Need Identification (Project Overview)

For the purpose of gathering scrupulous information on demographics, lifestyle and health patterns of the inhabitant of Rehri Goth, a study team from HOPE (Health Oriented Preventive Education) carried-out meetings with Muhammad Umar Jatt (Bin Qasim Town Nazim), Haji Khadum Sheikh (Union Council General Secretary), Muhammad Ali (Pakistan fisher Folk Forum) and Ms.________(General OPD by Rehri Health Development Organization and AKU). - Geography: Rehri Goth is one of the neighborhoods of Bin Qasim Town in Karachi, Sindh, Pakistan. It is located on the Arabian Sea coast and comprises large community of fishermen and farmers. Demographics and Lifestyle: Rehri Goth is a coastal fishing village in Pakistan with a population of around 60,000 residents. Most of the people are fisherman and farmers. Unfortunately, their jobs are very temporary and most people take debts throughout the year. The average household size is 10-11 family members with an average household income of Rs. 7, 000. About half of the population uses wood as fuel for cooking and heating and there are several ethnic groups in Rehri Goth including Sindhis, Seraikis and Balochs.

Percentage of Male and Female Gender in Rehri Goth

70% 60% 50% 40% 30% 20% 10% 0% Series1 Male 40% Female 60%

More than 60% of men and 90% of women have received no formal schooling or education (IUCN, 2003). Educational institutions beyond the primary and secondary levels are not present in the area. About half of the population uses wood as fuel for cooking and heating.

Health issues: The health perspective of the community reflects nutritional deficiencies and poor health status of pregnant women and children. Along with malnutrition, maternal health is affected by manual labor (getting water and fuel for their households). Moreover, the fertility rates among such women are high. The high energy demands on poor women from their combined productive and reproductive roles together with malnutrition thus have a substantial impact on their health. This is further compounded by poor health care. Children born to underweight and stunted women are also likely to be underweight and stunted which affect their future potential at the individual and community level. One of the strange diseases subsists among children of Rehri Goth in which lower limbs and sometimes the arms and other body parts are completely paralyzed. Furthermore, several diseases like measles, scabies, gastric problems and diarrhoea are common among children of the village. The poor families are not aware concerning benefits of safe drinking water. Recently, governement has decided to install twenty Reverse Osmosis (RO) plants in Lath Basti, Rehri Goth, Chashma Goth, Ali Akbar Goth, Ali Brohi Goth, Ali Mohammed Khaskheli Goth, Ilyas Jat Goth, Syed Para, Baloch Para and Jat Para. However, it is a long process to go. At the present, illegal dumping has severely affected life pattern of inhabitant. The intensive hazard chemicals contaminate water which later on is used by local dwellers hence causing severe diseases among men, women and children of the community. Drug addiction is another harmful practice which is common even among married women and children of the community. Usage of heroin, churus and other harmful drugs by women cause increase in mortalities rates of new born infant. Moreover, chewing pan, eating Gutka and smoking cigarettes are few of the daily routine activities. The village is nearby located at coastal region due to which majority of the community suffer from eye diseases, skin infection, allergies and other health problems. Primary health care is provided through a rural health center, mainly for immunization and minor clinical problems. The delayed referral is a key risk factor for maternal deaths in the Goth. Often, the severity of the womens condition is unrecognized by the family members that leads to insufficient care and delays in referral to an appropriate health facility. Furthermore, it is often customary for a woman to obtain permission from her husband or some other male relative to go to a hospital. Delay in acquiring permission even lead to her death. The lack of emergency transport is undoubtedly the major constraint to accessibility in the village. It was also discovered that the infant mortality rate is more than 30%. During survey, it was found that there is no hospital in the locality where women can deliver or have discussion with

professional doctors on maternal and child health issues. Individuals have to travel far away to Malir, Buffalo Colony,Sultan hospital (Korangi), Landhi, Ibrahim Hyderi, Civil hospital, Jinnah hospital for severe cases. The threatning fact reveals that residents have to use private or local transport to travel long-distance to reach hospital. It was also discovered from officials that dispensaries sell illegal and expired medicines to the dwellers of Rehri Goth which further affect patients in a negative manner. Most of the prevalent diseases among men and women is hepatitis C, joint pain, skin infection and fever (Malarial viral disease). Stakeholders: - HOPE - Community (rehri goat locals) - Oil and gas company