Departing DMJ…. A Harsh Reality

My arrival in DMJ was met with apprehension. There were concerns that the purpose of my visit may be misunderstood and this could unduly strain the projects relationship with authorities who are generally supportive of the work and profile of the project. So despite ‘having a foot in the door’ I had to maintain a high level of discretion. That’s not so easy when your carrying a Canon 5D Mark II with a cross strap and wearing hiking boots. Although the rest of my attire did conform, black long sleeved kurta [shirt] accompanied by a black chaddar [shawl].


Rabail age 2 at the day care clinic with her mother who is wearing a burka | Dera Murad Jamali | MSF

Rabail age 2 at the day care clinic with her mother who is wearing a burka | Dera Murad Jamali | MSF


I was advised to remain detached especially when visiting the nursery. I remember the words being spoken but only understood there depth when I found myself stopping by the IPD Ward for the third time in the space of two hours.

In IPD I met Shaban. Shaban’s condition was critical. Diagnosed with pneumonia, meningitis and cerebal malaria. In the photograph below oxygen is being administered. I am told his condition continues to deteriorate. That evening I head back to the ward with the team. Shaban’s bed is empty, which to me made sense as I assumed he’s been sent home. I wasn’t ready to hear the next words uttered to me. I enquire “has Shaban been sent home”, the nurse replies matter of factly “he has expired”, a term used in Pakistan for someone who has departed – died.


Patient Shaban | Age 9 months | Suffering from Pneumonia. Meningitis. Cerebal Malaria | Dera Murad Jamali | MSF

Shaban | 9 months old | Suffering from pneumonia, meningitis, cerebal malaria | Dera Murad Jamali | MSF


Abdul Shakoor is in the bed next to Shaban’s. Abdul is severely malnourished, his condition is not stable. He has had a blood transfusion, feeding via a nasal gastric tube and wrapped in survival blanket to maintain his body temperature. If his body temperature were to drop it would be near impossible to bring it back up. Abdul’s mother also shows signs of being malnourished, she sits with her son looking on with hope and trepidation.



Abdul Shakoor | 3 Months Old | Dera Murad Jamali | MSF


We head out the following day to a basic health care unit [BHU] in Dera Allah Yar, approximately 20km from DMJ. We are stopped at one of the check points as our security detail has not arrived. Once we arrive at the medical facility I am surprised by the number of people queuing hapazarly for a slip to enter the process of being attended too. Some infants are being carried by children barely able to carry them. A young girl informs my translator [Sanobar Khan] that the mothers of these infants are not allowed to leave their homes so infants are bought to the clinic by their siblings or young aunts.

Inayatullah Saleem [below] has been bought to the health care unit by his young aunt Amna. He is three years old but is not yet walking. I enquire into his condition and am told that he weighed 8kg the previous month and has since gained 0.4kg. He is given a weeks supply of PlumpyNut, which in such rural, remote and isolated areas is difficult to monitor whether this is being administered to the child or given to the father who is the main bread winner, as his well being is viewed as being paramount.



Inayatullah Saleem | 3 Years Old | Dera Allah Yar [BHU] | MSF

As human beings we are compelled to defragment situations in to bite size portions so that we can digest and accept them.  This is how I processed some of the expressions of these beautiful Balouch children. Their huge eyes drawing you in to examine and question an existence with no modern amenities. The harshness of their reality of working the fields along side parent’s, siblings and relatives is so painfully transparent.

In the morning I leave for Chaman, with an overnight stay in Sukkar and flying via Karachi to Quetta. From Quetta it’s a three hour drive through rocky and rugged terrain to Chaman, East Baluchistan on the border of Afghanistan.



Roadside graveyard. Heading from Quetta to Chaman, Baluchistan Pakistan | MSF










Ready! Steady… DMJ!

Bibi Naz's baby boy | 3 Days Old | Medecins Sans Frontieres | Dera Murad Jamali

Bibi Naz’s baby boy | 3 Days Old | Medecins Sans Frontieres | Dera Murad Jamali


Backpack check! Equipment – check!

First destination Sukkar. All set, double checked everything and ready to go. We left for the office where I was meeting my companions on the first leg of the journey – Islamabad to Sukkar.  It started to rain, absolutley pour down, which I like to think of as a good sign – cleansed and fresh!

We were  dropped off outside the entrance of the airport and I was already bubbling with excitement and feeling like an epic explorer off to make new discoveries. Although this was nothing of the sort! With a brand new NorthFace backpack in tow, who could blame me?

The flight to Sukkar would have been quite uneventful had it not been for the chap sitting next to me. His first response to seeing me (in the window seat) to the air steward was “ladies beyte howe hain” (there’s a lady sitting there). So the lovely lady steward asked me if I’d like to move. Rushing through my mind as I was overhearing their conversation was “heck no I’m not moving!” I didn’t change seats. Poor chap just had to sit next to me, whilst I read for the entire flight. He then went on to ask me if I was going to Sukkar to take an exam! Thankfully we landed shortly after. Finally I was in Sindh from where we would travel by road and cross over in to Baluchistan, Pakistan’s most isolated province.

We were staying over night at a guest house, which I must say was really nice (no hot water) but no mosquitos either. The team had a late lunch together of two local delicacies – chicken karai and daal marsh. By then we were famished.

The following morning we set off for Dera Murad Jamali in a standard Toyota Hi-Ace with curtains drawn. The highlight of the three hour drive was crossing the provincial border into Baluchistan. Along route we saw many trucks overturned and burnt, our driver told us that these were NATO trucks heading out of Afghanistan towards Karachi.

DMJ! Was I really in Baluchistan? Looking around at the hustle bustle in the bazaar and the streets leading up to the hospital [MSF] it could well have been any place that I’m familiar with in Punjab. Same atmosphere, similar faces – just the head gear was different on a few people, not the majority. Oh and the shalwar [trousers][on men] was significantly baggier and more flamboyant.


Taxi stand in Dera Murad Jamali.

Taxi stand in Dera Murad Jamali.


So… raring to go we wasted no time and headed off to the hospital facility. My translator beside to help with the many languages I would encounter. Punjabi not one of them – which I speak fluently! But I was assured Urdu would prevail. Sanobar my trusted right hand speaks – Baluchi, Sindhi, Urdu, Siraiki and English. Phew!

As expected my presence was met with apprehension. NO was the resounding decision to be photographed. So time to readjust approach.

Farzana Ahmed looked at me from the corner of her eyes careful not to make eye contact, sitting on a hospital bed with her two malnourished girls [ages 3 and 18 months]. I took a deep breath and took in my surroundings and the atmosphere in the ward [IPD/ITFC]. Then realized Farzana had two more children – Waqar and Farhan. Two healthy beautiful children. I asked Farzana if I could photograph them, she said yes. I snapped a few shots and shared the pictures with the family [on the LCD] and also had the pictures printed courtesy of the project coordinator which we then gave to them the next day. That was my foot in the door. Success!


Farzana Ahmed with her two daughters Rizwana and Shazia.

Farzana Ahmed with her daughters Rizwana and Shazia.