Hammad Hussain ( Fourth Year Medical Student,The Aga Khan University, Karachi. )
In August 1998, seven, third year medical students from Aga Khan University, including myself, went to the Northern Areas, a trip organized by the Community Health Sciences Department. They carried out a survey on prevalence of contraception, health seeking behaviour and the incidence of intestinal nematodes in school going children in two specified field sites. Here is a brief account of our experience in the “middle of nowhere”.
I wouldn’t be indecisive about the whole affair and start like a famous author once did by saying “it was the best of times, it was the worst of times”. For me it was a time and experience of its own.
In the initial two hours of the journey, all seven of us were excited. Unfortunately, the excitement was to fade away in the fifteen days to come. Four of us had to work in a gorgeous valley called Yasin, a seven hour bumpy ride from Gilgit. Personally, I was just amazed at the subtlety of nature there. The guest house we stayed at was as detached from civilization as Yasin itself was from the 20th century.
Each day started with what I considered the best meal of the day-local bread called Brath. What followed next was eight hours or 15 kilometers of walking on uneven terrain from house to house, asking odd questions about contraceptive use and collecting stool samples. The problems that we faced while in the fields were enormous like language barrier and getting urine samples instead of stool. However, on the contrary to our expectations, the women were not very hesitant when we questioned them on their use of contraceptives. The locals were extremely friendly and hospitable. Their houses usually had two rooms, a kitchen-cum-bed-living room and a drawing room and there were often two gardens, one for vegetables and one for fruits. With golden cornfields, snow-capped mountains and icy-cold river, none of us minded the long walks in the sultry August afternoons.
Everyday we were supplied with a bucket of water which we had to use conservatively over the course of the day. After separating the water from the mud we bathed. Bathing itself is not that difficult, but when the water is a good 5 degrees Celsius, well.., it’s not a bad way to find out what the passengers of Titanic must have felt before the big farewell.
After tea all four of us would sit down contemplating on the realities of life (sounds intellectual, doesn’t it?) and wondering how we wouldn’t be surprised if a UFO from planet Zinger would show up from across the mountains and beam us all up. Zingarians didn’t come but huge mosquitoes certainly did, forcing us into the shelters.
For dinner we used to have the same daal for fifteen days but amazingly in colour schemes that ranged from sunflower yellow, to pink, dull muddy brown and all conceivable shades of green. We used to hit the sacks at nine (as there usually was no electricity to do anything else). Unfortunately seven different species of bed-bugs also decided to hit the sacks at the same time.
The Aga Khan Foundation, to say the least, has done tremendous work for the people of the Northern Areas and Chitral. They have set up 48 health centres in different villages which have trained LHVs. A network of schools has also been set up and committees have been formed with the aim of organizing the communities so that they could identify and manage their own developing priorities.
Looking in retrospect, the two week trip brought out the best in us and also the worst in us. We believed to work in groups but we couldn’t ignore the power of individuality. For the severe of us who were almost always confined within the environment of an over civilized and highly protective medical instituitions, it was different going to a place so far off and so remote from all the eminities in life which we all take so much for granted. For all of you out there who want to do similar surveys, I guarantee an experience of a lifetime. It would change you in more ways than one.