MSF Mother and Child Healthcare Services in Balochistan, Pakistan: A Lifeline for Families
"Eight of my nine children were born here, and my daughter-in-law delivered her five children in this very hospital. It’s part of who we are," says Zarlast, her eyes gleaming with pride as she sits beside her daughter-in-law Zarnasha, both dressed in traditional Pakhtoon attire, adorned with a long, colorful shawl and a set of vibrant bangles on their wrists.
In the heart of the MSF-supported maternity ward in Kuchlak, their story rises above the hum of newborn cries and chattering of staff and attendants. This isn’t just a hospital—it’s a lifeline for generations, woven into the fabric of their lives.
Kuchlak, a modest town located outside Quetta, the capital of Balochistan province in southwestern Pakistan, hums with the rhythm of daily life. Nestled in the rugged landscape of the Bolan Valley, Kuchlak is famous for summer fruits such as apples and peaches. Along the bustling Quetta-Chaman highway, a vital artery connecting Quetta to Afghanistan, the MSF-run Kuchlak Medical Centre stands. While a small clinic near the entrance provides treatment for cutaneous leishmaniasis (CL), a neglected skin disease that is spread by a parasite transmitted by sandflies, the maternity unit is the heart of the facility. Zarlast walks through the narrow corridor, passing a pharmacy and a lab, until she reaches the shaded waiting area under a grapevine, where families gather. "If this hospital closes, where will we go?" she asks, her voice filled with the quiet desperation shared by many in Balochistan.
Reaching the hospital is no small feat for Zarlast. Living in Killi Samli, she spends Rs. 1,000 (USD $3.60) on a rickshaw round trip—an amount that weighs heavily on her family’s already limited income. "When my husband can’t find work, it becomes even harder to afford the trip," she says, her voice heavy with strain. Similarly, Fatima from Landi Killi walks two hours to reach the facility. All seven of her children were born here. "We can’t afford transportation," she explains, as the cries of her sister’s newborn echo in the room. "During my first pregnancy, another hospital insisted on a cesarean for no reason, but I refused. I came here instead, and they delivered my first child. Since then, I’ve had six more here," Fatima says, her relief palpable.
Further north, in Chaman—a town perched on the border between Balochistan and Afghanistan—healthcare is an even rarer commodity. Chaman, a busy trading hub, thrives on commerce but suffers from inadequate medical services. Since 2001, MSF has provided critical healthcare in the region. At the District Headquarters (DHQ) Hospital, MSF's health promotion team conducts awareness sessions in the packed waiting area. The sessions focus on topics including vaccination, breastfeeding, family planning, and personal hygiene, among others. Awareness is raised either through sharing leaflets or practical demonstrations of activities, such as handwashing. Fathers and family members watch as their loved ones receive care—whether it’s a routine vaccination or a life-saving delivery.
Walking through the hospital gates, MSF offices are situated on the right, followed by the pediatric ward, where the sounds of children and doctors merge. At the end of the building, the maternity unit and the operating theater stand side by side. Inside the maternity unit’s neonatal intensive care unit (NICU), Maria holds her baby Muhammad, who is ready to go home after ten days in the hospital. "They treat us with respect. Here, everything is free, and care comes with responsibility."
Maria, now cradling her child in her lap, listens attentively as doctors provide final checks, including assessment of vital signs and overall health. "They teach us about hygiene and healthcare—things we wouldn’t learn anywhere else," she says as the doctor performs one last thorough examination, checking all vital signs, before discharging him.
The reality in Balochistan is stark: the province has one of the highest maternal mortality rates in Pakistan—298 deaths per 100,000 live births, compared to a national average of 186 (Pakistan Demographic and Health Survey 2017-18). Access to medical services for mothers and their babies in Kuchlak, Chaman, and Dera Murad Jamali is not just critical—it is life-saving. In 2023 alone, MSF supported 13,200 births in Balochistan. By August 2024, the organisation had assisted 9,640 births and conducted 30,023 consultations for pregnant and lactating mothers through its comprehensive maternal healthcare program.
But it’s not just mothers who need support. The children of Balochistan, vulnerable to malnutrition and preventable diseases like measles, also rely on the dedicated pediatric wards. Four-year-old Sadia, recovering from measles in the isolation ward at DHQ Hospital, is about to go home, her tiny feet now clad in bright yellow flip-flops adorned with cheerful sunflowers, which her father just brought. "Without this facility, we wouldn’t have been able to save her," says Aiza, her mother, who has experienced the cruel toll of childhood disease firsthand. Of her nine children, only four have survived. Aiza’s husband, burdened by mounting debt says, "I take loans to get by, but the free care here has given me the chance to take my daughter home healthy,", his voice filled with emotion.