KARACHI: When night falls on Karachi’s Baba Island and a medical emergency strikes, residents say getting hospital treatment can mean finding a boat and making a costly journey across the water to the mainland.
The centuries-old fishing settlement sits inside Karachi Harbor, separated from the mainland at Keamari by a roughly 15-to-20-minute boat journey. Its only public dispensary operates from 9 a.m. to 5 p.m., Monday through Saturday, leaving serious and after-hours emergencies reliant on referrals and transport to hospitals elsewhere in Pakistan’s largest city.
Baba Island’s experience reflects a wider health care challenge facing old fishing communities scattered across Karachi’s coast and harbor. Research encompassing three islands and four coastal settlements in Keamari has described marine fishing communities as marginalized and hard to reach, with poverty and financial hardship among the barriers to accessing medical care.
Residents of Baba and the neighboring centuries-old fishing settlements of Bhit and Shams Pir have for years reported having to cross the water for medical services unavailable locally, including specialized treatment, diagnostic tests and maternity care. The geographical isolation means communities that are part of Pakistan’s largest metropolis can still face an additional journey before reaching comprehensive hospital care.
Against that backdrop, the Sindh government this month entrusted health care and pharmaceutical group Martin Dow with the management, operation and maintenance of Baba Island’s DMC Dispensary as part of a partnership to expand free primary health care.
But Saima Saleem, Martin Dow Group’s head of corporate communications, told Arab News there were currently no immediate plans to introduce 24-hour emergency services at the facility, despite residents and health workers interviewed for this story calling round-the-clock care one of the island’s most pressing needs.
“Our biggest problem here is regarding medical treatment,” Muhammad Rafiq, a 50-year-old resident and father of five daughters, told Arab News.
“The Indus Hospital OPD that operates during the day provides good treatment. But after 11 at night, the medical stores close, and there is no doctor available in the emergency.”
Rafiq said the cost of seeking treatment on the mainland could itself become a significant financial burden for island residents.
“When we take a patient (to the mainland), the medicine costs Rs800-900 ($2.90-$3.25) at most, but our travel fare (on the boat itself) ends up around Rs5,000-6,000 ($18-$22),” he said.
Health care provision on Baba Island has expanded over the years. Martin Dow says it has worked with the community since 2016, providing services including general physicians, medicines and vaccinations.
Anam Jawed Akhai, chief growth officer at Martin Dow, said the group’s health center was designed to address the community’s basic medical needs.
“Here, all basic health needs of life are provided to the entire population,” Akhai told Arab News.
She said arrangements were also in place with hospitals elsewhere in Karachi for patients whose conditions required care beyond what could be provided on the island.
“If there is a major emergency, a maternity delivery, or any serious health concern, they can go to various hospitals in Karachi through this collaboration and receive timely treatment,” Akhai said.
“TRAVEL TO THE CITY”
For residents, however, getting to those hospitals is precisely the problem.
Samina Ashraf, a 45-year-old homemaker and mother of three, said even traveling to obtain medicines for relatively common illnesses such as fever, vomiting and cough could strain household finances.
“We don’t have that kind of money for the (boat) fare,” Ashraf told Arab News. “We have to borrow from someone and then go to get the medicine.”
“If there is a major medical issue, then we have to travel to the city.”
Although Baba Island is part of Karachi, residents often refer to crossing the water to the mainland as going to “the city,” reflecting the physical separation between the fishing community and the metropolis surrounding it.
Ashraf said that during her first pregnancy, she moved to her mother’s home on the mainland when she was five months pregnant and stayed there through her delivery because maternity facilities on the island were limited at the time.
For pregnant women, that separation can become particularly critical when an emergency leaves little time to reach the mainland.
Maryam Bhatti, a 22-year-old Baba Island resident who works as a community health worker, recalled seeing a woman in labor waiting at the jetty for a boat to take her across the water.
“She couldn’t get a boat; she had to wait so long at the jetty,” Bhatti said. “Eventually, with great difficulty, she got a boat, but she delivered on the boat itself.”
Bhatti said the baby later died, which she attributed to delays and lack of access to appropriate medical care. Arab News could not independently verify the circumstances surrounding the death.
Maternal health services on the island have expanded in recent years. Mama Baby Fund, a nonprofit organization, operates a clinic providing maternal, newborn and gynecological care and says it runs a sea ambulance connecting island communities with Keamari for emergency referrals.
But health workers say emergency transport and primary care do not eliminate the need for round-the-clock medical facilities on the island itself.
Coral William, a midwife at the Mama Baby Fund center, said laboratory tests and advanced treatment were among the services for which patients could require referral elsewhere.
“It’s crucial to have a hospital here that operates 24 hours, with proper and trained staff, including trained doctors,” William told Arab News. “No one can predict an emergency.”
William said the problem extended beyond maternity cases, with any resident potentially requiring urgent treatment at night while facing the time and expense involved in reaching the mainland.
The new Sindh government-Martin Dow agreement is intended to expand the island’s primary health care network through the management of the public dispensary. For residents, however, the distinction between primary care and emergency treatment remains critical.
Arab News contacted Abdul Qadir Patel, the National Assembly member representing the area, and the spokesperson for Sindh Health Minister Dr. Azra Fazal Pechuho for comment on residents’ concerns and their demand for round-the-clock emergency health services on Baba Island, but neither had responded by the time of publication.
