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MSF in Pakistan, 2009
Field Staff: 819
Reason for Intervention:
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In 2009 there was a rapid escalation of violence across the country as fighting intensified and attacks on civilian buildings increased. More than two million people have been displaced by the armed conflict in the North West Frontier Province (NWFP) and in the Federally Administered Tribal Areas (FATA). Despite the difficulties, MSF offered free emergency medical and relief services in more than 12 sites in NWFP, FATA and Balochistan province. This included healthcare to people wounded or displaced by fighting, and maternal and child healthcare in some of the poorest areas of the country.
In February, two MSF medical technicians were killed as they travelled in an MSF ambulance on their way to pick up civilians injured in fighting in the Swat District of NWFP. This direct attack and the continuing increase in hostilities in the area led MSF to withdraw from the Swat District. Later in the year, travel restrictions prevented MSF teams from providing medical support to communities displaced by fighting in South Waziristan.
Critical care for those displaced
Local health structures in districts hosting displaced families were overwhelmed by patients, particularly in Mardan where around one million displaced people settled as they fled fighting in Swat. MSF supported referral hospitals, health centers and mobile clinics. In Mardan District alone between June and September, MSF provided emergency medical care to more than 3,200 patients, treated 880 hospitalized patients and provided more than 16,000 consultations. During the cholera season, MSF set up five treatment facilities in the region and treated 4,500 patients. An additional 56,000 medical consultations were carried out throughout the year for displaced people living in Lower Dir, Charsadda and Peshawar.
MSF teams also distributed basic relief items to thousands of displaced families and provided tents, latrines, and water and sanitation facilities to five camps hosting around 23,000 displaced people.
Throughout the year, nearly 5,300 trauma patients were cared for in the emergency room of the main referral hospital of Lower Dir, where MSF teams treat on average 4,000 patients each month. MSF also worked in all departments of Dargai Hospital in Malakand District, where surgical teams carried out more than 880 surgical interventions with Ministry of Health staff. Teams also support Darband rural hospital of Mansehra District and, in June 2009, started providing medical consultations to the neighboring Kala Dhaka tribal area where the parasitic disease cutaneous leishmaniasis is endemic. In Kurram Agency, MSF donated medical material to three hospitals to help treat war-wounded, and carried out more than 2,000 pediatric consultations each month in Alizai and Sadda hospitals.
Improving mother and baby care
Pakistan has one of the highest infant and maternal mortality rates in the region. Women and children tend to be most affected by the shortage of medical staff and unaffordable health services, particularly in remote rural areas. MSF strives to have female medical staff to provide healthcare to women patients in nearly all of its medical activities. In Balochistan in particular, teams have developed an extensive mother-and-child healthcare program. In Kuchlak, Chaman and in the eastern districts of Nasirabad and Jafarabad, teams carried out 18,000 antenatal consultations, helped with 4,000 deliveries and treated nearly 5,000 malnourished children. An additional 110,000 consultations were also carried out.
Woman displaced by fighting in Bajaur
‘My husband was killed in crossfire. I was preparing a meal for him when my neighbor told me that he had died .... I was very worried for my children and wanted to leave but I did not know how or where to go and there was continuous shelling. After a few days one of my neighbors agreed to come with us, so we left home and took nothing except the clothes we were wearing. We walked for a day and a night until we found some families already traveling in trucks. We joined them and reached Peshawar by truck.’
In Pakistan, MSF does not accept funding from any government and relies solely on private donations from the general public to carry out its work.
MSF has worked in Pakistan since 2000.