Critical aid continues for many as emergency response ends in some areas

- conducted 56,991 consultations through 5 hospitals, 7 mobile clinics and 6 diarrhoea treatment centres
- treated more than 3,634 malnourished children
- distributed 1,250,400 litres of clean water per day and built 714 latrines
- distributed a total of 58,270 relief item kits and 14,538 tents Ten weeks after massive floods began to hit Pakistan, the waters in Khyber Pakhtunkhwa and Punjab provinces have largely receded and people have begun to return to what remains of their homes. In Sindh and Balochistan provinces, Médecins Sans Frontières (MSF) teams continue to assist displaced people with not only immediate needs such as healthcare and clean water but also to help with transitional shelters until their situation is stabilized. MSF has 125 international staff are working alongside nearly 1,200 Pakistani staff in MSF’s existing and flood response programs in Pakistan. MSF’s current expenditure for the emergency response to the floods has reached approximately $10 million. MSF’s 2010 budget for normal operations in Pakistan is approximately $ 15.6 million. Medical activities Medical teams continue to run mobile clinic activities across Sindh province. In southern Sindh, the number of cases of diarrhea and skin diseases (the main causes of illness at the beginning of the floods) have decreased significantly. However, MSF teams have been seeing an increase in the number of patients suffering from general body pain fatigue. These symptoms are likely the result of the excessive stress that came with losing homes, poor access to food and safe water, and generally unhygienic living conditions in camps and shelters. In response, the team has started mental health activities, individual and group counselling, for almost 600 patients.
MSF medical teams also continue nutrition screening and malnutrition treatment in both Balochistan and Sindh provinces. In Dera Murad Jamali, where the team is running five ambulatory therapeutic feeding centres, the number of children enrolled in the program increased significantly following the floods – due to either food insecurity or the addition of displaced people to the local population. Constant population movements in the aftermath of the floods make it more challenging for the ambulatory feeding program team to ensure that children admitted to the program complete treatment.. Due to concerns about malnutrition, health promoters have changed their strategy from promoting knowledge on how to prevent acute watery diarrhea to raising knowledge on nutrition. Provision of safe water remains critical MSF water and sanitation teams continue activities to reduce health risks for flood-affected communities. The teams in Dadu, Dera Murad Jamali, Lakkana, Jamshoro, and Sukkur districts are distributing at least 535,000 litres of safe water a day. In Sukkur district, the team continues to identify places to build latrines, hand washing points, and showers before it hands over its water and sanitation activities to another organization. In Jamshoro, health promoters and water and sanitation engineers are working in several communities to improve sanitation and waste management and to increase awareness about hygiene. The team is also working hard to provide safe water to two villages in Sehwan district that are still cut off from access to safe water. In other districts, water pumps and more water storage points are being set up. Well-cleaning activities are also underway to meet the needs of increased populations in some areas.

© Seb Geo/MSF
Four-year-old Sadia goes seven times a day to get water for her family of seven. They were displaced by the floods and now live in an abandoned shack. Transitional shelters Many people have started leaving IDP camps and going back to their hometowns despite the fact that their homes were totally destroyed by the rains and floods. MSF plans to support families in southern Sindh by building 2,000 transitional shelters. The team will provide from 800 to 1,000 shelters in Jamshoro district and is assessing the needs for temporary shelters in Dadu district. “Since people keep moving everyday, it is quite difficult for us to have a complete picture of their needs,” says Elisabetta Maria Faga, MSF emergency coordinator in southern Sindh. “However, we are ready and we have the resource to provide about 1,000 transitional shelters in Dadu.” Each transitional shelter will be 25-square metres, constructed from bamboo and plastic sheeting and designed to last for one year. Reconstruction tool-kits will also be provided to families in need. The team will be doing this in consultation with community leaders. “We need input from the local community as to what will be useful for them, since they understand their needs more than we do,” says Faga. The team also continues to provide relief item packages to people who have not received any assistance. In Saifullah Canal, Dera Murad Jamali district, MSF plans to provide 2,500 relief-item packages.

© Seb Geo/MSF
Mutaaz delivers a tent to a displaced woman and her family who were among 27 families that received similar essential supplies. Allof the families had been living along the road under bed sheets.
End of emergency response activities in Khyber Pakhtunkhwa and Punjab Now that the floodwaters have receded and the emergency phase of the response has been declared over, MSF has closed its emergency response activities in Punjab and Khyber Pakhtunkhwa provinces. In Khyber Pakhtunkhwa, emergency response projects in Nowshera and Charsadda districts closed mid-October. MSF had provided emergency water supply, relief item packages and tent distributions, and mobile clinics since July 29. In Punjab, MSF closed an emergency response project in Muzaffargarh district, in the Tehsil Quarter Hospital of Kot Addu, which had been open since mid-August. MSF ran a DTC and treated 4,400 patients over the last 10 weeks. As the medical situation improved and the epidemiological situation held steady, MSF closed the DTC and handed over the medical wards to the Ministry of Health. Since 1988, MSF has been providing medical assistance to Pakistani nationals and Afghan refugees suffering from the effects of armed conflicts, poor access to healthcare, and natural disasters in Khyber Pakhtunkhwa, Balochistan, Punjab, and Sindh provinces, as well as the Federally Administered Tribal Areas and Kashmir. MSF does not accept funding from any government for its work in Pakistan and chooses to rely solely on private donations.

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