The World Health Organization (WHO) has completed and handed over 23 fully-equipped prefabricated Basic Health Units (BHUs) to the government of Azad Jammu and Kashmir (AJK), thereby revitalising an essential package of primary healthcare services in the earthquake affected areas.

WHO Representative Dr. Khalif Bile Mohamud formally handed over necessary documents of the prefabricated BHUs to Secretary Health AJK Major-General Abdul Malik and EDO Health Muzaffarabad Dr. Sardar Mehmood Ahmad Khan during a simple ceremony held in the city the other day. Ten of these 23 BHUs have been constructed in Muzaffarabad, nine in Bagh and four in Rawalakot. The site selection was made by the AJK authorities.

The objective behind the construction of these prefabricated structures is to reduce morbidity and mortality by assisting the government authorities in revitalising the BHUs to bridge the gaps and improve access to an essential package of primary health care services with an emphasis on child and maternal health. All these BHUs will implement WHO's Disease Early Warning System to foretell any impending outbreaks in their catchment areas.

The functions of each BHU also include routine immunization, control of communicable diseases including TB, identification of severely and moderately malnourished children, prevention, assessment and management of diarrhoeal diseases and identification, and management and referral of common mental disorders.

A Memorandum of Understanding (MoU) was also signed between Maj. Gen. Abdul Malik and Dr. Khalif Bile. According to the MoU, the Government of AJK is responsible for maintenance, up keep, operationalisation, provision of human resources, regular supply of essential drugs and monitoring and supervision of these prefabricated BHUs.

The WHO, on the other hand, is responsible for the standard supplies and equipment, provision of essential drugs for a period of three months, development of an essential package of PHC services which form the core of service delivery in all PHC facilities and technical support.

The WHO has already handed over 12 such fully equipped BHUs to the health authorities of NWFP; these are now fully functional. Moreover, it has provided a fully functional 100-bedded prefabricated 'Convalescence and Rehabilitation Centre' for earthquake affectees within the premises of the National Institute of Health.

In addition, WHO has also taken up a project with the support of AmeriCare Foundation to construct 20 'Pre-engineered Rural Health Centres' in the earthquake-affected areas of AJK and NWFP. The sites for the proposed RHCs have already been identified by government authorities in AJK and NWFP.

At the end of the relief phase, many NGOs withdrew their services, thus endangering the sustainability of healthcare delivery in the affected areas. In the early recovery phase, WHO, in collaboration with the Ministry of Health, decided to build prefabricated BHUs to temporarily replace the damaged health facilities till such time that permanent structures are built.

In addition to the infrastructure, WHO has supported these BHUs with essential equipment, furniture and supplies. It has also been supplying medicines for three months; these will subsequently be managed by the government from its regular budget.

These health facilities are earthquake-proof structures and are made of strong weather resistant metal spans. A BHU sized 72 square meters has separate rooms for outpatient consultations, MCH services, EPI and accommodation for female staff.

The October 8 earthquake had destroyed over 65% of the health infrastructure in NWFP and AJK. The Ministry of Health, health cluster partners and expert engineers believed that the construction of prefabricated health facilities is a temporary but safe substitute for the destroyed health infrastructure. It was the only available but rather difficult option in the wake of harsh weather conditions including snow, heavy rains and landslides.

Speaking on the occasion, Gen. Abdul Malik thanked WHO for the gesture. He sought help of the NGOs, communities and the international agencies for monitoring of the BHUs. "Primary health care is the backbone of healthcare. The health authorities should make sure that these BHUs are well-maintained and fully functional to provide the required services to the people," he maintained.

Dr. Bile briefed the audience about the rationale behind the construction of the prefabricated BHUs. He hoped these would go a long way in bridging the gap that has emerged following the October earthquake.