October 18, 2005
Destroyed roads, mountainous terrain, harsh weather conditions, and injured people spread across large swathes of land are all factors making it extremely difficult to reach the tens of thousands of people affected by the October 8 earthquake that devastated Pakistan and parts of Indian-administered Kashmir. Medical and relief supplies have reached only a fraction of the people in need.
When Doctors Without Borders/Médecins Sans Frontières (MSF) medical teams have been able to reach isolated areas the aid workers are finding thousands of people with severe wounds, including fractures, spinal cord injuries, lacerations, and infections. They have found that many health-care structures were destroyed, which makes setting up temporary facilities a critical priority. Tens of thousands of people are sleeping outside with little or no shelter from the cold and rain. And winter is fast approaching in these mountainous areas.
MSF is increasing its aid operations to remote villages that have been cut off by landslides and buckled roads in Pakistan. MSF is currently assisting thousands of people in 16 locations in Pakistan, but many people still remain out of reach and in desperate need of assistance.
MSF medical teams are traveling by helicopter, vehicle, and foot to reach more locations each day. MSF teams are seeing hundreds of patients every day and focusing on treating infected wounds and fractures. The organization also is increasing its capacity to provide surgical care, ability to treats earthquake victims with "crush syndrome" (see last paragraph), and provide mental health support to traumatized people. Distribution of thousands of blankets and shelter items continues while the first winterized tents have arrived in the affected area.
Currently, 120 international staff including doctors, nurses, surgeons, kidney specialists, psychologists, social workers, logisticians, water-and-sanitation experts as well as flight transport specialists together with about 40 local staff are working in MSF's earthquake relief operations in Pakistan. In addition, MSF teams in Indian-administered Kashmir are giving mental health support, provide medical, and logistical items to hospitals and distribute relief goods.
By now, MSF has brought a total of about 400 metric tons of relief goods into Pakistan including medical supplies (emergency medical kits, drugs, surgical material, dressings, plaster, dialysis machines, high-protein food, and oral re-hydration solution), logistical materials (water tanks, pumps and water treatment units), and shelter materials (about 70,000 blankets, 10,000 sleeping mats, and 1,200 winterized tents). Additional relief items such as hygiene and cooking kits are being purchased locally.
ACTIVITIES IN PAKISTAN
In and around Muzaffarabad:
Mobile teams reach out to several villages in a perimeter of about 15 km around Muzaffarabad. Since impassible roads often have blocked access to victims, the three- or four-person teams set out by foot. One team was heading towards Garhi Dopatta, a village that was cut off from medical aid since the earthquake struck, and treated patients there as well as any injured they saw on their way. Yesterday, the team reached Kumikot and found a lot of injured patients without any previous treatment.
MSF also is treating wounded in the village of Rapayan. A helicopter had dropped a medical team in that otherwise inaccessible village on Monday. Charakpura to the south of Muzaffarabad is accessible by road and reached by a mobile team on a daily basis. Mental health support also will be offered to earthquake survivors in Charakpura. In Muzaffarabad, where roughly 1,000 homeless people have gathered in a tented camp in the university campus, MSF offers psychosocial counseling. Since the start of the program on Friday, several hundred survivors have shared their stories with the two MSF mental-health experts during individual or group counseling. MSF distributes thousands of tents, mats, blankets as well as plastic sheeting to the enormous number of people who are sleeping in the open. MSF logisticians improve water-and-sanitation facilities in the campus area as well as in Abbas hospital and by now provide chlorinated drinking water for truck distribution.
Upper Jhelum and Neighboring Valleys
After reinforcement in terms of staff and medical material by helicopter, MSF continues to provide medical care to wounded people in Hattian, and has sent out two nurses and a mental health expert to Goharabad, a settlement on the opposite side of the Jhelum valley.
The team in Lamnian further north continues to treat more than a hundred patients per day in an outpatient facility. The majority of patients have open fractures and necrotic wounds. Some patients have old dressings that require urgent follow up. The severely injured are medically stabilized and evacuated by helicopter. Many people come from surrounding higher areas to receive medical care since MSF is there. Besides medical material such as additional dressings and anesthetics, a helicopter brought an additional thousand blankets to Lamnian, where distribution of relief items is ongoing. Meanwhile, two doctors, one nurse, and a logistician took a helicopter to Kaj Manja further northwest.
In and around Bagh:
MSF teams are treating patients in two outpatient facilities in Bagh. This town, which lies to the southwest of Muzaffarabad, was badly affected by the earthquake and about 90 percent of buildings have been destroyed or severely damaged. Medical capacity in Bagh needs to be increased urgently as it is estimated that the area includes Bagh's population of about 60,000 plus thousands of people living in the densely populated valley. That is why MSF has set up a field hospital on the grounds of the collapsed district hospital. Two huge tents are assembled in order to accommodate outpatient and inpatient departments as well as a surgical unit. Another team provides basic health care in Bir Pani. The devastation in that village about 15 kilometers north of Bagh is enormous.
In and around Mansehra:
To the northeast of Mansehra, two teams of three persons each have treated patients in Kawai and Kargan. Both villages can only be reached by helicopter. A team of six is has set up a health structure in Batagran and started treating patients today. The hospital in Mansehra is considerably damaged and is getting support from an MSF team. Two 80-square meter MSF tents provide cleaner and larger accommodations to patients and relieve pressure from the wards. MSF logisticians are setting up latrines as well as a water system with a total storage capacity of 15,000 liters.
A team of nephrologists (kidney specialists) treats victims with "crush syndrome" in the Pakistan Institute of Medical Sciences (PIMS), Islamabad's major hospital where hundreds of severely injured earthquake victims have been brought. Crush syndrome is a condition in which muscle tissue damaged by severe internal injury can release massive quantities of toxins into the bloodstream and lead to kidney failure. MSF flew in four dialysis machines and medicines needed to treat the syndrome. Left untreated, crush syndrome can be fatal. The pediatric ward, completely overburdened with mainly severely injured patients is getting support from an MSF surgeon, a pediatrician, and a psychologist. Another psychologist is giving psychosocial support to patients that are provisionally accommodated in the dressing rooms of a sports stadium.
ACTIVITIES IN INDIAN-ADMINISTERED KASHMIR
Doctors Without Borders/Médecins Sans Frontières (MSF) teams are continuing to work in Srinagar, Tangdor, and Uri in Indian-administered Kashmir.
Relief in Tangdor
MSF is supporting 3,000 families with tents and other shelter material. MSF aid workers are hiking for two to four hours to reach affected villages. Mobile medical team are providing basic supplies and redressing wounds. Psychosocial teams are doing outreach to communities and offering counseling.
Relief in Uri
MSF is supporting 500 families with tents and other shelter material. One mobile medical team is redressing wounds and performing other consultations while a psychosocial team is visiting communities to access mental health-care needs.
Medical Support in Srinagar Hospitals
MSF has distributed medical supplies including surgical equipment and antibiotics to emergency wards in Srinagar hospitals where the most severely injured were treated.
MSF is continuing to provide psychosocial support to victims of the earthquake including orphans and unaccompanied family members. MSF has provided trauma counseling to 700 injured people in the hospitals in Srinagar through 24-hour counseling activities in the medical wards. In addition to the trauma counseling, MSF has referred orphans to orphanages, helped reunite separated families, and advocated for the establishment of a relief center by the government, which was opened on October 17.
In the total so far, MSF has distributed 10,000 blankets, 10,000 jackets, 13,200 bottles of water, 700 tents, shelter materials for another 700 shelters, kitchen utensils for 3,000 families, and medical and food supplies.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)