When 20-year-old Shumila Iqbal went into labour at home, she was determined to travel to Merlin’s field clinic in Machiara for the delivery. The health facility is one of five field clinics set up by Merlin in the Neelum Valley in Pakistan-administered Kashmir, in response to last October’s earthquake.
In this region, women traditionally give birth at home, usually without the assistance of a trained midwife. However, as it was her first baby, Shumila decided that she would rather be in the safe hands of Merlin’s medical team.
Due to the mountainous terrain, it took an hour for Shumila’s family to transport her in a cart along steep and narrow paths to get to the clinic. It was a difficult delivery, and Shumila needed an episiotomy – a minor surgical procedure to assist with the birth. Seven hours after arriving at the clinic, Shumila gave birth to a daughter but the baby was not breathing. “Shumila was fine, but the baby girl was in a very serious condition,” recalls Merlin's midwife, Rakhil Mukhtar. “Thankfully, we had the necessary skills and equipment, and we successfully resuscitated the baby.”
After spending the night at the clinic, Shumila was well enough to return home the next day with baby Naila. “If Merlin’s clinic wasn’t here, it is likely that both mother and baby would not have survived,” says Rakhil. “It would have taken four hours to get to the nearest hospital, and they would probably have died during the journey.”
Over the past two months, Shumila has continued to return to the clinic for regular post-natal check-ups, and to ensure that her baby receives routine vaccinations against measles and other preventable diseases.
Before Merlin arrived, women in Machiara did not have access to maternal care because there was no midwife or female doctor. The local dispensary - which served a catchment population of around 11,000 people - was staffed by just one male pharmacist. As with most buildings in the region, the dispensary was completely destroyed by the 7.6-magnitude earthquake. Merlin set up the tented clinic, sending in staff, equipment and supplies by helicopter in February. Since then, Merlin’s team has been working alongside Ministry of Health staff and providing them with vital on-the-job training.
The Merlin team in Machiara includes four health promoters who visit people’s homes in surrounding villages everyday to encourage women to attend the clinic for maternal care and to bring their children for vaccinations. “Women here never had the option of seeing a female doctor or a midwife until we arrived,” explains Rakhil. “Merlin has done a lot to raise awareness of the importance of maternal care, and we are now seeing more and more women coming to the clinic for ante-natal and post-natal check-ups, family planning, as well as deliveries.”