This pesky thing called Malaria…

Greetings folks:

It's been almost 2 weeks since my last posting and much has happened in that time. I'd intended to write an update much sooner but was unable to for reasons which will be explained here. So my last posting was that of my journey to one of our project sites in Mirpurkhas district in Sindh Province, which is approximately 3 ½ hours northeast of Karachi. I was supposed to have stayed in Mirpurkhas from Sunday (2 May 2010) through Wednesday (5 May 2010), visiting the various project sites in Naukott and Umerkot (two sub-divisions of Mirpurkhas), after which I had a meeting in Hyderabad and then head back to Karachi for more meetings the rest of the week.

Alas none of this came to pass as during my first site visit on Monday, I started feeling nauseous, feverish and was about to faint. I thought it was a heat stroke as the heat was beyond stifling that Monday. The temperature range that day was somewhere between 43C and 45C (109F-113F). Alas, it turned out to be malaria. This would make it the 2^nd time in 2 years that I've come down with this nasty illness. The last time was in Kenya in 2008. Anyway, my office had me promptly sent back to Karachi on Tuesday, after I got the results of the blood test in Mirpurkhas, where I got treatment from one of the urban hospitals and spent the rest of the week resting in the staff guest house there.

This was my first experience with the Pakistani health care system and I have to say that the difference between the rural and urban health care systems could not be further apart. In Mirpurkhas I was taken to the "best hospital" in the area, which was a mission hospital – St. Teresa's Mission Hospital as opposed to the public hospital. Of course, when I first entered the grounds of St. Teresa's, my first thought was "has the construction on this building been completed?" The facilities seemed minimal and I was grateful not to have to be admitted there, though I have to say that the doctor who examined me did inspire some confidenceJ and I am extremely grateful for that. Upon getting back to Karachi, I was immediately taken to the Aga Khan University Hospital, which is supposed to be one the premier medical facilities in Pakistan. This hospital was massive in size and seemed pretty modern in terms of the facilities it had. I was impressed. The Aga Khan name was familiar to me as I recall that the Aga Khan Foundation also runs very good hospitals in other parts of the world, including in Kenya – in Nairobi and Kisumu. I have to say that I was pleasantly surprised at the cost of outpatient consultation and medication at Aga Khan. I learned later that the Aga Khan foundation that runs numerous education, welfare and medical facilities globally provides affordable and even subsidized healthcare for the poor. . Having said that however, this experience nonetheless illustrated the vast differences in quality of life experienced by both the rural and urban folk in this and many other countries across the globe.

Although the trip to Mirpurkhas was cut short abruptly, thankfully I was able to complete at le
ast the 1^st day's visit. I had the privilege of meeting with the women's Self-Help Groups (SHGs) and the Farmers Resource Centres (FRCs) as well as check out the new Earth Boxes, which we introduced not too long ago. Earth Boxes allow for planting of fruits and vegetables (albeit a limited quantity) that requires little watering. It's basically a self-irrigated form of planting. This form of planting is particularly useful in this part of the country as it is extremely dry and has been experiencing an extended period of drought. It also doesn't help that the irrigation water that is supposed to be channeled to the small farmers at the end of the line doesn't get to them due to the larger and more influential landlords (many of whom are residing abroad) exert their influence and take more than their share of water for their farms and orchards. As a result, the small farmers' crops die sooner and this affects their livelihoods and subsequently the welfare of their families. Needless to say that the road ahead is a long one in terms of ensuring food security and sustainable livelihoods for the communities in this area.

Come Friday, I started to feel a tad better and decided to come "home" to Islamabad as planned on Saturday. Unfortunately this episode with malaria was soon followed by severe stomach cramps and diarrhea that lasted me almost a week. I'm still on medication but am feeling much better. Ironically, all 3 of us who were in Mirpurkhas from my organization fell ill, with one of who also came down with malaria and the diarrhea, and the other who skipped the malaria but ended up having to be hospitalized when we got home to Islamabad because of the diarrhea. Thankfully we're all much better now but needless to say, this was one hellish visit for all of us.