Swat’s disable population suffers the absence of state-owned rehabilitation centers

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Swat: Nearly 1.75 per cent or 35000 persons population suffer from some sort of disability, out of over 2.1 million projected population of Swat district, experiencing problems in treatment and rehabilitation facilities owing to lack of proper setup at tertiary care hospitals, say health practitioner.

Dr. Sher Ali runs a private physiotherapy center namely ‘Hope Artificial Limb and Psychical Therapy Hospital’ at Swat’s Saidu Sharif town for the last 14 years situated at a walking distance from the public owned district headquarter hospital. He helps with the rehabilitation of the persons with disability (PWDs) coming from across Khyber-Pakhtunkhwa (KP) in the center where they have the arrangements for admission too.

“It’s the only center PWDs get admitted for rehabilitation for weeks and even for months,” Ali said adding, “No such facility is available in government-run hospitals. Most of the patients approaching the private facility have lower limbs disability problems for various causes.”

Mostly labourers, Sher said, approach the facility after becoming disabled mostly from falling during labor work. The data provided by the center to Truth Tracker Pakistan reveals that more than 15000 patients approached the facility in the last 13 years.

“The patients are increasing by four per cent after every passing year,” Sher said, adding, “Most of the patients belong to poor families.” The center provides treatment free of cost to those who cannot afford the expenses.

The patients from the middle class background only pay few hundred rupees while the rest of the treatment is supported by the center free of cost. “We support the center from our own pockets and there are no donors or any funds provided to the facility from the government.”

At the time of the interview, five patients, coming from far-flung districts like Bajaur Agency, Lakki Marwat, and Batkhela, were admitted at the facility. Salman Khan’s elder and younger were sisters admitted in the facility for a week. Sher was busy in physiotherapy with 12-year old girl Saima (name changed to protect privacy of the patient) who was facing problems in walking owing to disability in lower limbs.

Speaking to the Truth Tracker, Salman said his sisters suffered from the problem since birth but the condition is deteriorating. “We approached the government health facilities but the problems weren’t addressed properly.”

After spending a week at the rehabilitation facility, Salman noticed that his sisters had started walking a bit. He lamented that the government hospitals were not admitting them.

There is no rehabilitation or physiotherapy facilities available at Tehsil level. Swat District Health Officer (DHO) Dr. Ghulam Subhani, who heads tehsil level hospital other than Saidu Sharif Teaching Hospital told Truth Tracker that a physiotherapist needs to be hired at tehsil level to entertain the problems of PWDs.

Under the standardization policy of the government, Ghulam said it was suggested to the government that facilities like car parking, rest rooms and other special arrangements need to be made for the disable population coming for treatment of other diseases at the tehsil hospitals.

“Since rehabilitation required a proper setup which is needed at even tehsil level but it is yet to be available at secondary care hospitals,” he said. When asked if patients approach the facility for treatment, his response was affirmative. But these patients said come to the hospital for treatment of other diseases.

According to the data obtained from the Hope Hospital, a total of 6073 patients registered in the center when it started in 2006. Later on, the number of patients decreased to 2720 in 2007 and jumped to 3808 in year 2008.

Annual trend of the data shows that in 2009, 2010, 2011 and 2012 a total of 3870, 3952, 3996 and 3424 patients respectively approached the facility while the number increased to 4150, 4213, 4290 and 4372 in years 2013, 2014, 2015 and 2016 respectively. In the year 2017, a total of 4177 patients approached the facility from across the province.

When asked about decrease in the number of patients, he said the hospital was run with donations earlier but when the funds were utilized the hospital start charging a bit more fee than before. “Since the fee increase, the poor people would be reluctant to avail services at the facility,” he said, adding, “now the facility charges Rs500 per day for the physical therapy and accommodation while it’s Rs200 per day for the poorer patients.”

According to the 2011 data compiled by Benazir Income Support Program (BISP), a government initiative to provide monthly stipends to families living below poverty reveals that nearly 1.75 per cent or every 17 person per 1000 of the total 2.1 million projected population of Swat have some sort of disability.

Out of the total disable population, male are 0.42 per cent more than females. Among the disable population of Swat, the data shows 0.18 per cent have disability of the upper limbs, 0.71 per cent with lower limbs, 0.36 per cent are mentally retarded, 0.20 per cent have problem of speech impairment, while 0.08 per cent and 0.22 per cent are dumb and visually impaired respectively.

As claimed by Sher and, of the 1.75 per cent of the disable population, 1.8 per cent lives below poverty line and cannot afford the treatment expenses. Sher stated that most of the poor disable patients become bed-ridden owing to lack of proper rehabilitation and physiotherapy.

According to the 1998 census in the country, 2.49 per cent of the total country’s population has some sort of disability. However, World Health Organization (WHO) reports of 2010 on world disability reveal the prevalence rate of disable population is 13% in Pakistan.

Most of them, according to Sher, become burden on the shoulders of the families and they didn’t get any attention when it comes to their rehabilitation.

According to 2013’s report of Pakistan Poverty Alleviation Fund (PPAF), only 28 per cent of the disable population in Pakistan is literate and only 14 per cent of them work to make ends meet. The rest of the PWDs are reliant on family members for financial support.

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