A Health Update from Mohammad Hussham who worked with HANDS in Sindh:
Its been one of those breathtaking weekends which one fears to face in life.
Ill shed some light on the health status of the people we were able to visit. Unfortunately, we couldn’t cover a lot of villages which have been affected but can forecast the seriousness of the situation in regions barely accessible through land.
As might have been discussed, Sukkur has not been as badly affected as other regions in Sind like Jaccobabaad (especially Thull), Kashmore and Mirpur Khaas. Relief efforts have been mainly directed to Sukkur accounting for mismanagement of resources or delay in delivery of resources to regions which require them REALLY BADLY! Food supplies, shelter, medical relief camps, proper sanitation and clean water supply are barely present in these areas. Where these are present, crowd management is a huge issue.
Health is a major issue in these flood affected areas. As compared to the calamity of earthquake, we are left with more morbidity at present and a rise in mortality in the future if the situation persists. A few regions have an emergency declared due to the rising incidence of deaths secondary to diarrhea.
Kashmore presents one of such sad stories. The deplorable health setup in the district is itself an indicator to warrant immediate medical attention. The district has one DHQ Hospital which by definition is a tertiary care hospital. This DHQ is subordinated by 4 RHC’s (Rural Health Ctr.) and 16 BHU’s (Basic Health Unit). I did not get a chance to visit an RHC but was unfortunate enough to see the DHQ and a BHU. The DHQ has no means to cater to emergencies or patients who require admission. A lot of people have received medical relief through small medical camps that have been setup by different NGOs. We got a chance to offer medical relief to a small village by the name of Ghausspur.
Just to highlight the major diseases affecting or likely to affect the region:
- Diarrhea (especially cholera)
- Skin diseases (scabies, impetigo, abscess, etc.)
- Ear infections
- Eye infections
- High risk pregnancies
These diseases are easy to treat if timely medical help is provided. Or it can kill hundreds in no time! One patient of cholera might just be sufficient to account for hundreds of lives in a matter of days. Timely interventions that are needed urgently include:
- Clean water supply
- Proper sanitation
- Counselling on hand hygiene
- Keeping the skin dry (start by not swimming in the water at least, which is draining their sewage and is also serving as their drinking source)
- Provision of mosquito nets or repellents
- Medical supplies and personnel
I personally feel that you don’t really have to be a medical doctor to get this done. At most, a brief training session is all what is needed if necessary. Acute emergencies would be 1 in 100 I guess where a medical doctor might be of help. But the rest is a ground for epidemics which can be prevented by simple interventions highlighted above. A good medical team with doctors, LHWs, support staff would be ideal but not something which should limit us. These simple measures can seriously save lives and a generation ahead!
From a volunteer with HANDS in Sindh:
August 20, 2010, 11:10am: Yesterday we visited a camp which had 97 tents and housed around 450 people. The camp had only taken 3 days to setup and was now fully functional in terms of latrines, medical camps and food and water distribution. committees have been formed from within the people and have been given responsibilities like food, hygiene and health. From today onwards they start cooking for themselves.
There are loads of people who still haven’t been able to get registered in a campsite and are sitting under the scorching 50 degrees heat shelter-less. Hands are sending an appeal to their Karachi office for tents packed with a ration bag and you guys can help by spreading the word on Facebook. Aquatabs are also a necessity.
In terms of spread of disease, the situation isn’t too bad. The most commonly reported complaints are skin diseases such as scabies and diarrhea. They are being lectured on hygiene but there is a need for more doctors as the longer they live in closely packed places the higher the likelihood of diseases spreading like wildfire.
We will InshAllah start getting our case studies today. HANDS need some help in the communication department and that’s where we plan to play a role. One person we talked to yesterday said he traveled for 2 days from Jacobabad to get to the camp. The water is 8 feet deep in his village and he had to evade dead bodies and carcasses to make it to dry land. He made a dash for it with just his family and had to rely on generous shopkeepers to give his children food to survive.
We are headed to Kashmore at the moment, which is one of the badly hit areas, I will update you guys on that tonight. Huge traffic jams along the way though. Trucks that have been stuck for 2 days now standing in queues that apparently run all the way to Punjab.
We have also been told that MNCs are turning out to be quite useless in that they are only willing to help as long as only their products are used or as long as it fills their CSR program. This needs to be highlighted in the media somehow.
Lastly, it is abundantly clear that this is a long term issue. They see themselves stuck in campsites for at least 6 months (possibly more because it is widely expected to flood twice more in the coming few days) and since their land will erode, God knows how long it will be before they are able to stand on their own feet. It is therefore imperative that we keep the donation drives going, I don’t know if the concept of direct debit exists in banks in Pakistan but if it does that could be one way to get people to donate for a longer term. Another method could be to adopt families but whatever the solution is something needs to be done now before this becomes old news and the cameras start focusing elsewhere.
PS. We just entered Kashmore. Please take a look at the attached pictures.
August 20, 2010; 12:46pm: Update: Situation really bad in Kashmore. Four villages submerged in 11ft of water. People still stranded with no hope of getting out. Medical teams going to them by boat. So far, only HANDS providing medical relief and too are short on doctors. Doctors needed urgently. Please spread the word. Media is completely non-existent here. People are dropping like flies. Diarrhea, malaria, and gastroenteritis rampant. No clean water and very few drugs. There are 4 villages that are completely inaccessible by road. Around 15 people dying everyday of diarrhea and other preventable diseases.
August 21, 2010; 4:03pm: Just got back from a dyke located 20km from kund koth. All 4 villages that surround the dyke are under 18-20 feet of water. Around 3500 people cramped in a narrow strip 0.5 km long. One hand pump being shared by all of them, no ration supply, 15 deaths over the past few days. 50 pregnant woman, around 8 past their 8th month. No midwives, No medicine
Hungry and Homeless
A series of eyewitness accounts from volunteers at relief camps across the country:
The Pakistan Youth Alliance (PYA) made simultaneous deliveries on August 14 to Nowshera, Muzaffargarh and Rajanpur with 31 volunteers in three teams with eight trucks of relief goods.
Nowshera (Datta Kaka Sahib)
This time we went to a remote area of the district after passing through the devastation caused by the the floods. The water seemed to have receded since we were there last, but in its wake it has left behind lives of many who are now uncertain about their future.
On our agenda was delivering supplies to about 160 families at a camp set up in ‘Datta Kaka Sahib.’ Once we arrived, our group leader briefed us on how the operations would work. We were, however, not briefed about what to do if we were attacked like our fellow PYA team members were in Rajanpur. I guess it was best we kept that out of our minds. At the camp aid workers, with their official jackets, were seen who helped effectively distribute aid to the affectees.
We had with us different items such as flour, rice, oil, etc. according to the requirements of that particular camp. The list was made by our local contact in whom we trusted. Our team also had a list of 160 families that were to be given the goods. Each person was passed through a process of verification before he/she was given any help to ensure it was being given to the right person. I believe we did a good job and gave it our very best. However, one must always accept that 10-15 per cent of the aid may not end up in the hands of the intended recipients.
During the process, I took a short walk outside the camp to talk to the people and gauge how their lives had changed. What I heard were unconfirmed reports of a alleged ‘sex-for-food scam.’ I was also told that prices of everything had sky-rocketed and there seemed very little hope for any reconstruction in the future.
Yet, amidst all this chaos, I remain an optimist. No, a prisoner of hope would be more appropriate as Desmond Tutu once said. Pakistanis have weathered many disasters and calamities and we have never yielded, nor shall we this time. We will get through this, we always have – Pakistan Zindabad!
Ahmed Hasan, a volunteer for Pakistan Youth Alliance, contributed for Dawn.com
The second team embarked on the journey towards Rohela Wali but had to stay at Ghazanfargarh due to a road blockade. These areas of south Punjab have been worst-hit by the floods and what we saw here was unprecedented. Many IDPs were living alongside main roads and news of them attacking relief-convoys were heard. It was raining heavily and our dedicated volunteers decided to move on despite of warnings from local administration and Army.
On the way, during our stay at Ghazanfargarh we met Ghayur, a local who studies at Punjab University. He was extremely agitated with the government’s response to the disaster in his region. “In order to protect certain areas, the local authorities blocked the water which resulted in smaller towns being drowned completely,” he said.
Our final destination was Mehmood Kot camp at Alipur, but reaching there seemed impossible as flood water was now on the roads. We had to stop our convoy and walk through three to four feet of water to assess the situation on the other side. Our drivers and truck owners refused to go forward in the flood; we even requested some army personnel deputed in the region to help us deliver our relief aid but they advised us to go back as flood-warning was severe.
After three hours, the water level receded and we could now move forward. Around 250 families were anxiously waiting for food items we promised to bring to them on August 14. We finally managed to distribute the items only after cross-checking the ID cards to make sure it was going to the right person. IDPs at the camp also complained of mismanagement by local authorities and narrated stories of personal favours being given to particular group of people for political benefits
Areas of Kot Addu, Muzaffargarh, Rahim Yar Khan and Rajanpur have been severely affected by the flood and what we saw here, wasn’t comparable to what we witnessed in Khyber Pukhtunkwa. During our deliveries to Pukhtunkhua and south Punjab, we have felt the need of a central agency for coordinating relief efforts with individuals and organisations. At the moment, we are assessing the need of the areas ourselves as well as managing the logistics. Security is also an issue in certain areas where people, desperate for supplies, are attacking aid convoys. I was with the Rajanpur-bound convoy and 50 odd men attacked the truck of supplies. Only the government, with its manpower and logistics, can set up such emergency cells in flood-hit areas.
Syed Ali Abbas Zaidi is the founder of Pakistan Youth Alliance, who tweets @Ali_Abbas_Zaidi and is available on facebook as Syed Ali Abbas Zaidi. He can also be reached at email@example.com
Please email us your stories from the flood-affected areas at firstname.lastname@example.org so that we can share them on this page.