Long-running conflict has meant that 1.6 million people from the Federally Administered Tribal Areas have been displaced. To put this in perspective, consider that this area’s entire population is only 5 million. But this was not the only price to pay. The fighting has also extensively damaged its public health infrastructure.
In addition to the trauma of displacement, the people of Fata are victims of bomb blasts and many have been rendered amputees. These shell-shocked people exhibit psychological symptoms of trauma and have compromised communication capabilities. Many need medical treatment for affected hearing and others need rehabilitation therapy as early as possible to restore their quality of life. The government of Pakistan ratified the Convention on the Rights of Persons with Disabilities in the year 2011 yet no significant policy initiatives are visible to rehabilitate disabled individuals of FATA.
The International Committee of the Red Cross (ICRC) reports that in 2017 more than 52,000 persons with disabilities received physical rehabilitation services across the 22 ICRC-supported physical rehabilitation centers. In KP and Fata alone, 26,758 people received physical rehabilitation through 12 ICRC-supported centers. It was here that more than 9,000 prosthetic/orthotic devices were provided free-of-charge, including those for 1,147 mine survivors. Access to rehabilitation services remains a daunting task for persons with disabilities hailing from Fata on account of factors such as lack of awareness, logistics and terrain.
Unfortunately, FATA also has a high incidence of non-communicable diseases which pose a formidable challenge to the health authorities at the federal and provincial levels to develop a framework to safeguard the populace from preventable deaths and adhere to international commitments. International health donor agency concerns for the improvement of healthcare in FATA are oriented towards poliomyelitis campaigns but Pakistan’s health policy makers do not take a holistic approach.
The extent of government involvement in Fata can be gauged from the official generalized assertions that Rs80 billion (almost $720 million) has been set aside for rehabilitating and reconstructing essential facilities, inclusive of health facilities in FATA.
Reports indicate that 38 health facilities, including basic health units, dispensaries, child health centers and hospitals of D category have been damaged. It is expected and estimated that rehabilitation of health facilities and mobile health units will cost $8 million and the total budget is $60 million.
The interest of international donor and health agencies is kept alive as the health component is implemented in coordination with other ongoing health initiatives in Fata, particularly polio and nutrition programmes supported by the WHO and UNICEF.
FATA is perceived in Pakistan to be a neglected part of the country and its health sector suffers from structural issues inclusive of primary health care, maternal and child health, Tuberculosis control and emergency minefield accidents. Grim statistics reveal that 72% of babies are born at home and there is only one doctor for 7,670 people worsened by the fact that there is one hospital bed per 2,179 people.
Fata has six Agency Headquarter Hospitals and four Tehsil Headquarter Hospitals, eight Rural Health Centers, 168 Basic Health Units and 568
Community Health Centers and Maternal and Child Health Centers and dispensaries.
External financial support
The Pakistan China Recovery Initiative in FATA implemented by the UNDP has $4 million for community-based rehabilitation and restoration of quality of life. The contribution of donor funding towards health makes up around 8% of the total health spending but this is low when compared to average donor assistance of 14% for other countries of the region.
In 2017, USAID in partnership with the government of Pakistan awarded Rs1.6 billion ($15 million) to build sustainable livelihoods in Fata through the FATA Economic Revitalization Program. The FATA Transition and Recovery Programme UNDP is supporting government efforts to implement the Sustainable Returns and Rehabilitation Strategy by investing in the rehabilitation of basic infrastructure.
One of the major challenges is that people need to travel great distances to get medical treatment. For any specialised care, patients have to travel to Peshawar where the tertiary care hospitals are located.
E-health
One possible solution for the people of Fata includes e-Health or the use of Information Communication Technology (ICT) for health care delivery. This works for health informatics, digital data and telehealth. In Pakistan the scope for e-health is tremendous as there are almost 100 million cellular subscribers with mobile devices.
Health systems throughout developing and developed countries encounter challenges in managing rising demand for affordable health care. Pakistan has e-health in the informal private and philanthropic sector through telemedicine. Organizations such as Akhuwat and Taleem Foundation have launched initiatives in inaccessible and isolated settings. The health authorities and health policy planners have not realized the potential of e-health towards improving of healthcare in FATA. Pakistan’s National Health Policy by default perhaps does not explicitly include e-Health or digital-based healthcare.
In areas such as FATA no strategy appears to be in the offing in the future for sustainable integration of e-health into existing health systems although in 2005 through its e-Health Resolution, the WHO advocated the need for formulating a national strategy to address health care issues in resource-constrained countries. In essence through e-health care digital data, learning elements, products or services are instantly available. This approach can radically expand the health care system to FATA. Health data will become accessible on a common platform, spur research, reduce health costs and employ and engage health professionals including females. On account of general apathy for the plight of the persons living in FATA who are not conspicuous on the national horizon, e-health may be introduced to improve healthcare both in the short and long terms.
Dr Nazia Mumtaz is a PhD In Rehabilitation Sciences, and has a fellowship in Clinical & Research NeuroRehabilitation, Department of Rehabilitation Medicine from Seoul National University Hospital, South Korea
*Note: This article has amended statistics on the ICRC to update them.
In addition to the trauma of displacement, the people of Fata are victims of bomb blasts and many have been rendered amputees. These shell-shocked people exhibit psychological symptoms of trauma and have compromised communication capabilities. Many need medical treatment for affected hearing and others need rehabilitation therapy as early as possible to restore their quality of life. The government of Pakistan ratified the Convention on the Rights of Persons with Disabilities in the year 2011 yet no significant policy initiatives are visible to rehabilitate disabled individuals of FATA.
The International Committee of the Red Cross (ICRC) reports that in 2017 more than 52,000 persons with disabilities received physical rehabilitation services across the 22 ICRC-supported physical rehabilitation centers. In KP and Fata alone, 26,758 people received physical rehabilitation through 12 ICRC-supported centers. It was here that more than 9,000 prosthetic/orthotic devices were provided free-of-charge, including those for 1,147 mine survivors. Access to rehabilitation services remains a daunting task for persons with disabilities hailing from Fata on account of factors such as lack of awareness, logistics and terrain.
The health authorities and health policy planners have not realized the potential of e-health towards improving of healthcare in FATA
Unfortunately, FATA also has a high incidence of non-communicable diseases which pose a formidable challenge to the health authorities at the federal and provincial levels to develop a framework to safeguard the populace from preventable deaths and adhere to international commitments. International health donor agency concerns for the improvement of healthcare in FATA are oriented towards poliomyelitis campaigns but Pakistan’s health policy makers do not take a holistic approach.
The extent of government involvement in Fata can be gauged from the official generalized assertions that Rs80 billion (almost $720 million) has been set aside for rehabilitating and reconstructing essential facilities, inclusive of health facilities in FATA.
Reports indicate that 38 health facilities, including basic health units, dispensaries, child health centers and hospitals of D category have been damaged. It is expected and estimated that rehabilitation of health facilities and mobile health units will cost $8 million and the total budget is $60 million.
The interest of international donor and health agencies is kept alive as the health component is implemented in coordination with other ongoing health initiatives in Fata, particularly polio and nutrition programmes supported by the WHO and UNICEF.
FATA is perceived in Pakistan to be a neglected part of the country and its health sector suffers from structural issues inclusive of primary health care, maternal and child health, Tuberculosis control and emergency minefield accidents. Grim statistics reveal that 72% of babies are born at home and there is only one doctor for 7,670 people worsened by the fact that there is one hospital bed per 2,179 people.
Fata has six Agency Headquarter Hospitals and four Tehsil Headquarter Hospitals, eight Rural Health Centers, 168 Basic Health Units and 568
Community Health Centers and Maternal and Child Health Centers and dispensaries.
External financial support
The Pakistan China Recovery Initiative in FATA implemented by the UNDP has $4 million for community-based rehabilitation and restoration of quality of life. The contribution of donor funding towards health makes up around 8% of the total health spending but this is low when compared to average donor assistance of 14% for other countries of the region.
In 2017, USAID in partnership with the government of Pakistan awarded Rs1.6 billion ($15 million) to build sustainable livelihoods in Fata through the FATA Economic Revitalization Program. The FATA Transition and Recovery Programme UNDP is supporting government efforts to implement the Sustainable Returns and Rehabilitation Strategy by investing in the rehabilitation of basic infrastructure.
One of the major challenges is that people need to travel great distances to get medical treatment. For any specialised care, patients have to travel to Peshawar where the tertiary care hospitals are located.
E-health
One possible solution for the people of Fata includes e-Health or the use of Information Communication Technology (ICT) for health care delivery. This works for health informatics, digital data and telehealth. In Pakistan the scope for e-health is tremendous as there are almost 100 million cellular subscribers with mobile devices.
Health systems throughout developing and developed countries encounter challenges in managing rising demand for affordable health care. Pakistan has e-health in the informal private and philanthropic sector through telemedicine. Organizations such as Akhuwat and Taleem Foundation have launched initiatives in inaccessible and isolated settings. The health authorities and health policy planners have not realized the potential of e-health towards improving of healthcare in FATA. Pakistan’s National Health Policy by default perhaps does not explicitly include e-Health or digital-based healthcare.
In areas such as FATA no strategy appears to be in the offing in the future for sustainable integration of e-health into existing health systems although in 2005 through its e-Health Resolution, the WHO advocated the need for formulating a national strategy to address health care issues in resource-constrained countries. In essence through e-health care digital data, learning elements, products or services are instantly available. This approach can radically expand the health care system to FATA. Health data will become accessible on a common platform, spur research, reduce health costs and employ and engage health professionals including females. On account of general apathy for the plight of the persons living in FATA who are not conspicuous on the national horizon, e-health may be introduced to improve healthcare both in the short and long terms.
Dr Nazia Mumtaz is a PhD In Rehabilitation Sciences, and has a fellowship in Clinical & Research NeuroRehabilitation, Department of Rehabilitation Medicine from Seoul National University Hospital, South Korea
*Note: This article has amended statistics on the ICRC to update them.