Karachi

This is a story of a few good doctors who left their comfortable European lifestyle to aid suffering humanity in Karachi’s impoverished slum of Machar Colony.

In the process, they learnt to adapt – shed their western clothes for a modest shalwar kameez and headscarf, bear the intolerable May heat, and eat roti and spicy lentils for lunch.

Situated next to the Lyari Station on a service road off Mauripur Road, a clinic has been quietly, but efficiently, providing primary healthcare to the residents of the squatter settlement for over a year now.

The white single-storey unimposing structure in its first year delivered 498 babies, held 5,833 health sessions and treated 14,816 patients at its emergency room.

For the people living in Machar Colony where a preventable disease like measles claimed several lives last year, this is good news. For pregnant mothers, it is their only access to quality healthcare.

Inside the spotless labour room, Shamshad Begum has just given birth to her seventh child – a beautiful baby girl.

“It’s a girl again. I have five girls. Two of my children died. Because I wanted a boy so much, my sister gave me one of her sons to take care of,” she says lying on a hospital bed, surprisingly cheerful for a woman who has just given birth.

A nurse instructs her to use birth control. “I will have to ask her father,” says Shamshad pointing at her newly-born baby.

Her doctor, Katrina Nelson, does not understand a word of Urdu. It has been only a month since she arrived in Karachi. Originally from Denmark, when she signed up for the Doctors without Borders (MSF), an international not-for-profit organisation which works extensively in Asia, Africa and South America, she knew she would be travelling all around the world.

So how has the city been treating her? “It’s exciting work. Women have many more child complications in this part of the world. Many of the women we receive here are extremely anaemic,” she says.

“It’s not that they don’t know that they should rest or take breaks while having babies. But the fact is that their living conditions don’t let them take care of themselves or make decisions when it comes to childbearing.”

Marlies Degroote, a doctor from Belgium, heads the vaccination programme at the clinic. She has just returned from a long meeting planning the measles vaccination drive that will start in a few days. Dressed in a blue shalwar kameez and beige dupatta wrapped over her head, Degroote can pass for a Pakhtun woman.

“Last year we could only cover 29 percent of the population in Machar Colony for our vaccination drive against measles. Several children died last year. This year, we plan to vaccinate 69,000 children,” she says.

The colour of their skin was something that none of the locals at the squatter settlement liked. They viewed the doctors with suspicion – foreigners there to spy on them, take their pictures and sell them to America or worse, instil western ideals into their women.

“Every time you begin working in a locality, people view you with suspicion. They feel that we are intruders. It’s only natural. That’s why we need to play safe. The reason for our low vaccination coverage last year was precisely this,” says Degroote.

This year the team is prepared. They have talked to the community leaders and clerics and visited schools, madrassahs and mosques. Now they feel that the community trusts them.

They will go out in the field for vaccination without any security guards. Display of weapon or even carrying one is against their policy.

“That’s why you don’t see a security guard at our gate. We believe if the community understands that you are there to help, they will not attack.”

There was time when the clinic began receiving extortion threats from various crime gangs operating in the locality. The workers at the clinic say that the doctors invited the extortionists to the table to talk. “When they understood that the doctors did not charge patients for treatment, they apologised and never troubled us again,” says Mona Korejo, a health promotion supervisor.

So that the MSF does not become a tool for spy agencies of the world to collect information, it runs only through private donations.

Degroote excuses herself. Ruth and the others are waiting for lunch. She is hungry, “and the daal roti we just ordered is getting cold”.

originally published here