A big, heartfelt thank you to EMMS International for supporting me for this very meaningful and memorable trip.
If you would like to apply for a grant to help with the cost of your overseas elective you can find out more and apply here.