FMC - Free Medical Camp

Mid November 2006

The FMC is about to take place, doctors are informed and agreed, the date after consultation with the EDO health fixed for 19th of November. Now we should find a car that should bring the docs to Biriu, hopefully for free. So we ask informally at AKHSP (Aga Khan Branch related to health projects), a friend of Imtiaz tells us that there is a possibility, we should write an application. So I type, print, copy and sign it (sounds easy, but remember we are in Chitral…) and bring it back to AKHSP.
2 days ahead of the camp I again come to Chitral, pack and list all the collected medicine which was done by 2 pharma representants, who donated the better part of their samples for our camp.
A control call at AKHSP confirms that the cars are now used in another way and we again have no vehicle.
Imtiaz suggests calling the Tehsil Nazim of Chitral, who won’t need his car on a Sunday. He agrees.
Sunday comes and everything gets messed up again. 2 doctors come from Drosh along with Imtiaz, another one from Chitral in his own car and again another one was picked by the UCN Ayun, who was asked to find him on short notice. The Tehsil Nazim knows all of the doctors and is informed about their changed transport plan and therefore uses his car for other purposes. Our two medical representatives, who were supposed to join the car from Chitral therefore have no means of transport and hire their own car.
I arrived at Biriu the day before the camp to arrange the last preparations. The people should be informed once again – we do it via schools, mosques and some messengers. The government guesthouse must be cleaned and furniture such as desks and chairs must be arranged to serve as community practice for 3 doctors – we don’t know yet about the 4th one.
A place for the “drug store”, waiting room for the patients aso.
At half past eleven, as the first sunrays just reach the vast garden around the Guesthouse the doctors arrive – no single patient in sight.
But I am here long enough now to know that the kids who had been standing on the rooftops have seen the cars and are already shouting in the villages for the people to come. We have enough time to offer some tea, then the garden is full.
Shah Hussain, my Kalash uncle is in charge of writing the patient’s register and to divide the stream of sick people to the concerning doctor.
Everyone gets a paper with his/her name and age written on it and the number. Later the doctors should write the disease down there and the prescription on the back side. I will collect those forms in the end after handing out the medicine so that I also have a little overview of common diseases, number of patients, etc for another medical camp later.
The empty space for “age” was a little optimistic as I learn, hardly anyone knows his/her age, so we simplify the process and just write “baby, child, teen, adult or aged”
The docs do a great job, many other helpers are also around to guide the patients to the rooms, the drug store, the toilet or just calm them down if there is a little patience needed. The most critical point is handing out the prescribed medicines. The 2 pharma reps are there and do their best. Many people can’t read, so they need to paint easily understandable signs on the small boxes, dosage, time …
I won’t bore u with patient stories, but one really impressed me. A little girl comes along, on her back her even smaller brother, standing in the middle of the garden, kind of lost. I ask her, where her mother or father is, but I have to learn that the parents didn’t care to take the weak, feverish infant down to the children specialist, who was just in the valley. So that little 7 or 8 year old girl courageously took her brother and marched down alone for 20 minutes to get treatment for him. She had heard at school that the doctors will come.
At around 5 pm everything is done. The docs are taken home, the patients happily carry home their medicines already feeling much better…
As a notorious table lover I am tempted to insert them, but I spare you the detailed statistics. In short we had around 200 patients (the tenth part of population), the better part of them children and women. The latter ones because many a time it happens that they don’t go to the doctor even if they could afford it because they are to shy to talk about “ladies’ problems”. 80% of the female patients indeed visited the gynecologist, a very nice lady who also allowed our trained TBA girls to assist her and learn a little more. They brought along the tools kit, which we had bought in Chitral before – a huge suitcase filled with scissors, kidney trays, surgical gloves, delivery pad, injections, vitamins, pain killers, gauze and what ever else needed for delivery.
Early next morning, when sun doesn’t even think about sending down her rays to mountain surrounded Biriu I get up and armed with the yield of prescriptions that were not available or out of stock I search a car for Chitral.
I had promised to bring the missing drugs along, as it was called “FREE Medical Camp”.
It’s not easy to catch a jeep here, there are only about 4 in the whole valley and most of them occupied by wood loads.
But sometimes one leaves for Chitral, usually at 7 or 8 am, but sometimes earlier, sometimes later. This means: eyes still closed, peeling off the warm sleeping bag and blankets at 5:30, get dressed in Shalwar Kameez as the Kalash Piran assures staring attention in Chitral, get some hot tea, a walnut bread or beans and wait.
The family knows as soon as they hear noise from my room at this time that I will go to Chitral. Usually my door doesn’t open during those sunless cold morning hours. Many think I sleep till 10 or eleven each day, because that’s the time I come out of my room. Reality lies mostly between 8 and 9am, but I am not really talkative after getting up and so I enjoy a little peace and do some writing as electricity is sometimes available in the morning hours or other kind of work. As soon as the door is open, people drop by, I am asked to have tea 15 times until I really appear at the breakfast table. I love the social, warm hearted life here, but in grey dawn light I just don’t want to be entertained nor do I want to entertain.
But this day is meant to be spent in Chitral, so I sleepily blink across my cup and daydream about my warm bed.
Soon there is a jeep on the other side of the bridge, rumbling up and down valley for a few times, lulling me in an illusion of safety and waiting time until I suddenly hear the obtrusive sound of the horn: departure, quick…
The 2 pharma reps await me at Chitral and guide me through the jungle of drug stores. I had made – surprise – a list of total numbers of each medicine, so that the shop keepers wont need to rush forth and back with every single patient’s form. After visiting a number of stores, drinking an even higher number of teas and finally having the druggists write readable cash bills we retreat to my regular hotel, where even if I don’t stay overnight I am allowed to drop my belongings and use the phone line while doing my work in Chitral. Many times they invite me for lunch and tea, another kind of family almost. Now the real work starts. For every patient’s form we need to find the medicine or the alternative from the collected stock and pack it neatly in a small bag per person. That’s not easy for me as I have not yet memorized all Pakistani drug names – and as I also don’t intend to do this I limit my contribution to label the plastic bags with names.
The 2 guys should be given an award, they have dedicated their whole free time for a week and many hours of volunteer work to the success of the camp and the betterment of the Biriu people. Thanks!!
I have some more work in Chitral so I stay another day, but not without writing a long letter to my uncle Shah. He should hand out the bags to the right people. They would come anyway to my house to pick them as I had told them to do when I collected the prescriptions of unavailable medicine at the camp.
To my astonishment only 2 bags are left when I come home. No one seems to know the 2 ladies. The confusion is great as on the patient’s form are the “real names” mentions and so did I label the bags, but here women are commonly known as “mother, daughter or wife of XY”.
The bags are still with me, the ladies seem not to miss them otherwise they would have sent a “suda” messenger to pick them…

more FMC pics