The lone hospital in this tatty Kashmiri mountain town was on the eve of hosting one of the year’s biggest social gatherings, a health fair for several hundred villagers, and Todd Shea was not happy.
The hospital’s founder, Shea, an American who resembles a football coach more than a health worker, was outraged because one of the employees had failed to purchase enough hygiene kits — freebies the villagers had come to expect at the fair.
“This is a problem, and there is a solution,” Shea, strident but good-natured, yelled to a staffer on the phone from the field. “Let’s see how good you are. I know there are kits lurking in the walls. I guarantee you that if I come there, I will find them. You know me!”
Seven hours later, at midnight, the employee returned from a nearby city with a sheepish smile and 100 kits he had managed to round up.
Shea offered him a hug.
“I believe in you,” he said.
If Shea, 42, had a resume, it would by his own admission reveal far more experience as a cocaine addict than as a medical professional. But with his take-charge demeanor, he has transformed primary health care here in this mountain town in Kashmir, where government services are mostly invisible.
“Others are more qualified, but I’m the one who’s here,” he said.
Most recently, he has focused on the millions of people who have been uprooted by the army’s campaign against the Taliban, in the northwest.
But it is here that Shea spends his time and where he learned years ago that, as far as health care is concerned, every day is a crisis for Pakistanis.
He arrived as a volunteer rescue worker immediately after the 2005 earthquake that killed 80,000 Pakistanis. Overwhelmed by the community’s long-term needs, Shea never left, and in 2006 he set up a nonprofit charity hospital called Comprehensive Disaster Relief Services (CDRS).
Humanitarian aid flooded the region in the immediate aftermath of the earthquake, but the tide of aid and government support ebbed within months, leaving 25,000 wounded residents without doctors, medical supplies and an actual health outpost. That is, life returned to normal.
In Pakistan, less than 1 percent of the national budget is devoted to the health of its citizens, and the nation’s health care crisis is especially acute in remote communities.
“It’s frustrating and sad that’s the way it is,” Shea said. “But if I screamed from the mountaintop, it wouldn’t change a thing.”
So he does what he can. His hospital, with 38 employees and nearly US$200,000 in financing from Americans and UNICEF, highlights not only the desperate needs of Pakistan’s rural health system, but a glaring vulnerability for a government trying to brand itself an alternative to the Taliban.
“The Taliban terrorize people, but they put forth logical arguments about the state’s failures,” said Shandana Khan, the chief operating officer of the Rural Support Program Network.
“It’s very common to see primary health care facilities without doctors, or medicines,” she said. “Doctors don’t want to be posted there. Or they’ll sign up and get paid, but sit in cities, and no one monitors them.”
Chikar is only 137km from Islamabad, but it takes six hours up a switchback road to reach the hospital. Here, the government provides only 10 percent of the community’s medicine needs. CDRS picks up the rest.