By Amie Batson, Deputy Assistant Administrator for USAID’s Global Health Bureau

I’ve just returned from my first ever week in Pakistan and what a week it was.  Working with my colleagues in the US embassy and USAID offices, and with their Pakistani counterparts, I came to appreciate that development work in Pakistan is exceptionally hard but also very rewarding.

On Monday, I visited to Peshawar, a 2 ½ hour drive from Islamabad, to meet with the health authorities and to visit a public health school for Lady Health Visitors, Community Midwives and other paramedical staff.  You might know Peshawar from the news as one of the areas close to the Afghan border where lots of refugees have settled in camps to escape the violence in Afghanistan.

Although I’ve worked in global health for 20 years, this is the first time I’ve ever needed an armored vehicle to visit a field site.   Once we arrived in Peshawar we changed cars, picked up both US and armed Pakistani security escorts –– and continued driving ahead through the confused traffic of cars, bicycles, donkey carts and people. After a hair-raising journey through downtown Peshawar, we finally arrived at our destination – the school of public health that trains women to be deliver babies and health care in the most remote areas of Pakistan – and I was given the all clear to open the car door.

Re-arranging the head scarf and long coat that I wore to show respect for local customs, I cautiously went to meet the school’s director.  She was already waiting on the front step with a big smile and bouquet of roses in her hand.  After introductions to her all-female teaching staff of doctors and midwives, she gave me a tour of the school.

First we visited two classrooms with 60 young women, each of whom had been selected from over 600 applicants from around the country.   These women were in their 2nd year of the two-year Lady Health Visitors program, and would soon be accredited as midwives and medical personnel.  After they complete their training, these women will return and work in health clinics that provide the only medical care that many in their community will ever receive.  Most clinics serve up to 10,000 people – and the Lady Health Visitors provide services ranging from vaccinating infants and children to protecting them from diseases like measles, whooping cough, polio and hepatitis, to providing care for pregnant women to delivering babies and educating families about the importance of nutrition and spacing of pregnancies.

The women were excited to meet someone from the US and to thank our country for supporting their school.   For only about $24 each month, our US government supports a range of small upgrades to the school to help improve the learning environment and the quality of education provided.  These items included training materials, models for anatomy class, and structural upgrades to the classrooms and students hostels. For the Community Midwives that were trained there, basic equipment was provided for the girls to take to their health post once they graduated – equipment like a birthing table, safe delivery equipment, sheets, a sterilizer, a stethoscope and small stipends for the women to live on.  The Director showed us the “anatomy room” with plastic models of the human body, the delivery room and labor room – a room with 5 beds, the immunization and consultation rooms and the dormitories.  The tour finished in the kitchen – where the delicious smells of lunch (which couldn’t be eaten until we left) came from an enormous pot sitting on a fire.   As we said our goodbyes in the courtyard we spotted an old Dodge school bus, a gift from decades ago that was carefully cajoled into starting every now and then.

I’m grateful for the opportunity to contribute to the work our government is doing to improve health around the world and for the opportunity to witness first-hand the impact U.S. assistance has in Pakistan.  I’m confident that the lives and impact of the Pakistani health workers I met have been forever changed by our assistance.  In 20 years of development work – I’ve never had the armed escort  – but I’ve also never been greeted with a bouquet of roses.

To read more, go to http://www.usaid.gov/pk/newsroom/news/disaster/101220.html