Interview with Pakistani doctor Dr. Bilal from Balochistan

Dr. Ahmed BILAL works with Médecins Sans Frontières in one of Pakistan’s hardest-to-reach areas. This week, in eastern Balochistan, his team saved the lives of three babies born in the new MSF clinic set up to provide mother and child healthcare to one of the most disadvantaged populations in the region.

Actually, I’m from northern Balochistan, about 700km from here. To be honest, this is a very difficult area. Facilities are very limited. Most of the time, we have electricity for just four or five hours. And the weather makes the situation worse. In the summer, temperatures climb to 50 degrees centigrade. In the clinic, we have a generator, but there’s no air conditioning. It’s difficult to live here, but so many people do. If they can survive here, so can I.

We have an MSF house, for staff not from this region. It’s a bit like being in a hostel, living a student life again, queuing for the bathroom in the mornings. When I came here, the plan was to bring my wife and my one year old daughter with me, and to find a house. I haven’t found anything suitable yet, but we haven’t lost hope. I go back home for two to three days every month, and we keep in touch mostly by phone.

Health in general here is pretty poor. Around sixty per cent of mothers give birth at home, with no medical assistance whatsoever. The district has one of the biggest populations in Balochistan, around 600,000 people, but there is no gynaecologist.

We started a Mother and Child Healthcare (MCH) programme two days ago and have had three deliveries already. But each baby came out not breathing and needed resuscitation. I think that if they had been home deliveries where there’s no oxygen and no training about resuscitation, these children might have died. Mothers and babies are all now doing well.

Mostly mothers don’t know about the dangers of a long labour. They’ll come for help if there are complications – bleeding, severe pain or the baby does not come out. Of the three deliveries, one mother was from the city, about a ten minute walk from our hospital, but the other two were from the villages. There’s no ambulance, so one came 10km on a donkey cart; the other came even further by rickshaw.

The MCH programme aims to educate mothers by giving them antenatal care as well as providing a safe hygiene environment for the birth.  It has just started, so its hard to say what people will think of it. But our nutrition programme, which has helped nearly 1500 malnourished children since it started here last September, is a success. We get people coming to ask when we can start work in their area. Families tell us how their child was weak and sick before, but now they’re playing normally. I’m working far from home, but I’m happy here when people come to me and tell me, “My child is okay now”.

I don’t have much free time – mostly I’m at the clinic or on the phone to one of our project sites making sure everything is okay there, or helping out if there are complications. In the evening, I collect data and write up reports. There’s always something to do, but sometimes to refresh ourselves, I play cards or badminton with my housemates. To be honest, my house is just 700 km from here, but when I look at other MSF doctors who are coming to work here, whose homes are thousands of kilometres away, then I think that what I’m doing is a very small sacrifice.