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 The family had walked two hours through snow-covered
mountains along the Afghan border to reach a road, then paid almost
$40 — nearly a month's income — for a lift to a clinic many miles
away.
The baby was diagnosed with hypothermia. She died a few hours later.
Already enduring frequent attacks on militants by U.S. drone
aircraft, a Taliban insurgency, sectarian violence and poverty,
Pakistanis in the remote northwest face a new enemy: an unusually
bitter winter.
A growing number of cases of pneumonia, hypothermia and other winter
illnesses are stretching the few health facilities, says medical
charity Medecins Sans Frontieres (MSF), or Doctors Without Borders.
Tasneem Bibi's daughter died at Tehsil Headquarter Hospital in Sadda
town, where Dr Rahman Sakhi says cases of hypothermia and pneumonia
are up about 15 percent from last year.
The hospital treated 3,300 patients in January, 80 percent of them
for winter-related illnesses.
"Drone attacks and Taliban violence get all the attention while
people are struggling through this exceptionally harsh winter with
little access to healthcare," said Dr Javed Ali, the country
coordinator for MSF.
Some residents of the semi-autonomous region, known as the Federally
Administered Tribal Areas, complain that they have been neglected by
governments since Pakistan was created in 1947, making its poor
residents ideal recruits for militants.
"These are difficult areas, you have to understand," said Riaz Khan,
the head of the political administration in Kurram agency, one of
seven regions, known as agencies, in the ethnic Pashtun region.
"We have our own hospitals and clinics and we also work closely with
foreign groups and do what we can."
He said he did not have figures for deaths this winter.
Government reports on demographics, health and living standards
ignore the tribal areas. Most statistics come from international
donors.
"ANGUISHED CRIES"
UNICEF says mortality rates for children under five are 104 per
1,000 in the tribal areas compared with 94 in Punjab, the most
developed province. The figures are from 2009, the latest available.
Deaths are difficult to verify independently. Foreign journalists
are banned from the areas without permits and the government
controls access by international aid groups.
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In the last week, Reuters gained rare insight into the state of
healthcare in the area by interviewing several patients, doctors and
nurses at MSF's facilities.
All said this winter had been exceptionally hard. In December and
January, MSF reported 28 deaths of children under the age of 5 in
the region — almost double the figure from last year. Most died of
hypothermia and pneumonia.
Years of conflict and displacement have led to the near-collapse of
healthcare. Few doctors and technical staff will work in the region.
Snow and landslides often block roads to hospitals. Most sick people
see traditional healers or go to pharmacists for generic medicines.
The desperate may travel miles on foot or scrape together the fare
for a taxi to hospital.
Often, they are too late.
Sumaiya Bibi, 17, cries down the telephone, speaking about her
17-day-old boy diagnosed with hypothermia.
"I am tired of hearing his anguished cries," the mother says from
the northwestern town of Hangu. "I didn't have the money to rent a
private car so I waited to find a cheap bus. I hope I'm not too
late."
Things are particularly bad in Kurram agency, racked by sectarian
violence between Sunni and Shi'ite tribes and a 2009 army offensive
to flush out Taliban.
The offensive ended in 2011 but clashes are common and many people
need medical care.
"This area is remote. The terrain is hard. There is a security
crisis. If only there was one problem," said Dr Sakhi from Kurram.
"We need emergency wards within a 20 km radius. We need pharmacies.
We need a health policy."
(Editing by Katharine Houreld and Robert
Birsel)
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