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In Pakistan's flood-devastated Sindh province, female health workers play key role

By Tania McBride

AGHA ALI JATOI, Pakistan, 15 September 2010 – A breeze whispers through a plantation of date palms in the small village of Agha Ali Jatoi, in Pakistan’s Sindh province. On the mud brick houses, watermarks – some up to two metres high – are silent reminders of the devastating floodwaters that have since receded in this tiny rural village of 900 people.

VIDEO: UNICEF's Natasha DeSouza reports on a community health worker programme that is reaching the most vulnerable in Pakistan's flood zone.


Scattered around the village are stagnant ponds of dirty water, engulfed power lines and remnants of destroyed homes. In the clearing in the centre of town, a group of young women, mothers and children sit on string beds listening intently to a 'lady health workers' (LHW) programme session.

Supplied with medical treatments and health education materials, among other items, the LHW team has come to teach the importance of rehydration and cleanliness in the home.

Key health lessons

At the centre of the group is Kalsum Jatoi, who has been working as a community health worker in Agha Ali Jatoi and three surrounding villages for the past seven years. Ms. Jatoi’s work includes educating families about managing diarrhoea, as well as the importance of household hygiene and immunizing children against polio, measles and other diseases, and providing vitamin B supplementation.

© UNICEF/2010/McBride
A toddler suffering from diarrhoea in Agha Ali Jatoi village, in flood-affected Sindh province, Pakistan, drinks an oral rehydration salt solution prepared by community health workers.

With a round of visits every 15 days, Ms. Jatoi and her colleagues are well known in Sindh province.

Ms. Jatoi is a quiet, unassuming woman. During her lessons, she engages a small crowd with demonstrations on the use of oral rehydration salts (ORS), a treatment for diarrhoea. At the end of her presentation, a mother whose child has been suffering from acute watery diarrhoea offers a cup of ORS to the toddler. The child drinks it thirstily before the crowd of onlookers, which applauds. 

With four children of her own, Ms. Jatoi has learned much about health and hygiene through her own work. “None of my children have been ill since the floods,” she said. “I make sure they drink clean water, wash their hands regularly and I also wash them and their clothes.”

Urgent outreach

Ms. Jatoi was teaching a session on health promotion to the local village when she received warning of the impending floodwaters. She and the other villagers quickly took what belongings they could carry and fled to higher ground, where they camped on a roadside for the next four weeks. From there they watched in horror as the waters rose rapidly, washing away the lives they once knew.

© UNICEF/2010/McBride
Community health worker Kalsum Jatoi, second from right, demonstrates the use of Oral Rehydration Salts for treating diarrhoea in Pakistan's Sindh province.

Three weeks later, the village residents returned and began to rebuild their lives. Ms. Jatoi and her team of lady health workers started conducting sessions with children in the impoverished, flood-affected villages they serve – areas that are the most vulnerable to outbreaks of disease and diarrhea, especially among children.

UNICEF has supported the LHW programme in Sindh province since its inception, providing the health workers with blood pressure monitors, thermometres and health treatments such as ORS and zinc supplements.

It also supplies lady health workers with information, communication and education materials in order to support their training and outreach activities.

Vital community link

Although she hasn’t been paid for two months, Ms. Jatoi is dedicated to her job. Before the floods, she had even started to expand her regular repertoire of immunization and health promotion to include reproductive health advice. With 10 expectant mothers due to bring new life into the village of Agha Ali Jatoi – and some 28 other women currently breastfeeding – these sessions have become critical for the local women.

VIDEO: UNICEF Goodwill Ambassador Mia Farrow makes a fundraising appeal to help children and families affected by the flooding in Pakistan.

Ms. Jatoi explained that, at first, many women were hesitant to discuss reproductive matters. “However, now, they know me well and we have more open discussions,” she said. “They ask many questions they were afraid to ask before.”

In the difficult post-flood environment, Ms. Jatoi and her team are a vital link to the community. They are essential to ensuring that the millions of children affected by the disaster in Pakistan are protected from a further deadly spread of illness and disease there.

Meanwhile in New York, UNICEF Goodwill Ambassador Mia Farrow has made a new public service announcement with an urgent appeal for more emergency funding, to help ensure that a second wave of suffering can be averted in the Pakistan flood zone.



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