Quake-hit women still await medical treatment

Zubaida Bibi lies on a narrow cot outside the ruins of her home. Her infant son Wali lies besides her. Every tiny kick by the baby causes his mother to grimace in pain. The only medicine she has taken since the 8 October earthquake that devastated her village of Shinkiari, 90 km north of the Pakistan capital Islamabad, are eight tablets of paracetamol-based analgesic handed out by a team of medical students passing through the area. “Both my legs are broken at the ankle,” Zubaida explained. “I was pinned under a cement beam for over six hours. I cannot move even to go to the bathroom. My daughter, aged nine, must help me with even the simplest task, and the white tablets I was given by some doctors who visited have run out.” Like hundreds of other badly injured women, Zubaida will not allow male doctors to treat her, despite her obvious agony. Some women more seriously injured than her have declined treatment, even when husbands, fathers or brothers have begged them to permit doctors to examine them. “We cannot allow strange men near us, or let them touch our bodies,” explained Razia Bibi, 53, from the Shangla area of Malakand. “The thought is repulsive to us, even if our male family members grant permission.” Her arm, apparently broken in two places, is badly swollen and turning an ominous blue. Only a rough, home-made sling supports it. Like her, many other injured women are willing to endure immense pain, perhaps even risk the loss of limb or life, in order to maintain strict, centuries-old traditional codes. “It is the way our women and girls are raised. Nothing can change that,” explained Faraaduddin Khan, 72, a resident of Mansehra. “In some cases, their husbands have begged them to seek treatment, and some have done so, but most prefer to bear their pain stoically than to unveil their bodies before men from outside their immediate families.” As a clearer profile emerges of the quake’s victims in the tiny villages scattered across the mountain terrain of Mansehra and Malakand divisions and in Pakistan-administered Kashmir, women and children appear to have born the brunt of the quake’s devastation. While thousands of children were crushed under school buildings as roofs and walls caved in during morning lessons, women were caught inside their homes. In the deeply conservative areas affected by the disaster, women rarely venture far from their homes, while men are far more likely to be labouring in fields, tending livestock or working in markets, shops or other locations. As a result, thousands of women have died and many more been badly injured by the bricks, stones and slabs of concrete that fell on top of them. Some were pinned under rubble for hours, even days, before being rescued. Across the Mansehra area, where shelterless villagers continue to survive outdoors, many women lie behind thin curtains of cloth that offer some privacy, or out in the open, on cots, sheets of cloth or pieces of plastic. Their painful moans fill the air in some locations. Many of these women have badly fractured and crushed limbs, head injuries or deep gashes. Some of the cuts ooze blood and puss, while children and other women tending the victims try to keep flies at bay. But in Mansehra, Battgram, Shinkiari, Shangla and elsewhere, many have yet to receive even basic medical treatment. “Women are reluctant to allow us to bandage injuries, especially if these are on the torso rather than the limbs or face,” said Dr Fayyaz Khan from the Kashmir town of Bagh, about 150 km from Islamabad. “They demand women doctors and the handful working with us have really been on duty around the clock to treat the dozens of seriously hurt women being brought in.” Dr Samina Latif, a final-year medical student from Rawalpindi who has been working in Bagh for four days, said: “We were asked to rush up here because of the demand for women doctors. But it is often difficult for female doctors and nurses to come here, live in tents and so on, and their families to do not like them to go up to unknown areas.” It is even tougher for women to reach the remote villages perched atop towering hills in the Mansehra and Malakand areas. While volunteer women doctors and nurses have reached affected areas, they are mainly based in larger centres at Balakot, Muzaffarabad and Abbottabad. The huge demand for their services makes it difficult, even for those willing and physically able to undertake treks of up to eight or 10 hours, to reach specific villages. As a result, some women quake victims, particularly in the Mansehra area, have died from their injuries. In some cases, medical aid might have saved them. Hundreds have wounds that have turned septic, making amputation their only option for survival. Others lying untreated amid the ruins of their villages, too badly hurt to be carried down perilous mountain tracks, will almost certainly die, adding to a mounting death toll the Pakistan foreign office on Monday warned could rise above 200,000.