CURRENT PROJECTS
In the year 2010-11 we are working on two projects, one focusing on improving maternal health in Pakistan and a second smaller project to provide educational resources to a medical school in Sri Lanka.
Background
Statistics from the World Health Organisation (WHO) show that every year over 500,000 women die in childbirth and from pregnancy-related complications. 80% of these are caused by direct obstetric causes (sepsis, haemorrhage, complications of unsafe abortion and hypertensive disorders of pregnancy). In many cases prompt referral of emergencies and simple medical treatment can prevent these deaths. There is a huge disparity in maternal health globally, with 99% of maternal deaths occurring in the developing world. Neonatal mortality is much higher in mothers whose mothers have child during childbirth; thus maternal mortality impacts neonates as well.
Each year, ~400,000 infants die and ~16,500 mothers die from pregnancy-related causes in Pakistan. This may be because, in Pakistan the prevalence of contraception is only 30%, only 28% of women receive antenatal care at four timepoints (the minimum recommended by the WHO) and only 39% of women have a skilled attendant at delivery.
There are several possible reasons for global maternal health inequalities. According to the ‘Three Delays Model’ mothers may not receive the healthcare they require because of a series of interrelated delays:
- Delay in seeking medical help, This may be due to lack of education, financial problems, or failure to recognise an emergency for example.
- Delay in getting to medical facilities due to poor infrastructure or poor transport facilities for example.
- Delay in getting adequate care at medical facilities, this may be due to staff shortages or problems with the electricity or medical supplies for example.
Project Outlines:
We are delighted to officially collaborate with Maternity Worldwide. This is a registered UK charity made of a group of professionals who share a great enthusiasm to improve obstetric care for women and reduce maternal mortality in developing countries. We hope that their expertise in Obstetrics and Gynaecology will complement our strong links with the local hospitals and government officials within Azad Kashmir, to facilitate the establishment of our proposed projects.
Project 1: Community Screening Programme for Reducing Deaths from Pre-eclampsia in Azad Kashmir
Pre-eclampsia (pregnancy-induced hypertension) is a relatively common condition and can be fatal if left untreated. IEF, in collaboration with Maternity Worldwide, would like to use non-invasive testing (using urine dipstick and blood pressure measurement) to enable early detection of pre-eclampsia. We will arrange prompt referral of diagnosed patients to hospital for appropriate treatment. This will be supplemented by patient workshops and educational material to educate women and their families on the signs of pregnancy complications, on birth spacing timing and limiting, and on improving the nutritional status of pregnant women. We will also organise programmes to train local midwives and healthcare professionals on standards of maternal care.
The programme will be based in two rural hospitals in Azad Kashmir- the District Headquarters Hospital (Bagh) and the Combined Military Hospital (Rawalakot). The programme will replicate one already established in Uganda by Maternity Worlwide. We hope that, in time, similar programmes can be established around Pakistan.
Project 2: Centre of Maternal Health Excellence in Punjab
Mr Shahid is a philanthropist who has kindly donated an empty hospital in Jhelum (Punjab) to create a Centre of Maternal Health Excellence. Following a needs assessment conducted by a local charity, Kashmir Islamic Relief Fund (KIRF), we would like to prepare this hospital for dealing with obstetric emergencies. This will replicate work in Ethiopia by Maternity Worldwide.
In addition to reductions in maternal mortality rates, we anticipate other benefits from our projects. Firstly, we hope that both projects will help to generate epidemiological data to enable effective targeting of future interventions. For example, there is currently no national antenatal screening programme in Pakistan. Detailed data on maternal health will help us to tailor guidelines, produced by NICE and the WHO for example, to the specific needs of women in Pakistan. Secondly, the projects will be community led, which ties in with our aims of empowering communities to overcome issues.
Action Plan:
Fundraising and raising awareness
Throughout the year we will be raising awareness of the Pakistan Maternal Health Project. Keynote lectures have been scheduled where people can come along and discuss the campaign in detail with our team, make a donation or simply get involved. We will also officially launch the project in January. More details of this event are to follow.
Expedition Plans
From 9th-24th July 2011, the IEF will fly out to Pakistan. There we will spend time in the hospitals where the community screening programme is to take place. As medical students, we will help screen patients and provide basic maternal health education. For more information please do not hesitate to contact us.
PREVIOUS PROJECTS
Western Sahara Project (2009-2010)
At the moment there are around 200,000 Saharawi refugees living in the harsh Sahara desert in the South West of Algeria. Despite the harrowing conditions that these Saharawis live in, they have managed to create a simple infrastructure, building their society on the values of health, education and democracy.
In 2009/10 IEF raised funds in excess of £15,000 to provide computers for local schools working alongside a blind school, helping them receive specialist equipment, giving the blind a vision for the future. In the UK they organised a lecture series to educate people about the Saharawi refugees.
In February 2010 the team flew out to Tindouf, Algeria. They spent a few days in each of the main camps, carrying out their objectives. Several team members also participated in the annual Sahara marathon to raise money for IEF and show solidarity with the Saharawis. IEF ended their expedition with a celebration of the Saharawi National Day on 27th February 2010.
Ebe (Nigeria) Project
The IEF has started undertaking a detailed analysis of education standards and facilities in rural villages of Nigeria. In 2009 the IEF visited a rural village, Ebe, which has approximately 800 people. Many of its inhabitants are surviving through self-sustainable farming, providing them with just enough food to feed themselves and their family.
During their trip the IEF made an immediate donation of a set of up-to-date mathematics and science textbooks. We are considering plans to build a new school and laying field in nearby space.
Projects with the Kashmir Education Fund
We are collaborating with Kashmir Education Fund (KEF) on an ongoing basis. This is a registered UK charity that develops schools in Pakistan and Kashmir. Though the schools of KEF are highly recognised and well-equipped we have recognised a potential to increase prospects for the students at KEF.
Pearl Valley Public School (PVPS)
This was built in Rawalakot (Kashmir) in 1996. It caters for 450 students aged 5-18years. It is a purpose-built facility set in beautiful surroundings. There is also a well-furnished comfortable hotel adjacent to the school for members of staff. The school is situated in an earthquake zone it is built to withstand earthquakes of 8 on Richter scale. It was the only two-story building in the area to survive the 2005 earthquake.
PVPS has a well-stocked library of books donated from the UK. In 2008-09, IEF raised funds to increase the volume of this literature further. Furthermore, IEF organised a scheme whereby teachers and undergraduates can volunteer to spend time in this school to optimise its running. Volunteers are provided accommodation in the staff hostel. IEF is also continuously looking into various ways of improving the understanding of the students in their subjects.
Other on-going work with KEF
By continuing our work with KEF we are aiming to improve standards of education in the developing world, so that children are able to have careers that improve their individual standards of living as well as the community as a whole. We will create a sustainable education system which is targeted at producing young people that are career motivated.
We are looking into developing specialist summer programmes in schools in which Imperial students can participate. Although details are to follow we have devised a 3 week "Doors to Success" course which will involve 32 children to include homeless children and orphans. We will be introducing these children to digital literacy, mathematics and science. Click here for an example of the science syllabus. These children will be followed up by year round internet communication. Our website is soon to host this forum as a means to maintain communications between the children we have worked with and our student volunteers. Children will have the opportunity to post academic queries regarding their current teaching or future careers. Through this we will be able to a gauge the impact of resources provided and long term the efficacy of teaching and syllabi directly from children. Therefore, the children's forum is a port of knowledge for children whilst allowing us with feedback and highlighting area of schooling that need our attention.
Another method to improve educational standards is to improve the delivery of course content by native teachers. Communicating the teaching expertise of academics of higher education institutions and our collaborators we will optimise current teaching methods. Collaboration with the Institute of Teacher Education (ITU), shown below, provides an excellent medium through which we can achieve these aims. The ITU is part of Soan Valley complex. It was first set up in 2000 at PVPS but in 2005 it was relocated to its own purpose built facility in Basali, Soan Valley Complex. The ITE trains primary level teachers not just from Kashmir but from all over Pakistan. At present, there is a capacity to train 50 teachers a year. The IEF is looking into devising specialist teacher training programmes for entrants to the institute and providing appropriate facilities.
Ongoing work with AKAB School for the Blind
AKAB has been struggling for many years to help disabled people get government jobs according to the specified quota. Government ministries are violating the quota and AKAB raises voice for disabled people on different forums. We aim to get fully involved in supporting this element of AKAB’s work by working closely with all interested parties to ensure the children of this school access an unbiased world which acknowledges their merit.
We were delighted that AKAB, the only school for blind children in Azad Kashmir, accepted our proposal for collaboration in 2008. This gave us an opportunity to make a meaningful contribution to the excellent work it carries out.
The school provides students the same course work required of all school-aged children in Azad Kashmir and Pakistan. Specialized classes include orientation and mobility, adaptive physical education, independent living skills, vocational education, music instruction and Braille.
In 2008-09 IEF raised funds to help to increase educational materials and standards for the blind children. The IEF also organised a charity dinner in August 2010 in Waltham Forest Assembly Hall through which we raised over £7,000 to pay towards buying a school bus. The bus will be used for educational trips and to transport the children between the hostel and the school.
Although the school already has an eye specialist who performs checkups of all the students, the IEF was keen to mobilise UK expertise to further add value to these checkups. In July 2010 the IEF founding chairman, Adeel Iqbal, visited the school with esteemed ophthalmologist, Dr Aman Kirmani. Over the course of two weeks, they conducted a series of checkups. They managed to diagnose the cause of blindness in every child and referred cases for treatment as necessary.