Cuban field hospital works to make a difference

Two hours along a steep road high in the mountains, is a field hospital in the middle of the village of Danna, some 40 km from Muzaffarabad, capital of Pakistani-administered Kashmir and close to the epicentre of the 8 October regional earthquake. The facility is like many others set up after the quake, except for the fact that it is staffed by Cuban doctors and nurses who have travelled from the Caribbean to attend the high number of patients, mainly women, queuing up outside the tented clinic. Havana has a history of international solidarity work and emergency assistance. The Cuban health system, once the envy of developing countries, has suffered from a lack of resources in recent years but still has a high proportion of doctors to people. Held by her father in the hospital’s treatment section, Hansa is crying loudly while a Cuban nurse is cleaning her scabs before treating them with medical preparations. The two-year-old girl is afraid of doctors, while the itching pain of the scabs all over her frail body only intensifies her fear. “We came to the hospital for the second time. Several weeks ago she got scabies and got treated, but she got infected again,” said Hansa’s father Abdulaziz, 26, a resident of Danna, while the nurse continued Hansa’s treatment. Scabies is an infestation of the skin with the microscopic mite Sarcoptes scabei. It is common, found worldwide and spreads rapidly under crowded conditions where there is frequent skin-to-skin contact between people. “The reason [for the scabies] is poor hygiene and sanitation, they [quake survivors] have not been able to bath the children and change their clothes regularly,” Ariadna Auero, a doctor at the hospital, explained. Home to some 8,000 residents, Danna is one of numerous mountain villages above 1,500 m in Pakistani-administered Kashmir badly affected by the earthquake, which claimed the lives of more than 80,000 and injured scores more. A labourer in the Pakistani city of Rawalpindi, Abdulaziz came back to Danna to take care of his family, currently cramped together in a small tent after their house was flattened by the quake. Abdulaziz said that they could neither wash up nor clean their clothes due to cold and a lack of water. “Electricity is available only for few hours and when there is no electricity, there is no water,” another resident remarked. Around 20 children come to the hospital every day with scabies and get treatment. “The number of scabies cases in villages around continues unabated as it had been when we first arrived here more than a month ago,” Auero added.

Local residents queue up outside the Cuban field hospital in Danna for treatment

Although there are no figures available on the number of scabies cases in quake-affected Pakistani-administered Kashmir and North Western Frontier Province (NWFP), it is a common problem in the area, Dr Imran Raza from the United Nations Children’s Fund (UNICEF), confirmed from Muzaffarabad. There are some 50 paramedics at the Cuban field hospital, including general practitioners, specialists and nurses. There is also an ultrasound device, X-Ray machine, electrocardiogram and a mini-laboratory in the facility. Margarita Hernandez, a paediatrician and deputy head of the hospital, said that the major health issue in the area was respiratory disease. “There are so many pneumonia, bronchitis and dermatological illnesses, including scabies and dermatitis,” she said, adding that upwards of 250 patients were currently visiting the facility, while a month ago the number was around 350, with mainly injuries sustained during the quake. Although there are several interpreters helping the doctors, language is something of an issue, with triple translation from Urdu into English, then into Spanish and back again. “We have already learnt some Urdu words and it’s helping us a lot,” Auero said. According to the doctors, there are some 30 Cuban field hospitals in the quake-affected areas, with around 900 medical staff, of which almost half are female, an important factor in this conservative area, where women are traditionally seen only by female medical practitioners. The lack of female doctors is a challenge, according to the World Health Organization (WHO). "One particular issue I want to highlight is the need to train more women in health," WHO Director-General Dr Lee Jong-wook said earlier after visiting the affected area. "This month, 13,000 women in the earthquake area will deliver a baby. And 2,000 of those women and 1,500 of those babies will need urgent health care. But there simply are not enough women health workers to help them," he added. Meanwhile, the Cuban field hospital is expected to operate in the area until spring comes. “But if the Pakistani government wants us to stay longer, we will be happy to do that,” Auero noted. Pakistan and Cuba do not have diplomatic relations.