On her travels to rural villages in Pakistan's Balochistan Province, Dr. Shazia Khpalwak witnesses the impact of inadequate nutrition, poor infrastructure, and limited education.
All those factors contribute to a high infant mortality rate and poor health outcomes for young children.
"Their children appear to be less developed for their age, both mentally and physically, due to poor nutrition," Khpalwak said.
A lack of nutrition is an issue for nursing mothers, as well. And in many cases, "the mothers don't know how to effectively breastfeed their babies or how to increase the mother's milk," she said.
Khpalwak has made it her life's work to bring neonatal care to some of the poorest and most remote parts of Balochistan.
She provides treatment and helps educate mothers on the physical needs of their newborns.
But the problems caused by water shortages and inadequate infrastructure are beyond her control.
"There isn't enough water here," Khpalwak said. "This is why the people drink the same [untreated] water that their camels, donkeys, goats, and sheep drink. And because of water shortages, the food they eat is not clean, either."
In Pakistan as a whole, infant mortality rates are nearly double the global average. Many mothers give birth at home, which contributes to the risk of serious health complications.
Rural areas also lag behind on vaccination. In Balochistan, the rate of childhood vaccinations is less than half of that in Pakistan's wealthier Punjab Province, according to the World Bank.
International aid programs have helped increase vaccination rates over time.
But Khpalwak sees an ongoing crisis that only sweeping changes to Pakistan's health system will address.
