Two weeks after the first floods hit Pakistan the situation is extremely dire for millions of people. MSF is concerned at gaps in the relief effort. In Khyber Pakhtunkhwa and Baluchistan, MSF is intensifying its activities and remains focused on medical care, clean water provision, and distribution of essential goods. More assessments are also ongoing in these provinces, as well as in Punjab Sindh.

Click here for an interactive map of MSF's flood relief operations. 

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© Ton Koene.  Dr. Majid treats a patient at Utmanzai mobile clinic

Basic Medical Care

Since 1st August MSF has provided more than 7,000 consultations to people affected by the floods in different areas. 1,800 of these consultations were provided through eight mobile clinics travelling to remote areas or places with a high concentration of people such as schools or camps.

Three of those mobile clinics are in Baluchistan (Dera Murad Jamali, Khabula and Sobhatpur. The four remaining clinics are in Khyber Pakhtunkhwa: Malakand, Swat and Lower Dir, and two in Charsadda. More mobile clinics will start soon including in Pir Sabak, near Nowshera.

In Baluchistan, the mobile clinic in Khabula identified four children with severe acute malnutrition who were later admitted in Sobhatpur clinic.

“At this point, we cannot link these cases of malnutrition to the aftermath of the floods” said Pierluigi Testa who manages MSF activities in Baluchistan. “But we will be keeping a close eye on the nutrition issue as the food situation is worrying with harvests threatened by flooded fields. Needs in many parts of remain extremely dire.”

© Ton Koene  Distibution of basic relief supplies on the highway between Peshawa

Distributions
In addition to the scale up of medical activities, MSF teams are providing families with basic items and drinking water so they can have a minimal standard of living conditions and to prevent the spread of disease. Up to the 10th August MSF had distributed kits to 5,143 families (36,000 people) in Kyber Pakhtunkhwa and Baluchistan provinces.

A typical package contains clothes, soap, toothbrush, towels, razor blades, bucket, a jerrycan, blankets, a mosquito net, plastic sheeting and tarpaulins. But the kits can be modified according to specific needs at local level.

“Weather permitting, we will distribute thousands of kits this week in Khyber Pakhtunkhwa and Baluchistan” said Thomas Conan, MSF country representative in Pakistan. “But we fear that too little is being done for affected families. Two weeks after the first floods, people’s needs are immense and are still increasing. Much more must be done for them.”

During a distribution at Khurasan camp for Afghan refugees, people from neighbouring villages came asking for kits as they had not received anything. MSF distributed kits to a hundred more families than planned for that day. MSF is worried at the lack of aid getting through.

Finding a place to organize distributions is proving to be a major challenge. Many places are still under water, and a zone that is dry one day might well be under water the next day. As distributions are big logistical enterprises involving tons of materials and dozens of trucks there is very little margin for error.

© Ton Koene Clean water distribution in Charsadda

Clean water desperately needed

Provision of clean water continues in order to prevent disease. 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. 

Water points have also been set up in Lower Dir and in eight localities in Swat. In addition, MSF also provides clean water to the district hospital in Lower Dir and Nowshera. Now that the road has been cleared, three water points will be installed in Totakan, Isar Baba and Kalangai in Malakand. 

Yesterday, the water and sanitation team in Nowshera finished the rehabilitation of a borehole and managed to extract and distribute 35,000 litres to the community with trucks. The daily quantity should increase in the next few days.  In and around Charsadda, MSF is providing clean water through a combination of 21 mobile water points on trucks and minivans and seven fixed bladder ones.

© Ton Koene Children outside Utmanzai secondary school, now a centre for displac

Assessments
More assessments are taking place daily in Khyber Pakhtunkhwa and Baluchistan to identify pockets of population in need of aid. MSF is increasingly worried that a large number of people are yet to receive any kind of assistance both in remote areas and in places supposed to be easily accessible.  Two MSF teams are also currently assessing affected areas in the Punjab and Sindh provinces. 

110 tons of water and sanitation equipment, drugs, medical and logistical material have arrived in Pakistan and will be followed by more relief supplies according to the needs identified.  More than 100 international staff are currently working alongside 1,200 Pakistanis in MSF programmes in Pakistan.
 

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