In the beginning, Taliban started bombing government installations in an attempt to establish their presence in different tribal agencies. By doing so, they were trying to destabilize peace and create chaos.
Educational institutions were perhaps the most easiest target for the militants as hundreds of schools were blown up in the tribal belt during the past few years.
Health sector also faced the brunt as large number of basic health units and dispensaries were blown up. Besides, the medical staff supervising these units abandoned their duties as they were facing life threats.
That is the reason that provision of health facilities to tribal people was not satisfactory even before the exodus of people from their hometowns.
As peace is being restored in major parts of the tribal belt, the government has started an overall rehabilitation process in Fata. Infrastructure is being developed. New roads, schools and health facilities are being established while the older ones are being rehabilitated.
However, people of these areas still think there are lots of deficiencies which need to be addressed.
Haji Noor Zaman, a resident of Mohmand agency says though health units in Khwezai areas have been operationalized yet people are not being facilitated properly.
“There are a couple of small health units in Khwezai which facilitates locals to some extent but the deficiency of health staff is affecting the healthcare delivery system. It has been five or six years since staff at the civil hospital in Khwezai do not come for duty,” he says.
Nadir Manan, another resident of Mohmand agency hailing from Kola Khel area says private clinics of doctors and health practitioners have been opened in the area but no steps have been taken on government level.
“There is a government hospital in Baya Qila but I do not think someone may have get treatment there,” he remarks.
A tribesman from Orakzai agency portrays a bleak picture of health facilities, saying there are no health facilities in his hometown. “Most of the health units established earlier have been destroyed. The recently returned IDPs in Ali Khel, Aakhel, Mulla Khel and other areas will face great problems in future due to non-availability of health facilities,” says Shahid, a resident of Dabori area.
On the contrary, people in Bajaur agency have different opinion over the provision of health facilities and improvement being made in the healthcare delivery system in public sector hospitals.
Sultan Yousaf from Chinar area in Salarzai subdivision says he is satisfied with the performance of the public sector health facilities. “Doctors are available in our area and thankfully the civil hospital in Khar bazaar has also been reopened and the facilities there are comparatively better than past.
On the contrary, Bacha Zada Hairan says no improvement has been witnessed in the performance of government hospitals in the agency.
“We still do x-ray, ultrasounds and other clinical tests from private facilities as the government-run hospitals either lack the equipment or they are nonfunctional due to non-availability of electricity,” Hairan observes.
Ghazni Gul Manzoor from the Lower Kurram agency says health centers have been opened in the agency but they are unable to deliver. “The basic health unit (BHU) could not be rehabilitated completely till date. The building has been acquired on rent but there is no medical officer or a Lady Health Visitor (LHV) in the center. Only a medical technician is there who checks up patients,” Manzoor informs. He further complains that free medicines are not being given to people visiting the facility.
Sakhi Gul, another tribesman from Manatoo area of the Kurram agency says they usually go to Sadda bazaar for medical needs as there is no doctor available in his hometown.
According to statistics provided by the Fata Disaster Management Authority (FDMA), so far more than 54000 families have returned to their homes in North Waziristan. Before the start of the Operation Zarb-e-Azb, a total more than 0.1 million families left their homes and moved to safer places to avoid collateral damages.
The officials say special attention is being paid to the rehabilitation of health facilities in the agency.
“There are a total of 313 health facilities in North Waziristan agency including basic health units and major hospitals. The civil hospital in Razmak has recently been upgraded while the upgradation of civil hospitals in Spinwam and Shawa is in progress,” Agency Surgeon Dr. Ikramullah Safi revealed while talking to TNN.
Dr. Safi claims that the health units in areas where people have returned to their homes have been completely rehabilitated. However, his claim has been rebuffed by local tribesmen of Mir Ali subdivision. They say they still refer most of their patients to Bannu for medical treatment.
“Strength of senior doctors’ at the Mir Ali hospital is short. Most of the time patients are being treated by technicians as the doctors seldom attend their duties,” complains Ameen ur Rahman, a resident of Mir Ali. He points out that the doctors usually prescribe medicines worth thousands of rupees to poor patients which are beyond their reach. “The only medical store in the hospital charge upto Rs9000 as the doctors prescribe costly medicines,” he maintains.
Meanwhile, Medical Superintendent of the Agency Headquarters Hospital in Miranshah, Dr. Mazhar Hayat says the hospital has been partially rehabilitated, adding the female section is currently under construction and will hopefully be completed soon.
However, local people complain that though the hospital has a well-crafted building but the doctors do not perform duties regularly. “There are 36 sanctioned posts of specialists doctors in the hospital but only 16 are posted here. Doctors having specialties in other fields are yet to join the hospital,” Anwar Baig Khan, a local elder reveals.
“Thousands of families have returned to Mir Ali and Miranshah but the hospitals are not fully equipped to cater to the needs of the local people. These hospitals are of no use to us as they are not able to provide emergency cover,” the elder maintains.
Political agent of the agency Kamran Afridi says provision of standard health facilities to people is the top priority of the government.
“All major hospitals have been made functional. Doctors and other required staff have been provided while medicines have been delivered. Civil hospitals are being upgraded while the smaller health units have also been operationalized in areas where people have returned to their homes,” he informs.
The political agent further says that they have been trying to extend all possible facilities to the health units in peripheries.
“The hospital administrations have been strictly directed to overcome shortage of staff and equipment so that people can be provided better health facilities,” he asserted.
The repatriation process of Temporarily Displaced Persons (TDPs) to Bara and Tirah valley of Khyber Agency has also completed. As per official details, there are 44 health centers in Bara and Tirah subdivisions of the agency including a civil hospital in Dogra area of Bara. A new health facility has recently been established in Bagh area of Tirah valley.
Officials of the agency health department say all health units including the civil hospital in Dogra have been made functional where people are being treated and facilitated.
Abdul Mateen Afridi, a resident of Bara subdivision seems satisfied with the healthcare delivery system in these government-run centers.
“We, the people of the area are happy that the hospital has been reopened. At the same time, we request the authorities to fill the vacant posts of doctors, paramedics and provide proper medicines so that the local people should not go to other hospitals,” he maintains.
Health officials say provision of free medicines and clinical tests has been started in Dogra hospital. However, locals say the hospital does not have specialist doctors. They also dispute the claims of the officials and say that health centers in far flung areas are yet to be operationalized.
Aziz Khan, a local of the Kamar Khel tribe informs that the basic health unit in Bazgarah area is still laying deserted.
“The BHU in Bazgarah has no doctors and other staff. It is a ghost health unit,” says Aziz Khan. “The government should focus more on health sector as it is a matter of life and death for people. Our women continue to die during delivery cases due to non-availability of healthcare facilities in the area,” he continues.
On the other hand, Agency Surgeon Dr. Niaz Muhammad says the health units in Bara and Tirah are fully equipped with both male and female staff.
“In the first phase of rehabilitation, we reopened all the BHUs and CHCs in different areas of the Bara such as Mera Aka Khel, Nogazi Baba and Shalobar. Staff, medicines, furniture and other necessary items have been provided to them and labor room and casualty services have been made functional,” he adds.
He keeps on to say that 36 medical officers including four female doctors have been posted in Dogra hospital while demand for the posting of additional doctors and staff has been sent to the Fata health directorate.
Similarly, in South Waziristan agency, more than 70,000 families were displaced as a result of the military offensive against militants. Among them, FDMA statistics show, about 26,000 families have returned so far.
According to officials of the health department, there are about 136 health facilities in South Waziristan including two civil hospitals and the agency headquarters hospital in Wana. Out of these 136 facilities, up to 40 health centers were affected due to militancy and the subsequent military operations in the agency.
The acting Agency Surgeon Dr. Zain ul Abideen says the rehabilitation of healthcare delivery system is in progress. “Healthcare facilities are being given to people in areas where the TDPs have returned,” he says.
A tribesman from Sararogha area seems satisfied with the facilities being provided to people in health centers.
Muhammad Jamal says that situation has improved and the government has done effective measures to ensure provision of medical facilities to the tribesmen.
“In past, healthcare facilities were almost equal to nil in South Waziristan. Now thankfully the situation has changed a lot but there is always space for improvement. The government should further improve the mechanism,” Jamal says.
He suggests that a committee should be constituted to monitor the performance of the doctors and other medical staff and keep a check on them whether they perform duties at their designated posts.
According to the Agency Surgeon, 30 percent of the tribesmen have returned to their homes and the administration has geared up its rehabilitation agenda.
“The agency headquarter hospital has been made functional since long. About 300 to 400 outdoor patients are being checked up daily by senior doctors in the hospital. Similarly, five to seven general surgeries are being conducted while about 40 delivery cases are also done on daily basis,” he says.
He continues that the hospital constructed with the financial assistance of UAE government in Sholam area has been providing services to large number of people.
“Four specialist doctors have been transferred from the agency headquarter hospital Wana to the newly build facility as a result, the daily influx of outdoor patients has also increased,” he informs.
According to Sahibzada Muhammad Khalid, Assistant Director Health, Fata Secretariat, about 2.6 million patients were treated in different health facilities in Fata during the past year. Similarly, about 6000 patients were operated upon in these hospitals.
“Fifty thousand patients were admitted in government hospitals in Fata during the previous year. About 400,000 clinical tests were also done in these hospitals,” he further says.
He informs that new hospitals have been established in Toi Khwla, Tiarzah, Sholam and Molvi Sirai in South Waziristan.
“About 80 hospitals in Fata were affected due to militancy. Out of these, 80 percent have been rehabilitated. Besides, the headquarter hospitals have been upgraded,” he adds.
He admits that hospitals in Fata face shortage of specialist doctors, adding to overcome this problem, the Khyber Pakhtunkhwa government has been requested to provide more doctors for the hospitals of Fata. He hopes the problem will be resolved in a couple of months.
He maintains that a summary was moved to the KP government three months ago to which the provincial government sent us a list of 60 doctors who will be posted in the relevant hospitals.
The assistant director while recounting the achievements of the health directorate recalls that awareness drive was launched all over the Fata to eliminate measles.
He further informs that Fata is the only region in Pakistan where injectable anti-polio vaccines were administered to children.
He expresses displeasure over the allocation of Rs45 rupees in the annual budget for purchasing medicines, terming it insufficient and meager.
“We prepared a new scheme for the returning IDPs under which we will purchase more medicines,” he adds.
Apart from all these, a new project has been launched in which prosthetic limbs will be provided in all agency headquarter hospitals to people who lost their body parts in bomb blasts or other terror related incidents, he informs.
He adds that the project has already been launched in Bajaur and now the same is being started in the agency headquarter hospitals of other tribal districts.
Besides, the ill-equipped health centers will be properly equipped with all necessary items, he concludes.
This article has been translated from the TNN programme “Da Manzal Pah Lor”, which discusses about FATA TDPs or repatriated peoples’ rehabilitation development and the concern. The programme was produced by TNN producers “Shan Muhammad” and “Abdul Qayum Afridi”.