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MSF Earthquake Relief Operations
November 14, 2005
Distribution of relief goods
Temperatures are dropping and the first snowfalls have been recorded in mountain villages of the region affected by the earthquake. Therefore, the most urgent issue is still to provide shelter to thousands of homeless in remote villages before winter strikes. Doctors Without Borders/Médecins Sans Frontières has already completed the distribution of 4,800 family tents, 61,000 blankets, and 1,300 construction kits–including iron sheets, plastic sheeting, and construction tools–to the survivors of the earthquake in remote areas of Pakistani-administered Kashmir and the country's North- West Frontier Province. Thousands of relief items such as cooking and hygiene kits have been distributed as well. These distributions will continue in the coming weeks, trying to ensure that all families have shelter for the winter.
As the acute phase of emergency is ending and the winter is coming, MSF teams will now focus on ensuring primary health care in areas where the Pakistani health structures have been severely damaged and on improving hygiene conditions in the tented settlements where victims are gathering. MSF's teams carry out hundreds of consultations every day in 12 permanent sites and assess the region to identify new locations where victims of the earthquake are in need of assistance. Cases of respiratory infections, skin infections, and diarrheas, all pathologies related to the poor living conditions of the victims, are increasing. MSF teams have recorded as well a large number of people suffering from chronic disease and are lacking the appropriate treatment. To avoid possible outbreaks, MSF continues to vaccinate children against measles and wounded patients against tetanus. In addition, the organization still provides mental health support to traumatized victims.
Staff and material
More than 140 international staff, including doctors, nurses, surgeons, psychologists, social workers, logisticians, water-and-sanitation experts together with over 350 local staff are working in MSF's earthquake relief operations in Pakistan. The organization has already brought more than 1,000 tons of relief goods into Pakistan including medical items (such as emergency medical kits, drugs, surgical material, dressings, plaster, dialysis machines, high-protein food, oral rehydration solution), logistical material (especially water-and-sanitation material such as tanks, pumps, and water treatment units) and shelter (including winterized tents, blankets and sleeping mats). Additional relief items such as hygiene, cooking, and construction kits are being purchased locally.
In addition, MSF teams in Indian Kashmir give mental health support, provide medical and logistical items to hospitals and distribute relief goods.
DETAIL OF THE OPERATIONS IN PAKISTAN
Distribution of relief goods
MSF is currently distributing family tents, construction kits, blankets, and hygiene and cooking kits to thousands of affected people in Bagh, Muzaffarabad, Mansehra and Batagram districts.
In Muzaffarabad district, 3,400 tents and more than 31,000 blankets have been distributed around the district capital and in the villages of Lamnian, Kai Manja, and Hattian. In addition, 3,000 cooking kits and 6,900 hygiene kits have been distributed in the region.
In Bagh district, 13,000 blankets and 1,300 construction kits–including iron sheets, tools and plastic sheeting–together with cooking and hygiene kits have been distributed in the Badhal and Bedi region.
In Mansehra and Batagram districts, 1,400 tents and 20,000 blankets have been distributed in the areas of Kaghan and Gangwal. In Mansehra town, MSF has carried out targeted distributions of relief kits (tents, blankets, cooking sets, and hygiene sets) to discharged patients of the hospital and their families who wish to return to their home villages. Sixty-eight families have received these kits so far.
Bagh district (452,531 inhabitants):
In Bagh town, MSF has set up a tented medical facility outside the compound of the collapsed district hospital. MSF's structure, made of 25 tents, includes an operating room, laboratory, delivery room, intensive care, emergency room, and an inpatient department with about 40 beds. MSF's activity in the hospital is mainly focused on surgery. So far 71 operations have been performed in this structure. MSF has agreed with the Pakistani Ministry of Health to set up as soon as possible a more permanent hospital, made of containers, with capacity for 70 beds.
Permanent outpatient facilities are running in Bagh town, Bir Pani, and Mallot, where 50 to 100 consultations are carried out every day in each location, and consultations will start this week in Chikhar. Another mobile team goes on a regular basis to the village of Paniali. In the last week, 1,600 children have been vaccinated against measles in Bir Pani and Mallot. Other teams still explore the region to identify new needs.
Muzaffarabad district (894,364 inhabitants):
The organization has set up permanent outpatient facilities for consultations, vaccinations, and referrals in the villages of Saidpur, Kai Manja, Hattian, Lamnian, and Chamukam (near Lipa). In each one of these locations, 50 to 100 consultations, including measles and tetanus vaccinations, are carried out every day.
Mobile medical teams also perform outreach activities in the surroundings of Muzaffarabad, Hattian, and Lamnian by car and from the other sites on foot. Rapid transport in Muzaffarabad district is now facilitated by the use of two MSF helicopters.
Mansehra (1,361,032) and Batagram (319,973) districts:
MSF continues to support the Pakistani staff of Mansehra's damaged district hospital. MSF medical team works in the operating room and in post-operative care. In the dressing tent, an average of 50 patients are attended every day. An MSF physiotherapist, with a team of 8 local staff, has started rehabilitative care for patients who underwent surgery. Next to the hospital, MSF has started to install inflatable tents to set up a hospital facility focusing on surgery, emergency, and intensive care. To accommodate the patients, MSF has set up six tents, filled with 120 patients and some of their relatives.
In association with local organizations, MSF has started to install medical villages inside Mansehra town, with a capacity to accommodate 25 families each. MSF provides the tents, water-and-sanitation equipment, and expertise, and organizes a medical follow-up for patients coming from the hospital.
In Kaghan, 3,500 children have been vaccinated against measles. In this mountain village, MSF team still assists an average of 60 patients per day in an outpatient facility. MSF has stopped working in the village of Gangwal. During the intervention, an average of 40 consultations were carried out every day.
Mental health support
MSF continues to provide mental health care to hundreds of traumatized victims in Muzaffarabad, Mansehra, and Bagh districts.
In Muzaffarabad district, mental health teams, including international and national staff, are working in Hattian and Muzaffarabad town. In Bagh district, a mental health team provides psychosocial support to patients treated in MSF outpatient and inpatient facilities and to their relatives. Community sessions, with the help of local social workers, are organized as well.
In Mansehra, an international staff member and two Pakistanis psychologists are working in a consultation tent, focusing on patients of the hospital.
Water and sanitation
In Muzaffarabad, MSF is following up closely the hygiene conditions in several displaced sites. Water bladders have been set up, 300 latrines installed, and hundreds of hygiene kits distributed in nine tented settlements. Also in the town of Muzaffarabad, MSF supports two truck points with chlorination. In Hattian, the organization ensures water supply to the hospital and performs water-and-sanitation activities to support the town population.
MSF has also set up water supply and sanitation facilities to support Bagh and Mansehra district hospitals.
Several water supply tanks have been installed in Bagh town and water and sanitation facilities established in 5 displaced sites around the city. In Bir Pani, the organization is supervising the operations to repair the water supply system of the village. Similar activities have started in Mallot.