Doctors deplore decision and point to country’s high neonatal mortality rate as bank, which opened in June, forced to close without taking a single deposit
When he heard a hospital in Karachi was setting up a milk bank for babies, the news was a “huge relief” to Mohammad Munawwar.
With his wife very sick and their premature son Ayan in hospital, the 52-year-old father had had to collect milk five or six times a day from different female relatives who were breastfeeding their own babies.
His elation was short-lived; last month the bank closed before a single ounce could be deposited after complaints from Islamic clerics. Doctors who had been working on the bank for more than 12 months share Munawwar’s disappointment.
“We had been working on the bank [for] a year and had been in intense discussions with the religious clerics from Jamia Darul Uloom Karachi [for] the last eight months,” said Dr Jamal Raza, executive director of the Sindh Institute of Child Health and Neonatology (SICHN), which had established what should have been the first-ever milk bank in Pakistan, in collaboration with Unicef.
He said the scholars had raised several concerns, all of which were addressed, and after finally getting a nod from the seminary, the bank was inaugurated on 12 June.
But the seminary has now withdrawn its fatwa of assent, saying it had new advice that the hospital would find it not only “difficult but almost impossible to adhere to the strict conditions” set down by the institution’s clerics.
“The objective of the doctors who wanted to set up the human milk bank may be in good faith, but we concur with Jamia Darul Uloom Karachi, and do not think it needs to be encouraged,” said Hafiz Muhammad Tahir Mehmood Ashrafi, chair of the Pakistan Ulema Council, though he refused to elaborate.
The complexity arises due to the kinship bond. In Islam, when a baby feeds from a woman who is not the biological mother, any future marriage is forbidden between that baby and any of the woman’s own children.
Further exacerbating the concern is that in the 750 milk banks in nearly 70 countries, donors are anonymous and milk can be combined from several sources.
However, Raza said this would not have been an issue. “The original fatwa allowed us to mix a maximum of three to five mothers’ milk but we intend to keep it to one mother donating to one child at a time.”
Dr Azra Pechuho, health minister for Sindh province said: “When there is a properly developed digital identification system in place in Pakistan, keeping a record of which child got milk from which woman is not difficult.”
She said the state should not let this opportunity of “saving the lives of premature babies lapse because of this issue which is clearly resolvable”.
Ayan is not the only baby whose survival is at risk, said Dr Hassan Jabbar, who works in the 52-bed neonatal unit. The unit has, on average, between five and eight premature babies, who stay until they are strong enough to go home. A baby born at 26 weeks will stay for an average of six weeks, for instance.
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“It’s the same story that keeps repeating and which is very distressing,” said Jabbar. “I just saw a baby weighing a kilogram whose mother died while giving birth; how do we feed him?”
