On finding out about the case, MERF Clinical Superintendent, Dr. M Saeed Hassan held a counseling session with the grieved staff and persuaded him to come regularly to the facility, as all staff are required to carry out their duties in order to ensure efficient and quality healthcare services at the facility. Today, Nazeer Ahemd, with a revived determination, helps more than 1200 patients per month in getting OPD consultations from the doctors.Before handing of health facilities under Public Private Partnership Model to MERF, RHC Jherruck was plagued with high staff absenteeism which severely impacted the quality of health services at the facility. Among the frequent absentee staff was a differently-abled staff, Nazeer Ahmed, posted as ward attendant in the facility. Being a differently-abled person, staff at the facility did not find his services useful and hence was not asked to perform his duties. Dejected, as a result of other staff attitude, MR. Nazeer Ahemd did not come to the facility at all as his daily commute consisted of 16 KMs journey and he had no purpose of coming to the facility.“I feel equal as I do the same job as other attends do at the facility. Previously, I felt like a lesser-being due to my treatment at the facility. I feel proud, happy and fit by performing my duties”.
Rural Heath Centre (RHC) Var is a 10 bed Primary Healthcare hospital in district Thatta. It’s Sindh Government owned hospital where Medical Emergency Resilience Foundation (MERF) under Public-Private Partnership (PPP) Node is intervening since October, 2016 to improve quality of health service delivery in Catchment Population of 19623 per annum.When the MERF started intervening at Var, there were shortage of necessary staff including Medical Officer, Dispenser along with allied support staff to provide quality healthcare services in Maternal and Newborn Health. Resultantly, there happens to be only 47 first Antenatal care visits (ANC-1) and 21 Antenatal Care revisit along with eight 1st Postnatal Care visit (PNC-1) in the healthcare facility.
In this backdrop MERF intervened here by taking up the overall management in RHC Var from October, 2016 onward. After detail need assessment of health facility, it came to know that the health facility require 14 additional staff to improve quality of healthcare and service delivery. On the basis of this assessment, MERF provided 10 medical staff and doctors including three Medical Officers, one Registrar, one Dispenser, one Aaya/Dai and two Midwives to Maternal and Newborn Healthcare department of RHC Var.
Now after the provision of the aforementioned doctors and paramedical staff as par requirement, the quantity of Maternal and Newborn Health service delivery have been increased 101% at RHC Var. This include 162% increase in first Antenatal care visits (ANC-1) and 138% increase in 1st Postnatal Care visit (PNC-1) in the healthcare facility. Furthermore, the timely provision of medicines and supportive supervision have further improve the quality of service delivery at this health facility.
From this success story, we can infer that subletting Primary and Secondary Healthcare facilities under Public-Private Partnership (PPP) Node in district Thatta is a right move of Health department, Government of Sindh in the right direction.
Lately when he visited THQ Sujawal to attend his relative, it came to know that THQ Sujawal have started free-of-cost major surgeries after upgrading it from June onward. Therefore, he visited Surgery department of THQ Sujawal on 25th July, 2017 and within no time he received appointment and went to examination room within seven minutes for onward consultation. Surgeon Dr. Shaista Shoaib examined his case in privacy. During detail investigation, he was diagnosed as a case of right inguinal hernia. Therefore, after explaining procedures to patients and getting his consent for the same, Surgeon Dr. Shaista Shoaib along with her team carried out Spinal Anesthesia and operated for Right Inguinal Hernia (RIH) and hernioplasty was done. On the 3rd day of his operation patient Abdul Shakoor was still at recovery room. When I met him, he told me that “the hospital is just eight minutes away from my home where operation hours are very satisfactory” he further added that “since I went through all procedures including pre, during and post operation care within no time and without any charges, therefore, I am more than happy for being operated at my doorstep”. He was especially happy for postoperative care and free of cost healthcare services at surgery unit of THQ Sujawal. Surgeon Dr. Shaista Shoaib said that “it was my earnest desire to serve my own people in my home town. Now that, MERF have upgraded its operation and started major operation, I am more than eagerly looking forward to use my expertise to provide quality healthcare and operations at the doorstep of our people from Sujawal.” Nevertheless, she have suggested to provide an opportunity to build the capacity of OT Technicians and OT Assistants regarding use of procedure-wise instruments and post operation care to further bring improvement in quality of healthcare services at operation ward of THQ Sujawal.
Medical Emergency Resilience Foundation (MERF) is working to save lives by providing effective, efficient and affordable healthcare services and medical relief for vulnerable people in areas of natural disaster, conflict, disease outbreak and health systems collapse. In this backdrop, MERF have taken over the overall admiration and management of 13 Primary and Secondary Healthcare Facilities (HFs) in district Thatta and Sujawal. Tehsil Headquarter Hospital (THQ) Sujawal is included amoung these HFs where MERF under Public Private Partnership (PPP) Node of Government of Sindh have started intervention from October, 2016. After taking over the management of THQ Sujawal, MERF have upgraded from it from 14 bed hospital to over 100 beds hospital and inducted over 80 paramedical staff including Medical Officers, Doctors, Paramedics, Specialist, Surgeons and Support staff who have provided healthcare services to 2,15,951 community members from December 2016 till June, 2017.
After inauguration of upgraded facility on 29th May 2017, THQ Sujawal have started to perform major operations besides providing primary and secondary healthcare services under 19 different departments. After the break of eight years, MERF have first time started free of cost C-Sections at THQ Sujawal to ensure deliveries through a surgical. In this regard, MERF have equipped THQ Sujawal including Gynaecology ward with require equipments along with six Specialist Doctors and Para Medical staff including 12 trained technicians, 4 Dispensers and 13 Staff Nurses.
Dr. Bushra Mushtaq (PCPS Gynaecology) is amoung the MERF inducted Specialist doctors who joined us as a Gynecologist to become the part of solution to healthcare issues in Sujawal, her home town. She have recently started to deal with cesarean sections including emergency cases in Gynae ward.
Bibi Hanifa Wife of Akbar from Village Pinyari in district Sujawal is one of such an Emergency Cesarean case that was brought to Gynae ward of THQ Sujawal after developing complications at a private clinic on 19th July, 2017 as the patients were not affording 20,000 rupees demanded to perform cesarean section on the said patient. Dr. Shala was duty doctor when this case was brought to THQ Sujawal at midnight of 19th July, 2017. Since, the case was complicated one due to Rupture of membranes (ROM) wherein the fetal head was plugging the hole and retaining fluid in the sac. Thus, have a potential of Intrauterine Death (IUD) in case of referring the case to DHQ Sujawal. Therefore, duty Dr. Shala coordinated with Gynecologist Dr. Bushra Mushtaq and informed about the case under discussion. Gynecologist Dr. Bushra Mushtaq thoroughly examine the case and successfully operated patient Bibi Hanifa for emergency delivery through cesarean section. Thus, mitigate the sufferings of moaning mother but also save a life of child before developing further complications and Intrauterine Death (IUD). After that, the team of Gynecologist Dr. Bushra Mushtaq admitted the patient Bibi Hanifa for three days from 19th July onward and discharged her on 21st July. Patient Bibi Hanifa revisited Gynecologist Dr. Bushra Mushtaq after a week for post-natal care along. During this visit she was so happy for receiving free of cost pre and post-natal care services including Iron and Calcium Supplements from THQ Sujawal. She was especially grateful for MERF inducted Gynecologist Dr. Bushra Mushtaq, duty doctor Shala and team for timely mitigating her sufferings that too without any charges and saving her child from potential IUD. “I am very happy for all the support that I have received here and appreciate the staff for their timely help for me and my child. I am grateful and praying for all of you” said the patient Bibi Hanifa.
Before MERF, the condition of hospitals in Thatta was very poor. We see that after MERF taking over of hospitals, there is huge improvement in service delivery despite the fact that the budget given to them is same as previously available and there is no increase in budget. MERF has managed to add new specialties like cardiology, Eye, Dental and are doing a good job in maintaining the cleanliness of the hospital. There is very significant improvement in Gynae department with proper labour rooms. Similarly, significant improvement can be witnessed in Accident and Emergency Ward, where previously doctors and medicines were not available.
Nursing inspired me since my childhood and I used to tell my mother that I want to be a Nurse. Though my mother supported my inspiration, however, she couldn’t afford to send me to another city and bear my expenses. When I came across MERF nursing program, I applied and got selected from FATA. In this way, I was able to fulfill my childhood dream.
Nursing Student from FATA
Before MERF, I travelled to Karachi city from Thatta for dialysis which required 3 hours of traveling on one side. After dialysis and 6 hours of traveling, when I used to reach home, I would be so weak that my family members would carry me to home from car. Now I get my dialysis done from DHQ Thatta at my door steps and don’t get through all the pain and hassle of visiting Karachi. The quality of this center is same as the facility available in Karachi. By establishing this center, they (MERF) have done a very good job for the community.
I was born in Mishti Mela. Since the operationalization of the Mishti Mela Hospital, the doctors and staff have served the community very well. Previously, the local communities faced huge difficulties as they were forced to take their patients to other areas and the health services there were not good. Now they get all the services from this hospital. If the hospital is kept running in this way, it will be very beneficial for the local population. I pray for their (MERF) success.
I had a terrible accident in Year 2014 where I suffered fractures in both legs. I was in a very bad shape as my leg bones were shattered. For next two years, I sought formal and informal medical treatment, however, my condition got worst by each passing day. I didn’t standup/moved in those two years. Then I visited Orthopedic department at DHQ Thatta, where Dr. Zulfiqar took my case and start treating me. After medication and surgeries, now I am able to stand up and walk by using a walker. The doctor has assured me that I will be able to walk properly within one years and me and my family are very happy and thankful to the hospital on my recovery.