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PublicationsInternational Activity Report 2008PakistanMSF in Pakistan, 2008Field Staff: 478 Reason for Intervention:
MSF Activity Reports on Pakistan: Recent update: All articles on Pakistan » Throughout 2008 there were increasing numbers of attacks on civilians in Pakistan, leading to the displacement of hundreds of thousands of people. People’s overall health and living conditions have greatly deteriorated in a country that already had high infant and maternal mortality rates. Women and children in the rural areas of North West Frontier Province, the Federally Administered Tribal Areas, and Baluchistan are particularly vulnerable due to a shortage of medical staff and unaffordable health services. While needs have increased dramatically, insecurity and targeted attacks on aid workers have made it extremely difficult to provide assistance. In Bajaur Agency, Swat, and Mohmand regions, hundreds were killed or injured in suicide bombings, or by aerial attacks and fighting. Thousands of people have been repeatedly uprooted from their homes. In October, a peak in violence sent an estimated 600,000 people into neighboring regions as well as to Islamabad, Lahore, and Karachi over the course of a few days. Many found refuge in private homes, mosques, schools, and makeshift camps. Doctors Without Borders/Médecins Sans Frontières (MSF) provided basic materials such as food, hygiene kits, shelter items, blankets, and mats. Teams also set up water and sanitation facilities in the camps. Host families took in more than two-thirds of the displaced people. MSF adapted its primary healthcare programs to respond to sharply increasing numbers of victims of violence. Teams provided medical supplies to treat war wounded, assisted in referrals, and, together with local health structures, provided treatment for watery diarrhea caused by the poor quality of the water. As local health clinics began to close due to fears of insecurity, MSF opened mobile clinics in partnership with local providers and established a clearly identifiable ambulance service to bring patients safely to hospitals. During the many curfews imposed by the military, the MSF ambulance was one of the only vehicles allowed to travel around, transporting 700 patients over a five-month period—primarily women in labor and victims of violence. However, in Swat this service was suspended after two MSF staff members were caught in crossfire and killed. Similarly, in Kurram Agency, providing assistance is increasingly difficult due to violence and insecurity caused by armed groups operating in the area. In addition to mother and child healthcare, including obstetric surgery and neonatal services, MSF teams provided emergency supplies during clashes, and non-food items to displaced families. Earthquake responseIn October, the mountainous region of northwestern Baluchistan was hit by a magnitude 6.4 earthquake. Most of the mud-brick houses were destroyed. People were forced to sleep out in the cold due to the damage and fears of aftershocks. The official death toll rose to approximately 300, while 35,000 people were injured and 40,000 left homeless. In addition to emergency medical support and relief supplies, MSF teams also provided mental health care. Treating infectionIn Mansehra district, MSF set up a program to respond to the parasitic infection cutaneous leishmaniasis. MSF teams estimate that in some villages 60 to 70 percent of children are infected. Cases are referred to the hospital in Darband in Mansehra district, where an MSF medical team works in the outpatient department and hospital wards and supports the management of emergency cases. Refuge assistantFurther south, in Baluchistan, MSF assists Afghan refugees by supporting mother and child healthcare in Kuchlak, a town near the capital Quetta. In the border town of Chaman, health agencies are struggling to provide care for city residents, so MSF assists local communities and patients coming from Afghanistan by providing reproductive healthcare, including emergency obstetrics, neonatal services, and nutritional support. In September, MSF was authorized to open new projects in the eastern districts of Jafarabad and Nasirabad following findings of malnutrition. By the end of the year, the feeding program had admitted 1,300 children, and mother and child healthcare was being incorporated into the program. MSF has worked in Pakistan since 2000. |
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