Homepage of Razwal Kohistani

HEALTH

The people of Palas, and women and children in particular suffer serious problems of health, nutrition and sanitation.  Child mortality is high and female reproductive health is precarious.

 Palasi women in general do not eat enough, or enough of the right food.  The monotonous diet based on maize bread can be indigestible and many women complain of loss of appetite and stomach pains.  Women often drink insufficient fluids and urinary infections are common.  They do not clean themselves adequately or often enough, because of limited privacy and with many family members living under one roof.

 All deliveries are at home and the birth is usually assisted by the mother-in-law, who generally lacks the necessary skills, particularly in dealing with breech presentations.  Babies in this position usually die.

 Health problems common to men, women and children in Palas include: tuberculosis; skin problems - parasitic worm infestations, scabies, fungal infections, deeply cracked skin on feet as a result of walking barefoot; in winter, coughing (caused by upper respiratory tract infections, dry air, smoky and dusty air in the house); and in summer, diarrhoea caused by Giardia and Amoebic dysentery.

 Some of the problems specific to women include: infertility and goitre caused by iodine deficiency; problems related to delivery; bone deformities caused by osteomalacia (Vitamin D deficiency); muscle and joint pains connected with osteomalacia, caused by carrying heavy loads on the head, and carrying children on the flanks; painful ribs often due to pleuritis (as a result of tuberculosis); psychological problems related to the social pressure for male children, and/or ill-treatment received from husbands or in-laws; depression.

Treatment trends    

Public awareness regarding health and hygiene is lacking in the area. Because of this negligence and other nutritional deficiencies, the incidence of diseases in the valley is high and people usually seek advice at the terminal stages of an illness. Since the area lies in the remote pockets of Kohistan, herbal and homeopathic cures are commonly sought. A variety of medicinal plants are found through out the valley especially in Bar Palas and the possibility of iodine deficiency is common, the reason being use of crude table salt.

 The EPI is not effective due to difficult access to the valley and problems in keeping the vaccines in proper storage. There is a trend to wear a tight cap for the newborn infants for the first few years, which may affect the normal growth of skull bones.

 Table 30:     Treatment priority for both sexes