More needs, new activities in new locations

In Balochistan and upper Sindh, the rising water levels of the Indus river have forced 90 percent of the people living in areas like Usta Muhammad, Dera Allar Yar and Ganakha to leave their homes. South of Kashmor, and Sindh, floods have also forced poor families to seek refuge on higher ground, on embankments along the main canals, the railway lines or any available space they can find along the roads.

In Sukkur, Northern Sindh province, MSF has now started distributing relief items and launched three new mobile clinics to provide free medical services to the flood affected community. The mobile teams in Sindh are coming across groups of up to a thousand people at a time who are, especially the children, desperately in need of medical attention. Also in Sukkur, MSF is now supporting a 30-bed paediatric ward for children under-five years of age.

In southern Sindh, MSF has set up a new office in Hyderabad to coordinate more relief activities in the area.

Exploratory teams continue their assessments to identify gaps in Khyber Pakhtunkhwa, Punjab, and Sindh and Balochistan for immediate interventions. In these new locations, MSF teams are now preparing to respond to the immense medical and humanitarian needs of the affected population. This will be done through the continued distribution of relief items and provision of safe water, as well as the setting up of more mobile clinics and diarrhoea treatment centres.

More than 110 international staff are currently working alongside 1,200 Pakistanis in existing and flood response programmes in Pakistan.

Improving access to clean water and sanitation

To curb the possible outbreak of waterborne diseases, MSF is increasing clean water distribution activities in the main towns and remote villages of Khyber Pakhtunkhwa’s Charssada, Swat, Nowshera, Lower Dir and Dargai. In the coming days MSF will also start water and sanitation activities in the provinces of Sindh and Balochistan.

In addition, teams are planning to assess the water supply system of Dera Murad Jamali town in Baluchistan and Sukkur in Sindh province, in order to ensure that the public water supply plant undertakes chlorination before it reaches population.

Across Pakistan, MSF is now providing at least 540,000 litres of clean through different fixed and mobile water points including trucks, tanks, tap stands, and house-to-house distribution. MSF is also providing containers and buckets to families who do not have enough water containers. MSF is also helping the local communities to clean up and rehabilitate contaminated wells.

“It’s worrisome that some families with small pumps at home have started using their water source again,” explained Muhammad Shakeel, a member of MSF’s water and sanitation team in Nowshera. "This is not good because the water is still contaminated, and this can lead to many waterborne diseases. We will continue to provide safe water until we can put in place a system to check if the water is good enough for daily use."

Health workers: A vital component

Health promotion workers are playing a crucial role in raising people’s awareness about health risks. For example, during distributions, they show people how to use water purification tablets to obtain safe drinking water at home. Relief packages distributed typically include 20 purification tablets which, when used properly, means that a family of seven can have safe, clean water for two weeks.

For example, in Dera Murad Jamali, Balochistan province, MSF is concerned that, in addition to the current poor hygiene conditions, the already existing malnutrition situation is only getting worse. Consequently, health workers are raising awareness about malnutrition issues, as well as health and hygiene messages. MSF is currently treating at least 300 children under-five years old with severe malnutrition in its already existing emergency feeding program for children under-five in the area.

Boosting mobile clinics and health structures

Since the first of August, MSF has provided more than 16,664 consultations to people affected by the floods in different areas across Pakistan. About half of those consultations were conducted in 14 mobile clinics in remote or highly populated areas of Dera Murad Jamali, Khabula, Sobhatpur, Malakand, Swat, Lower Dir, Charsadda, Sukkur and Peshawar.

Due to the rise in the number of patients with acute watery diarrhoea, MSF has also set up six Diarrhoea Treatment Centres (DTC) in Swat, Lower Dir, Malakand, Hangu, Kot Addu and Dera Murad Jamali. At the same time, human resources, medical and logistics capacities to treat waterborne diseases such as cholera have been significantly increased, and MSF stands ready to open new DTC if there is a need.

In Swat, Khyber Pakhtunkhwa, a 20-bed isolation unit has been established at the hospital in Mingora, including a tent for oral rehydration treatment as well as hygiene promotion. In Dera Murad Jamali, Baluchistan, the team has set up a 20-bed DTC in order to cope with the massive influx of patients from the neighbouring districts which are still flooded. In Kot Addu, Punjab MSF added another 70 beds to the 30-bed DTC to treat more hospitalised patients.

So far, the teams have approximately treated 1,600 cases of acute watery diarrhoea.

Distributions continue

With the threat of new floods still very present, MSF continues to provide affected people with basic necessities in order to help them maintain a minimal standard of living and prevent the spread of diseases. In Baluchistan and Khyber Pakhtunkhwa more than 14,675 relief kits and 4,855 tents have been distributed in the affected areas. A typical kit includes buckets, soap, laundry soap, tooth brush, jerry can, hygiene items for women, towel, plastic mugs, kitchen utensils, plastic sheeting, tents and mattress as well as water purification tablets. In the coming days, as teams assess new locations more relief kits and tents will be provided to those in need.

Since 1988, MSF has been providing medical assistance to Pakistani nationals and Afghan refugees suffering from the effects of armed conflicts, poor access to health care, and natural disasters in Khyber Pakhtunkhwa, the Federally Administered Tribal Areas, Balochistan, and Kashmir. MSF does not accept funding from any government for its work in Pakistan and chooses to rely solely on private donations.