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MSF in Pakistan, 2011
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Insecurity and natural disasters have reduced access to essential healthcare in Pakistan.
At the beginning of 2011, some six months after the floods first hit Pakistan, many people started returning to their homes. Doctors Without Borders/Médecins Sans Frontières (MSF) teams providing medical care and safe water scaled down their activities. In Sindh and Balochistan provinces, where the water was slowest to retreat, the road to recovery remained daunting, and people still lacked food and shelter. For this reason, teams in Dera Murad Jamali, Balochistan province, and Johi and Karachi, Sindh province, continued their activities, running nutrition programs and providing relief and temporary shelters. With the onset of winter in Johi and Jamshoro districts, around 2,000 temporary shelters made of bamboo and plastic sheeting were distributed.
On the outskirts of the city of Karachi, more than 20,000 people were living in camps in unhealthy conditions. To prevent the spread of disease, MSF started running mobile clinics and distributing safe water and emergency relief. After conducting around 21,000 medical consultations, the team handed over medical and water and sanitation services to the Karachi health authorities at the end of May.
In August, weeks of rain once again led to severe flooding, and Sindh was particularly badly hit. In the subdistrict of Tando Bago, land on both sides of the elevated main roads was still under water two months later. From September until November, MSF provided medical care through mobile clinics to displaced families living in camps or on the roadside in Badin and Tharparkar districts. Staff extended the same support to people affected by floods in Moro district.
During the monsoon season, to cope with the increasing number of patients with acute watery diarrhea, MSF opened temporary diarrhea treatment centres in several areas of Khyber Pakhtunkhwa province, and in Kurram Agency in the Federally Administered Tribal Areas (FATA). A total of 9,774 patients were treated.
Although there were periods of respite, the situation in the northern regions of Khyber Pakhtunkhwa and FATA remained tense due to longstanding sectarian violence and fighting between government forces and armed opposition groups. In this context, emergency medical assistance continued to be a key component of MSF’s work. In Khyber Pakhtunkhwa, staff treated thousands of patients in the emergency departments and operating theatres of hospitals in Dargai and Timergara. More than 18,800 patients were treated in the resuscitation room in Timergara, and surgeons performed over 2,000 operations.
Around 70 kilometers (44 mi) from the Afghan border, in Hangu, teams provided lifesaving care in the emergency department of the Tehsil headquarter hospital, where they saw an average of 1,500 patients each month. In the towns of Alizai and Sadda in Kurram Agency, MSF supported local hospitals, providing pediatric care and managing incidents involving large numbers of casualties. MSF also operated an ambulance service, which transferred patients from Kurram and Hangu to Peshawar for further treatment.
In October, after working in the casualty department of the main hospital in Mingora, Swat district, for 18 months, MSF boosted its capacity and handed activities over to the Ministry of Health.
MSF also provided emergency care in the district hospital of Chaman, Balochistan province. Chaman lies on the border with Afghanistan, and Afghans often come in search of medical assistance. MSF treated nearly 9,300 patients in 2011.
In all the hospitals where MSF works, a no-weapons policy is implemented, for the safety of both patients and medical staff. Each hospital is set up to cope with the arrival of a large number of wounded, for example after a traffic accident or bomb blast.
Maternal and child health
Limited access to good-quality emergency obstetric care means women in Pakistan face significant risks during childbirth. In insecure areas, travel restrictions make access even more difficult. In Khyber Pakhtunkhwa province, MSF staff delivered more than 7,000 babies in Dargai and Timergara hospitals.
In May, MSF opened a women’s hospital in Peshawar district. The 30-bed hospital focuses on providing care during complicated pregnancies and births. MSF also supports ante- and postnatal care at clinics run by the local authorities.
In Balochistan, staff deliver comprehensive obstetric care in the district hospitals of Dera Murad Jamali and Chaman. MSF has opened a pediatric hospital in Quetta, the provincial capital. The 50-bed hospital provides free neonatal and paediatric care, and has an inpatient therapeutic feeding center.
In the town of Kuchlak, home to many Afghan migrants and refugees, as well as nomads and a local settled population, MSF runs a mother and child clinic that also contains a birthing unit. Women who require caesarean sections or other specialist medical care are transferred to Quetta hospital.
At the end of 2011, MSF had 1,295 staff in Pakistan. MSF has been working in the country since 1986.