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Pakistan hospital cut off by floods struggles to help survivors

By Brian Walker, CNN
Staff at Gilgit Town's District Headquarters Hospital try to offset unsanitary conditions by prescribing antibiotics.
Staff at Gilgit Town's District Headquarters Hospital try to offset unsanitary conditions by prescribing antibiotics.
  • Maternity hospital in flood area battles lack of water, electricity
  • Sanitation a major problem; bathrooms, sterilizers, laundry not working
  • Doctors deliver babies using cell phones for illumination
  • Staff works amid threats of dysentery, more flooding

(CNN) -- The baby's heartbeat was failing, the mother needed medicine, and the doctors wanted clean instruments. But three weeks into Pakistan's flooding crisis, staff in one maternity ward in northern Pakistan had nothing but candles and light from a cell phone on hand to perform a high-risk emergency delivery.

The young mother had been pushing for hours as the day turned into a dark gloom. With nothing moving, the physician on duty faced the prospect of a cesarean surgery without anesthetic, or likely death of both mother and child.

The maternity nurse turned to the pregnant woman's mother and whispered, "Which is more important -- the mother, or the baby?" She answered adamantly, but also sadly, "The mother."

That was the scene that Dr. Emma Varley found in the delivery room at the Kashrote hospital in Gilgit, more than three weeks after unprecedented flooding hit the town.

Torrential rains had triggered landslides from the soaring Himalayas surrounding it and floods that left the town virtually cut off from the rest of the world.

The young woman was having her first baby, and it was not going well. As Varley entered the labor room, she recalled, "The smell and heat that greeted me at the main entrance ... left me nauseous and light-headed."

"Spatters of old and fresh blood could be seen all across the floor. Without electricity, the ... one autoclave [sterilizer] was not operational and delivery instruments were being bathed in a small pan of Biodine [disinfectant]," she recounted. "The bathroom could not be used due to a lack of water, and the sheets on beds in the pre- and post-partum patient rooms were heavily stained. Nothing had been washed or changed in over a week. "

Varley, a Canadian medical anthropologist doing research in Gilgit while studying in Pakistan, described hard-pressed surgeons delivering infants by the dim light of a cell phone, while patients recovered from complicated and dangerous C-sections in rooms swarming with flies.

Gilgit Town's District Headquarters Hospital is the only tertiary-level maternity hospital in a region of 1.5 million people. It handles up to 20 deliveries a day normally, and almost all the high-risk cases in the region.

Doctors reached there said they fear for their patients, in an impoverished region already suffering from some of the highest infant mortality rates in Pakistan.

"It's a slow-burn disaster for the people there," said Nur-ul-Ain, a former government official working with the hospitals. "They will pay for this over a generation."

The doctors and hospital staff are facing their own dangers due to the risk of dysentery from contaminated water and the ever-present threat of new flooding.

Mudslides have created dangerously unstable lakes above the scenic town, which nestles below the soaring rocky Himalayan peaks. The water flowing down the mountains, which people largely rely on for drinking, is generally unfit to consume due to mud and disease.

The foundation of another local hospital itself is threatened after it was undercut by sweeping flooding in July. There's concern that new rains or a sudden release of water from the dam or new lake upstream could collapse the building and wash it away.

Varley said the hospital is trying to make up for the unsanitary conditions by prescribing powerful antibiotics to recovering patients. But given the high rate of hepatitis in the area, she is concerned about the long-term health effects on them.

Electrical power is intermittent, usually just an hour per day, physicians at the hospital reported. Generators stand idle due to a severe lack of fuel to power them, forcing people to line up for hours for the few trucks that are able to make their way in. Police who could be helping elsewhere find themselves forced to stand guard at the stations to make sure there are no problems or scuffles.

After weeks doing what she could to help the doctors, Varley was finally evacuated last week on the daily C-130 military cargo plane that is the town's lifeline to the outside.

As for the young mother with the difficult delivery, In the end, her baby lived for only a few more hours and died during the night. And with little left for the hospital and committed medical team to offer, the mother was released back into the surrounding disaster.

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