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In the streets of Chaman, in Pakistan’s southern state of Baluchistan, women are not easy to find. When they are seen, they are accompanied by a male relative but protected from view by a full veil.
More often than not they are at home, unable to leave on their own for hospital check-ups. They do not hear messages welcoming them to visit the nearby Médecins Sans Frontières/Doctors Without Borders (MSF) clinic for pregnancy examinations and giving birth.
How do you contact women with information about maternal healthcare services in a place like Chaman?
Last year doctors and nurses from MSF saw almost 14,000 pregnant women for at least one consultation before they gave birth, and assisted almost 9,000 women to deliver their babies in three separate projects in Baluchistan.
Over 4,000 of those deliveries were in Chaman alone. Still, almost three-quarters of pregnant women in the district were estimated in 2014 to receive no medical check-up before giving birth.
MSF provides maternal health services in the Chaman local hospital. It functions alongside the emergency room that treats, primarily, individuals caught up in violent clashes stemming predominately from local tribal rivalries.
As women pass through the door of the mother-and-child clinic they remove their burkas and invariably reveal a perfectly made-up face and hands covered in intricate henna designs.
They come once they know the hospital is here; how can we make sure more women hear about it?
International Women’s Day was commemorated on the 8th March. It was an opportunity for us to promote our maternal health services and meet people. It was also an opportunity for us to misread local sensitivities and stick our foot in our mouth.
What is the best way to approach the need for regular check-ups during pregnancy? Which is the most appropriate way to promote breast-feeding, something that is so important when MSF’s three projects in Baluchistan have treated approximately 40,000 children under-five for malnutrition since 2010?
In discussion with the women we work with, and with some male community leaders, we draw up, adapt and readapt our agenda until we are satisfied with our balance.
First suggestion: keep the focus local and drop “international.” So on 8th March 2015 we celebrate “Women’s Day” in Chaman.
That Sunday we invite the wives of prominent community leaders, as well as all local female teachers and female health staff from both MSF and the local Ministry of Health.
All of them are in a position to pass on our messages to other women in the community. Sixty women come to take seats we have decorated with informational posters, and listen as MSF and community spokespeople present.
Many say they had no idea before that MSF was offering such healthcare. They tour the delivery room, the operating room, the paediatric wards and the blood bank.
We talk openly about our capacities, our limitations, and the challenges we face. They ask questions on our hygiene and disinfection practices. Over lunch, they have an informal opportunity to ask more.
In a parallel session in another part of the hospital, we invite the all-male press so that they can write about our hospital; however, it is unlikely many women will be able to read their reports.
Literacy tracks so very closely with gender in this part of Pakistan.
It is a small opportunity seized, but such a meeting here is indeed unique and we are proud of the team for making it happen. We hope it means that many more women in Chaman hear about us and can visit during their pregnancy.
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