As new areas of Pakistan are affected by floods daily, the zones that received the first blow suffer a fresh water level rise. Continuous and sometimes heavy rains that fell on the Khyber Pakhtunkhwa and Baluchistan provinces have significantly impeded humanitarian and medical aid. As MSF teams on the ground battle to deal with the consequences of the initial floods, more MSF staff are now assessing the needs in the newly affected provinces of Punjab and Sindh.
In Noshwera, the MSF team had to postpone a distribution of basic relief items to around 4,500 families as the place identified had been flooded. Unfortunately, heavy rains in the last couple of days have interfered with the desperately needed delivery of items such as soap, buckets, toothpaste and cooking utensils.
“The place we had identified to organise this major distribution is under 1 metre of water,” says Anthony Thouvenin, emergency coordinator for MSF in Nowshera. ”Two days ago it was dry, but the water rose very quickly. Now we’ll have to explain to people that the delivery of much-needed goods will have to be delayed by at least one day. Our team is frustrated, but this is nothing compared with affected people who really need help”.
Victims of the floods in Gulabad, Pakistan. 8th August 2010 Photo by Ton Koene
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At the weekend, Hangu district, spared until now, was hit by flash floods affecting the hospital where MSF has a diarrhoea treatment centre and engages in surgical activities. Houses were also destroyed and the displaced people’s camp suffered damage as well. MSF immediately donated some materials to support the local health centre. This morning, the team reported dozens of homeless people and is still trying to learn more about the aftermath of the flash floods.
In Baluchistan, the road between Dera Murad Jamali and Khabula was flooded, preventing an MSF truck from reaching the identified distribution point and the team had to use 4x4 cars to carry out a distribution of hygiene and relief items kits to 1,000 families. The distribution will continue through the week.
Nevertheless, MSF continues to provide drinking water, relief goods and medical care to thousands of people in dire need in Nowshera, Peshawar, Charsadda and to large pockets of people around Manjoshori in Baluchistan.
Medical activities
Medical activities continue with mobile medical teams providing care in resettlement areas, mainly in schools. New mobile clinics are expected to start today in the Baluchistan, Malakand-Swat and Peshawar divisions, focusing on the most deprived and vulnerable populations without access to health facilities. MSF continues to support health structures but the constant changes in the level of water means families move from place to place regularly, making the delivery of aid challenging. For example, the number of consultations at the Pabbi hospital in Nowshera ranges from 100 to 350 per day depending on new flood alerts.
An MSF medic providing consultations in a mobile clinic in Utmanzai, 45 min from Peshawar, Pakistan. 8th August 2010 Photo by Ton Koene
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In the Nowshera DHQ hospital, the installation of generators now allows the emergency room to remain open 24 hours a day. After rehabilitation, the outpatient department is now functional and saw a decrease in attendance during the rainy weekend, but more than 320 consultations were provided last Friday. Three ambulances have also been provided, ensuring around 10 referrals per day so far.
In all health facilities run by MSF, the most common pathologies remain linked to the living conditions. The situation is similar to MSF medical programmes that existed before the floods in Dargai, Malakand-Swat district, where the teams have started new mobile clinics.
“One out of three patients that we see here has a skin infection,” said Dr Majid, a Pakistani doctor working in one the mobile clinics north of Charsadda. “The fact that people live very closely together in wet and unhygienic conditions is a major factor. Other diseases like diarrhoea are also very common”.
Clean water desperately needed
One way of avoiding disease is the provision of clean water. MSF water and sanitation teams are working hard to provide water to communities. In places like Charsadda, Nowshera and Swat, the teams are supporting local authorities to rehabilitate the local water delivery system while trucking water to families who need it.
“Our priority is to provide drinking water to as many people as possible,” said Thomas Batarday who manages the water deliver programme in Charsadda. ”We are delivering more than 85,000 litres every day and that’s on top of the 21 water points we set up in the city. We’ll keep that set up until the water delivery system is functioning again”.
Water distribution at a mobile clinic in Utmanzai, 45 min from Peshawar, Pakistan. 8th August 2010
Photo by Ton Koene
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Water points have also been set up in Lower Dir and in eight localities in Swat (with approximately 100,000 beneficiaries). In addition, MSF also provides clean water to the district hospital in Lower Dir and is working on restoring drinking water provision in the Nowshera through system rehabilitation and water trucking.
New provinces badly affected
More assessments will take place in most affected areas as it is believed many pockets of people remain isolated and have not yet received any aid. But the weather has prevented MSF from carrying out assessments by helicopter in the last few days.
The situation in the provinces of Punjab and Sindh is a major cause of concern. The authorities have been organizing evacuation of hundreds of thousands people as heavy rains have poured down in recentdays. An assessment team of five MSF workers, including two doctors, left today for Muzaffargarh district, Punjab province, and another team will be evaluating the needs tomorrow in Kashmor, Sindh province.
A first cargo plane carrying 60 tons of water and sanitation equipment, drugs and logistical material has arrived in Pakistan and will be followed by an additional 50 tons of relief supplies in the next few days.
More than 100 international staff are currently working alongside 1,200 Pakistanis in MSF programmes in Pakistan.