Yesterday we posted here on the threats facing medical aid workers in unstable countries, with a special focus on the work of the international aid organization Merlin in Pakistan following this summer’s catastrophic flooding. Today we publish a first-person account by Azra Habib, a Lady Health Worker who has been working for Merlin’s diarrhea treatment unit (DTU) in the flood-affected Charsadda district of Khyber Pakthunkhwa. She, like many health workers, has opted not to focus on the potential risk she faces or her own family’s losses, but instead on the immediate need for basic health care services.—Jacob Molyneux, senior editor/blog editor

Azra Habib at a Merlin Diarrhea Treatment Unit in Pakistan

I’ve recently taken a new post as a Lady Health Worker for a diarrhea treatment unit (DTU) at the Charsadda District Hopital in KPK. After the floods there were many villages in the district with no clean water, and the demands on this specialized ward can be extreme. Having lost everything, many people don’t have the resources to get transport to the hospital. Often, by the time they get here, patients are moderately or severely dehydrated and need to be admitted. There are 40 beds but we’ve had as many as 189 patients arrive on the ward in a day.

A toddler recovering from dehydration brought on by acute watery diarrhea

Early one morning, not long after I started my position here, I was about to sign off from my night shift duty. A woman came in, crying out with a child not yet three years old in her arms. She was screaming, “He is not moving, he is not responding.” He had been suffering from diarrhea for two days. When the doctor saw him, he noted that his condition was grave and we started immediate treatment: an IV line to restore his fluid loss and antibiotics to treat his infection.

The boy had lost his father and 5-year-old sister in the flood. This meant that his mother had no one else left. I asked if I could take care of the child and continue my shift rather than sign out, and the doctor allowed me to do so. So I put in all my efforts to his recovery and the child started to respond in the evening. He remained in the DTU for five full days, and when he fully recovered he was discharged.

Noshad Ali holds his 2-year-old grandson, Mohammad Faizan, who is recovering from severe dehydration brought on by acute watery diarrhea

A very personal catastrophe. I wanted to make sure he survived because I know what it means to lose everything and to be left with heavy responsibilities. Prior to the floods in Pakistan, I worked for five years in my village, Banda Malahar, as a health worker. At the same time, I was close to finishing my nursing and midwifery studies. I was in the process of taking my third-year nursing exams when the floods hit and destroyed the area where I live. That day, I was on my way to the city to take exams when I saw water was fast approaching on the motorway. As the bus driver backtracked, I saw all the bee boxes from the nearby farms, floating in the water. I suddenly forgot about my exams and started to worry about my home.

I couldn’t reach my family by phone, but I’d heard on the radio that all of Khyber Pakhtunkhwa had been affected by flash floods. When I finally reached my elder brother by phone the next day, he told me that the whole village had been swept was away by water and there was nothing left. He told me that my sisters-in-law and their children found refuge in a school, while my three brothers were living in a tent on the motorway. He told me that our parents refused to leave the house. So we had no idea if they had survived. I was horrified by the news and felt very restless.

Only silence. Eight days after the flooding started, I finally found my parents. They had found shelter in a school. A week later we returned to Banda Malahar, which was washed away. There was nothing left, only silence. I was standing in ankle-high muddy water and debris. We took the household items we could salvage and what we could find to pitch up a tent to live in. Neighboring families began returning, pitching tents in the footprint of where their homes had once been.

Now everyone is developing severe skin infections, or coming down with diarrhea and malaria, which my sister has also contracted. Living conditions prior to the flood were very poor and now they’ve gone from bad to worse. The floodwaters took everything we had; even my elder brother’s beekeeping business is finished.

Now I’m the only one who can find work to support my family of 12 people. This diarrhea treatment unit is new at the Charsadda District Hospital; it was established by Merlin and supported by the WHO. It’s a place where many lives have been saved, because there is no clean water in the villages. Waterborne disease outbreaks have been a serious consequence of the flooding.

The disaster here has left me with enormous new responsibilities: my aging parents and injured family members are depending on me now. My uncle lost his leg in the flood. It can be hard, but I’m lucky to have a job and I’m happy that I’m working where I’m needed. All these people that I take care of every day are my people; they’ve been affected just the way I have. I sometime cry with my patients, sharing their losses; and I smile with them on their recovery. But I am thankful . . . that I can be helping them out.

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