PROJECTS > Completed Projects:

The Foundation has so far completed the following projects:

1. Detecting common life-threatening diseases (Silent Killers):
    Survey period: February 12 - 2000 to March 28 - 2001

2. A Drought Aid Mission to the Thar area of Sindh.

3. An Educational Video on the self-management of Diabetes.

1. Detecting common life-threatening diseases (Silent Killers):

A large percentage of Pakistan's population is facing grave hazards to its health. A comprehensive health survey of four suburban villages on the outskirts of Lahore, (Pakistan's second largest city and the capital of Punjab province) was the first project of Dr. Zeenat Hussain Foundation.

In Pakistan, there is an urgent need to collect data of these possible killer indicators. Hypertension, elevated blood cholesterol, high blood sugar levels and obesity are generally considered the principal indicators of the onset of `silent killer' diseases leading to cardiovascular complications, diabetes and problems of the eyes, kidneys and the brain.

On the basis of an early detection awareness, suitable programmes can be designed that will make the population health conscious. Through timely counselling before diseases set in and through correct medication, the public can be helped to sustain active lives. This advice is reinforced by annual health checks and the maintenance of reliable records. The benefits of early detection helps prevent complications, reduces the financial burden on individual household expenses as well as public expenditure on healthcare facilities. The cost of hospital-bed occupation is also substantially eliminated.

"The growing surge of heart disease in developing world will not be blunted and reversed by the medical profession alone", Dr Bernard Lown, the famous Nobel Laureate has written. "What is required is a public understanding of health issues to engender a climate of support for policies of primary prevention."

With these objectives in mind, Dr. Zeenat Hussain Foundation launched an exploratory survey to identify some of these silent killers. To the list of the known indicators were added investigations about reportedly high occurrences of Hepatitis B and C viruses in the survey area.

Survey Area:
Four suburban villages were surveyed by Dr. Zeenat Hussain Foundation for the prevalence of Cardiovascular Risk Factors, Hepatitis B and Hepatitis C viruses (Silent Killer Diseases).
Preliminary data from the first village (Village 1), a suburban community situated 20 kms. from the centre of Lahore city comprising 206 houses with a population of 1200 adults showed that out of the total respondents,1021 (85.1% of the total population):

• 25.3% suffered from mild to severe hypertension.
• 15.8% females and 7.7% males suffered from elevated cholesterol.
• 30.5% females and 22.9% males showed high triglycerides level.
• 17.0% females and 12.8% males were overweight.
• 10.2% females and 2.7% males were obese.
• 4.5% females and 2.9% males were diabetic.

• 16.5% females and 13.9% males were found to be serologically Anti HCV Positive.
• 2.4% females and 7.2% of the males were HBsAg Positive.

Among 206 female children, between 2 to 15 years

• 7.8% were Hepatitis B Positive and 3.4% C Positive.

• 4.4% were Hepatitis B and 4.0% Hepatitis C positive.

• 31.1% females and 23.5% males were illiterate.

• 0.9% females and 23.0% males smoked cigarettes.

A small irrigation water channel goes past the settlement. Not far away, upstream from Village 1, a sewer drains directly into it. The people wash their cattle in this channel and use the same source of water for irrigating their fields.

There is a government school in the village for boys and girls up to 8th grade (age 4-14). Only a few can afford to send their children away from the village to other schools and colleges for further education. One could see many young boys loitering in and around the village all day long. Girls are not allowed to go out of the house. They remain within the home, doing household chores and looking after younger siblings. The boys are usually idle and some are known to have taken to drugs. For entertainment most families rely on television.

There is no government dispensary or hospital in the village. A ward boy of a hospital in Lahore runs a private clinic, even though he is both inexperienced and unqualified. No family planning facility is available in the village. No maternity care is available. The traditional midwife or 'dai' delivers 90 percent of the babies born in the village. Infant mortality rate is very high, as are maternal deaths during childbirth. Nearly every woman has lost one or more children during or after labour. Women generally are not allowed to work outside their houses.

Final report of the above project will be released by the end of the year.

Conclusion:
The preliminary data from this village is cause for concern. Hypertension, obesity, elevated lipids and diabetes mellitus, hazards of health being prominent in the community. The data focuses on the plight of women whose lifestyle predisposes to ill health. The prevalence of cardiovascular risk factors are far more common in women than in men. Women with multiple pregnancies (6 to 11) were housebound causing an inactive life. Youth comprises 50% of the population. The danger lies when they reach the age of late twenties onwards. They too will be prone to cardiovascular risk factors, which will register a marked increase of cardiovascular disease in society.

Infection with Hepatitis B and C viruses is alarming.

There is a great need for effective educational awareness programmes to prevent obesity and sedentary habits. Of major importance is to remove illiteracy in the population in particular regarding reducing smoking of cigarettes which is more prominent in the youth and a cause of cardiovascular disease.

To change the community into a healthier life style both men and women should be made aware of these avoidable hazards to life by providing them with reliable methods of information for propagating this awareness and counselling them on the hazards of smoking and the importance of regular blood pressure checks with hypertension being recorded on a blood pressure card.

The women should be encouraged to participate in community based activity to reduce their lethargy and increase their physical activity. These are the fundamental issues that require debate.

Multiple causes of obesity in the poor need to be further defined particularly as neither the children nor the adults are short in stature.

Prevalence of overweight and obesity with poverty was studied in countries of Latin America and the Caribbean. The characteristics specific to these countries are very different from the lifestyle of our study. More meaningful work needs to be carried out on obesity and poverty.

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2. A Drought Aid Mission To Thar Area Of Sindh:

High temperatures during the summer of 2000 in the Thar district of Sindh and the failure of rains brought the area under severe drought conditions. There had been no rains for the previous two years. The few wells situated kilometres apart had dried up. The end of winter left the vast desert areas completely barren and unable to sustain its scattered population. Severe shortage of food and water for people and animals soon began taking its toll.

Among other organizations that mobilised relief operations in that stricken area, Dr. Zeenat Hussain Foundation also mounted a medical aid mission from 7 - 13 June, 2000.

The worst affected area was that of Taluka Chhachro in Mithi District of Mirpur Khas Division. Moving into this most inhospitable and trackless piece of desert was a challenge. Help was sought from a former member of Provincial and National Assembly of Pakistan who agreed to host the mission, to provide it with guides and interpreters, and to disseminate information. He generously made arrangements at selected locations to enable the medical team to perform its task.

The mission comprised three young doctors. They travelled a distance of 569 km. over an area of 2500 square kms. In the days of the drought, the population may be estimated to be half its normal complement - i.e. about 13,000. The patients stated that some of the villages had never been visited by a doctor.

The mission carried medications to treat a variety of ailments known to be currently prevalent, such as respiratory and gastrointestinal infections and severe dehydration. They also carried considerable quantities of powdered milk, oral and intravenous rehydrating salts, vitamins and a variety of antibiotics.

The mission team examined 1253 patients. The general data of the patients is detailed in the table below :

	• Respiratory tract infection		210
	• Chronic backache + arthritis		170
	• Urinary tract infections		143
	• Diarrhoea		110
	• Abdominal pains		94
	• Skin problems		89
	• Eye infection		79
	• Vaginal infections		71
	• Asthma		16
	• Visual problems		11
	• Inguinal hernia		8
	• Polio		6

Suspected tuberculosis and referred for further investigations :		156
Suspected renal and urinary tract calculi and referred for further investigations:		73

Infections of the respiratory tract, skin and urinary tract (among women) were found to be very common. A very large number of patients complained of body aches. The rates of infant mortality and of women dying during childbirth were reported to be very high. The entire area of Thar is without the supply of potable water for drinking. The well water is salty and there are no arrangements to keep it contamination free.

Recommendations:

1. The fundamental problem of the area is poverty. The people are too poor and destitute to bear the cost of reasonable level of health care. There is a need to start projects to increase the earning capacity of inhabitants for example, they are very skilled and artistic in producing handicrafts which can fetch handsome returns in national and international markets.

2. If properly used in a scientific manner, Pakistan is not short of water for agricultural purposes. The area needs to be allocated its proper share of the waters of the Indus Basin. Drinking water needs to be provided on an emergency basis through pipelines and special water storage facilities.

3. The area lacks the infrastructure of civilized existence -- water, sanitation, roads, electricity, housing and remains deprived of its share from the national resources.

4. The area lacks basic educational facilities. In other parts of the world similar desert areas have been successfully provided with education infrastructure. The Thar awaits such efforts.

5. There is immediate need to give elementary health care training to suitable men and women in the area who should be provided with a radio or a satellite telephonic link with qualified medical advice and a package of medications free of cost. For cases requiring advanced medical attention arrangements would have to be made to transport patients to proper medical care facilities.

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3. Educational Video On The Self-Management Of Diabetes:

Diabetes is one of the ailments which can be controlled and effectively managed to enable the victim to lead a normal life. However, most of the diabetics, especially the potential diabetics do not have the necessary awareness of the nature of the affliction. The Foundation has prepared an educational video to help and guide potential as well as existing patients.

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