French humanitarian medical mission in Kashmir

A 26-member humanitarian mission of renowned French surgeons has treated some 30 patients with complicated surgical disorders, at the Combined Military Hospital (CMH) in Muzzaffarabad, capital of Pakistani-administered Kashmir. “The team includes a gynaecologist, urologists and general surgeons. They are here to treat gynecological complications in women, such as fistula, Dr Qais Mehmood Sikandar, provincial programme officer of the United Nations Population Fund (UNFPA), told IRIN in Muzzaffarabad, some 135 north of the Pakistani capital, Islamabad. “Some 80 percent of deliveries are being carried out by traditional midwives, creating post-delivery complications. The problem is further aggravated by the lack of proper obstetric facilities in the state, which is mainly comprised of hilly terrain with a scattered population,” Sikandar said. “French surgeons have mainly operated on people who cannot afford specialised surgical procedures, most of the surgery is endoscopic,” Dr Ziad Kiani, general surgeon at CMH Muzzaffarabad, told IRIN. CMH Muzzaffarabad, a 410-bed hospital, is the only big hospital in the state of Kashmir which has specialists for almost all main outpatient departments (OPDs). “Our catchment area is far bigger than any other hospital in Pakistan. We cater for patients not only from the seven districts of Kashmir [nearly 3 million people] but also the North West Frontier Province (NWFP). So naturally the caseload is heavy,” Kiani said. On the part of the patient, endoscopic surgery involves less chances of developing post-operation complications and recurrence of the disease, the CMH official said. “It also shortens the patient’s stay at hospital,” he added. Three-year old Hamza Tariq, who was suffering from hypospadia, has benefited from the work of the French surgeons. “It was very difficult for me to take my son to any other city for such complicated surgery, as my resources are limited,” Tariq’s father told IRIN. The French mission was made possible by a two-year tripartite agreement signed last year between the government of Pakistani-administered Kashmir and the French NGO, Action Pour La Sante (APS), France and was coordinated by UNFPA. But some health NGOs are sceptical as to the usefulness of such foreign surgical missions. “There should be sustained efforts at capacity building of medical staff as well as improving the facilities at the health centres,” Iftikhar Abbas, senior administrator at the local office of the UK-based charity, Islamic Relief, said. “Treating a few patients annually doesn’t make a big difference. But to have a long-term, large-scale impact, we need regular training of medical staff and provision of the latest equipment at least at district level hospitals,” Abbas added. “Such missions should also consult NGOs working at the grassroots level, who are aware of the health problems of the population,” Khawaja Javed, who works at a free medical centre operated by another Islamic charity, told IRIN. “We need basic health awareness education among the masses, which will ultimately decrease the prevalence of several general illnesses,” said Javed. Health experts stressed the need for special capacity-building programmes to improve midwifery skills at community level to lessen the number of female disorders that can later require complicated surgery. CMH is aware of the need to build local health capacity. So far, four physicians from the hospital have been trained in special surgical procedures at French medical institutions under an exchange programme set to expand in 2005.