Shimshal (July 2nd)

Our first morning in Shimshal involved a number of meetings and organising food and gear for our upcoming hike to the summer pastures of Shimshal Pass.

We visited the Shimshal Health Centre early in the morning. We met the staff and then joined Mr Farman Ullah at his clinic, seeing patients together. We discussed current health issues in the Shimshal Valley including hypertension, bronchitis, pneumonia, anemia, urtis, maternal, child care/nutrition issues and had a long discussion with all the staff about their current perception of TB prevalence in the Shimshal Valley.

We discussed previous government/Aga Khan and privately funded studies on the TB issue and the absence of an active DOTs program in the area.

We indicated that BHI would be willing to act as consultant in setting up and completing a comprehensive TB surveillance program in partnership with the Government of Pakistan ,Aga Khan Health Services and any other interested parties. Mr Zulfiqar agreed to access and provide copies of previous TB studies to BHI so we can look at the best approach for a comprehensive community TB assessment, treatment and prevention plan.

We discussed future e health possibilities once mobile phone and internet services open up in the Shimshal Valley. We discussed training of medical staff in e health possibly through the KADO IT centres.

Apparently there has been some discussions with S- Com recently re future mobile/internet connectivity in the Shimshal Valley.

We later met with local Sam (IT trainer) and his new wife Nazarine (dental hygienist from Afghanistan)

We discussed multiple medical issues including the dental health of the people of Shimshal Valley.

Nazarine and I discussed the possibility of doing a joint dental health improvement seminar in the community at a future visit.

We then had a lunch meeting with Ashraf’s father Doulat Amin at his beautiful home in central Shimshal.

It was so nice to visit with him again. He is a great educator and spiritual leader in his community and always so hospitable and generous with his knowledge and time.

He provided a beautiful lunch for us all and agreed to have Pat record a video interview.

KADO rep Imran Khan interviews 95 year old Baig Doulat, Shimshal village, Karakoram Range, PakistanWe then visited Nambardar Baig Doulat and family at their beautiful home in Khizarabad overlooking the Shimshal Valley. He is an amazing 95 year old farmer, father, grandfather and great grandfather, community and spiritual leader living with four generations in the same house. When we arrived, he had just come back from working in his beautiful garden.

He is in great physical and mental shape and a true example of the old Hunza traditional life with long life expectancy. He attributes his good health to regular physical and mental exercise, good diet (grows a lot of herbs in his garden/ low salt intake) and reduced stress. He grows lots of vegetables, herbs, apricots, mulberries, cherries and apples and has a large yak herd currently in the Pamir. He apparently rarely has to visit the Health Centre. He is a great example of what can be achieved in areas such as Shimshal and what can be learned from the elders and past generations. He agreed to do a video interview with Pat.

Imran agreed to do a simple random household TB surveillance study in all communities in the Shimshal Valley while we were travelling in the Pamir. He went from house to house collecting data and interviewing residents. He did a wonderful job and was received well by the community. The results will hopefully give us some guidance in regards to setting up a more comprehensive household TB surveillance study in the Shimshal Valley.

With the help of Imran, Zulfi, Hasil (hotel owner)and hotel staff we prepared food and gear for our hike up into the Pamir.

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