A short history of the

Baltistan Health & Education Foundation

Founded in 1990 by a visitor to the region Dr.Nasima Frey-Rahman, a medical doctor from Lahore, when she witnessed the misery of the people of Baltistan, particularly women & children, and local people were shy to come forward to join hands in the struggle against what was accepted as fate. She was encouraged by German friends and her husband Dr.Hans Frey with experience in the development field, Dr.Ursula Sagaster, who had traveled Baltistan for many years, written about it and arranged for German donor funds, her husband Prof.Sagaster, an expert in Balti and related languages, Dr.Helmut Zappe from the Medical Faculty of the University of Heidelberg, and Bernd Simon, the man who marched the earth in support of children, also mobilised funds for our work, friends in Pakistan, late Justice Sardar Jabbar Khan & Col.Mukhtar Ahmad Khan, Dr.S.A.Haider, Dr.Imran Hamid & Prof.Mushtaq, who provided technical assistance, Muhd.Ilyas Sheikh, legal advice, Ikhlaq Ahmed and Ali Bilgrami, who donated and mobilise funds for the Foundation and its Hospital project.

•  Registered in 1990 at Islamabad under the Societies Act and at Skardu with the Social Welfare Department

•  Auditor: M/s Waseem Siddiqui, Chartered Accountant, Islamabad

• Headoffice: Chattha Bakhtawar, Park Road, Islamabad/Pakistan

• Ph & Fax: 0092-51-2249006      bhef@comsats.net.pk

• Meezan Bank Ltd., Islamabad, SWIFT-Code: MEZNPKKA 
  Pak.Rs.Acc.No.0081-33132-01, Euro-Acc.No.0097-33132-20

• Deutscher Baltistan Förderkreis e.V., Oberer Fauler Pelz 3, D-69117 Heidelberg/Germany, Umweltbank Nürnberg (BLZ 760 350 00) Kto.193 194

•  or Gudula/Ernst Schwab, Am Knapp 7, D-58455Witten/Germany

 BH&EF – its service

• Since for most of times there were no gynaecologists available in the Govt.hospitals in Baltistan, the Rahman Clinics of the BH&EF at Skardu & Khaplu (100 km East from Skardu towards the LoC & Siachen glacier battlefield) engaged gynaecologists to provide out-patient gynae and other medical services, but treat also children and men at its clinics and hold medical field camps in surrounding villages.

• Preventive healthcare incl.health-education in schools & homes, family planning services for men & women, and immunization of women (Tetanus) & children (five communicable diseases) had a high priority in our services. Nearly 200 female para-medics (midwives, community health-workers) have been trained at these clinics, subsequently found jobs elsewhere, at our clinics or run their own health-centers in mohallas & villages of the area, and are encouraged to refer patients to the clinics for treatment they cannot or are not allowed to perform. Still, emergency & other cases requiring surgery had to be referred to the District Hospital, which has surgeons, but no surgeon-gynaecologist, or to Gilgit a 200 kms away or down-country 800 kms (24 h bus-ride on the Karakoram Highway, historically part of the Silk Road) or an expensive flight to R’pindi/ Islamabad, as we had only basic gynae-surgery facilities and junior gynaecologists at our clinics. That was one reason why we joined hands with the Jabir-Bin-Hayyan-Trust and shifted in 2003 into their  Abdullah Hospital recently built at Skardu, to jointly develop there a Hospital with special facilities for women with a maternity home and a gynaecologist, when available.

Baltistan – the people & their environment

•  Population:400,000(95,000 women,200,000 children,105,000 men) of which 50,000 live down-country & abroad;

• Growth: 3%, Birth: 5%, Mortality: 2%, Fertility: 10;

• Maternal mortality:1%; Infant mortality>5: 15%;

• Malnutrition: 50%, iodene-iron-calcium & vitamin-deficiency,

• TB: 30% hidden, : 5% open;

• Literacy: 25% men, 5% women;

• 50% of population below poverty line;

•  Area:30,000 sqkm, 3/4 mountains & glaciers; 300 villages & 2 towns;

• 20% of Pakistan´s fresh-water resources originate from Baltistan; how people live here with their environment, determines to a great extent the availability of water, floods & droughts in the plains.

Baltistan`s – nutrition scenario

Malnourished 50%

Severely malnourished 20%

Govt.healthcare facilities for 100.000 wome

1. District HQ-Hospital Skardu, Gynaecology-Dept. with junior gynaecologists & LHVs,  but most of times no senior-gynaecologist;

2. Military Hospital Skardu some times with gynaecologist, but only for military personnel, immediate dependants & private patients;

3. District Hospital Khaplu with lady medical officer (LMO) and LHVs (Lady Health Visitors/midwives), but no gynaecologist;

4. Civil Hospitals at Keris, Kharmang, Shigar, Dambodas, without gynaecologists & LMOs, some even without LHVs;

5. Basic Health Units with male medical doctors & Mother & Child Health-Centers with LHVs;

6. Dispensaries & First Aid Posts with Dispensers, no LHV or TBAs (Trained Birth Attendants) or Dai (untrained traditional midwife).

NGO – healthcare facilities for wome

1. Jabir-Bin-Hayyan-Trust & Baltistan Health & Education Foundation run Abdullah Hospital Skardu, with medical doctor, gynaecologists & tele-health consultation by specialists via satellite, clinics at Khaplu & Gamba with visiting gynaecologist, medical field camps in villages, training of midwives, a medical helpline via phones placed with village midwives, MCH-Centers & Dispensaries of co-operating NGOs, for consultation & emergency incl. ambulance-services.

2.  Marafie Foundation, Hospital Mehdiabad, MO, LHVs; constructed 35 Dispensaries & MCH-Centers for Govt.& NGOs, some function with LHV, TBA or Dai.

3.  Aga Khan Health Services’ MCH-Center with 2 LHVs at Skardu.

4. FPAP, holds contraceptive-surgery camps once a year at DHQ- or Abdullah Hospital and runs FP-Centers at Skardu, Shigar & Khaplu with LHVs, FP-field camps in Skardu & Shigar areas.

5. 10 Al-Asr Free Dispensaries & 1 clinic at Skardu.

6. 10 MCH-Centers/Dispensaries of local CBOs.

Government healthcare facilities for 100,000 women

District HQ-Hospital Skadu, Gynaecology-Dept. with junior gynaecologists & LHVs,  but most of times no senior-gynaecologist;

1. Military Hospital Skardu some times with gynaecologist, but only for military personnel, immediate dependants & private patients;

2. District Hospital Khaplu with lady medical officer (LMO) and LHVs (Lady Health Visitors/midwives), but no gynaecologist;

3. Civil Hospitals at Keris, Kharmang, Shigar, Dambodas, without gynaecologists & LMOs, some even without LHVs;

4. Basic Health Units with male medical doctors & Mother & Child Health-Centers with LHVs;

5. Dispensaries & First Aid Posts with Dispensers, no LHV or TBAs (Trained Birth Attendants) or Dai (untrained traditional midwife).

NGO – healthcare facilities for women

1. Jabir-Bin-Hayyan-Trust & Baltistan Health & Education Foundation run Abdullah Hospital Skardu, with medical doctor, gynaecologists & tele-health consultation by specialists via satellite, clinics at Khaplu & Gamba with visiting gynaecologist, medical field camps in villages, training of midwives, a medical helpline via phones placed with village midwives, MCH-Centers & Dispensaries of co-operating NGOs, for consultation & emergency incl. ambulance-services.

2. Marafie Foundation, Hospital Mehdiabad, MO, LHVs; constructed 35 Dispensaries & MCH-Centers for Govt.& NGOs, some function with LHV, TBA or Dai.

3. Aga Khan Health Services’ MCH-Center with 2 LHVs at Skardu.

4. FPAP, holds contraceptive-surgery camps once a year at DHQ- or Abdullah Hospital and runs FP-Centers at Skardu, Shigar & Khaplu with LHVs, FP-field camps in Skardu & Shigar areas.

5. 10 Al-Asr Free Dispensaries & 1 clinic at Skardu.

6. 10 MCH-Centers/Dispensaries of local CBOs

Rahman Clinic Skardu - Patient Statistics

Incomes, Expenditures & Assets Baltistan Health & Education Foundation

• Incomes* from 1989-2003            Rs.33.0 Million

• Expenditures* 1989-2003              Rs.33.0 Million

• Assets at cost         Vehicles           Rs.  2.7 Million

•                               Equipment       Rs.  3.6 Million
                                Furniture         Rs.  0.2 Million

• Assets depreciated                        Rs.  2.0 Million

• Assets at market price                  Rs.  3.0 Million

 * incl.receivables & payables