Dr. Masooma Sardar, explained health issues in Faisalabad, and the need for her plan for a disaster management cell as part of the city government.

1. The City

Faisalabad lies on a flat stretch of the great Indus valley a few hundred miles up river from Karachi and the river’s delta on the Arabia Sea. It is a relatively new city, developed around the extension of canals from the Chenab River, just over a century ago, which brought life giving irrigation and a new market town to the region. It is now a major center of textiles, whose exceptionally high quality cottons have given it an enviable position in the world textile markets. Its geographic position provides important protection from natural disasters. The earthquakes that have devastated Pakistan lie far to the north and west. The arid climate gives it ten months of virtually no rain and only about 2 inches during the summer monsoon. Its flat topography does, however, produce a major problem. Lacking natural drainage, an extensive sanitary infrastructure is needed to pump away waste materials. The existing infrastructure is antiquated and has become overtaxed with the rapid growth of population, now numbering more than 6 million in the greater urban area. Thus during the short rainy season, waste waters overflow and contaminate the drinking water and have produced epidemics of gastrointestinal diseases. In 2006 this brought an estimated 10,000 patients to the city’s health system; fortunately the number of actual casualties was quite small. The system was unprepared for the disaster and was rather slow to respond, taking some two weeks to control the outbreak. Emergency centers were established ultimately directing house visits with instructions on producing clean water and managing the disease.

Since then a new system has been established to deal with such emergencies, and also to upgrade the regular services. There are now some 286 clinics with 289 doctors and over 1,000 other medical personnel to provide regular services. District Health Committees have been organized throughout the city. There is now a system of lady health workers, one for every 1,000 people, or 150-200 households. These people make household visits and organize training courses on public health and family sanitation. A recent improvement has been the development of a phone system that now links 90% of the centers to one another and to city hospitals. The result is seen in the fact that this year the outbreak of gastrointestinal diseases in the rainy season was contained in two days. In effect the limited nature of natural disasters implies that the progressive strengthening of primary health care and maternal and child health will be sufficient. With assistance from the World Bank, the city is also undertaking a large scale improvement in its sanitary infrastructure.

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2. The Proposed Action Plan

That the city is not subject to natural disasters such as floods, earthquakes or typhoons, only fails to provide a stimulus to create the needed organizational capacities to manage emergencies, and as a relatively poor city suffering from rapid growth, Faisalabad has yet to develop structures to deal with emergency situations. Dr. Sardar developed a plan to deal with this organizational weakness. Her plan proposes the establishment of a disaster management cell in the city government. It will be focused on maternal and child health care, but this is expected to grow into a more widely capable structure to deal with all manner of emergencies. The plan calls for the creation of a standing committee under the City District Nazim (chief administrative officer) to deal with the maintenance of MCH care during an emergency. It will identify members from relevant positions in government, lay out tasks and responsibilities, bring together the members for the development of specific plans, and prepare for a variety of emergencies. Dr. Sardar will also take this opportunity to increase the scope of MCH care. For this, the plan calls for the filling of all vacant MCH posts (now about 30 percent of the total), and the doubling of the MCH budget. It is an ambitious plan that will prepare the city for emergencies and also greatly improve the MCH services it now offers.

Health care facilities in Faisalabad

Faisalabad Action Plan Time Frame: September 2007 – December 2008

 
Action plan indicators and targets