Navigating the Unknown: COVID-19’s impact on MSF’s work in East Balochistan

10 Jul 20

MSF Project Co-ordinator Aine Lynch updates on the impact of COVID-19 on MSF’s work in East Balochistan, Pakistan.

I have been working as a Project Coordinator with MSF in Pakistan since November 2019, remotely managing the project in East Balochistan, covering two districts of Naseerabad and Jafarabad.

MSF staff Quetta

East Balochistan Project

The project focuses on Maternal and Child Health services including a paediatric and neonatal ward, a birthing unit providing basic emergency obstetric care and a specific program for malnourished children through our inpatient therapeutic feeding center, in the District Headquarter Hospital in Dera Murad Jamali.

We have a network of mobile clinics and outreach sites to ensure that those living in remote, hard-to-reach areas, can also access the services they need. These outreach activities are accompanied by a team of health promoters engaging communities with positive health messages.

COVID-19 Cases

Like many countries around the world, Pakistan closed its borders to international travel in mid-March in an attempt to curb the spread of COVID-19. Unfortunately, the pandemic had already reached the country. In response, MSF made contingency plans for the inevitable influx of positive case arriving at our facilities. Currently, Pakistan is ranked in the top 10 countries with the highest positive COVID-19 cases.

A view of the COVID-19 screening system installed by MSF at Timergara DHQ hospital in Lower Dir.

Challenging Climate

For MSF operations and response, it was a trial in navigating the unknown. Supply changes were affected and not only were our international cargoes of vital medicines for our regular project activities being disrupted, but the unprecedented spike in demand for Personal Protective Equipment (PPE) was resulting in a tug-of-war of priorities between different countries and programs.

Our number one priority was not only to ensure that all the lifesaving elements of our day-to- day activities were maintained but that our staff were safe, protected and enabled to do their job effectively.

In early April, I got a call from a staff on the ground to inform me that the Government were starting a mass recruitment drive of medical professionals to be reallocated to work in COVID-19 hotspots around the country within Ministry of Health facilities. 

A view of the temporary drying area for the reusable protective equipment at Timergara DHQ hospital. The screening and triage was installed in just 7 days, and now the team is working on setting up a dedicated drying area for the for the reusable protecti

We had to deal with fall-out and disruption of reduced critical staff within a time when we could not afford to lose them. Fortunately, we managed to keep activities running and to ensure that people affected by other common diseases were not losing out of receiving the same high quality care.

Navigating the Unknown

As the months roll on, it is apparent the fatigue that this virus and all its uncertainty is having on the mental wellbeing of the staff and we have been very mindful of ensuring that staff needs and worries are being taken into consideration. We are encouraging and facilitating those who can work from home to do so but obviously for the frontline health workers this is not an option.

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We have been placing a lot of emphasis on tele follow up check-ins with patients where possible to reduce traffic in and out of the facilities.

Working Remotely

Due to difficulties of non-nationals obtaining permits to Balochistan I have not yet been able to actually reach the project. The wait for official access can be anywhere between 2-9 months. As such, local staff have adapted really well to this over the past number of years and strategically we have been putting our efforts towards the development of our national staff supervisors and ensuring they are empowered to do their job accordingly.

Health promoter Sarir Ahmad is holding an awareness-raising session on COVID-19. Since the first report of a COVID-19 confirmed case in Pakistan, our health promotion team has incorporated COVID awareness messages into their sessions on health and hygiene

COVID-19 is only one of many challenges people are facing in East Balochistan. The harsh environment is now backdrop to searing temperatures reaching 55⁰C and locust plagues in a context where the majority of the population rely on agriculture for their livelihood. This will soon be followed by the monsoon season, which can often lead to natural disasters such as flooding with the Indus River prone to bursting its banks and causing large scale destruction.

Despite the grim stories that make the news headlines with the odds seemingly stacked against this resilient population, hope is still managing to prevail. Only last week healthy twins were born in our facility. So when the apparent semi apocalyptic situation and shared global anxiety is getting all a bit too much, it is important to remind ourselves of these positive events that are happening around us.

our response to covid19 >