Pakistan: MSF Increases Distributions in Flooded Areas as Worrying Gaps Remain

MSF is scaling up its response in Pakistan as the needs remain immense and the lack of aid delivery in general is cause for concern.

Pakistan 2010 © Jean-Marc Jacobs

A man struggles to move down a flooded street in Nowshera.

Two weeks after the first floods hit Pakistan, the situation remains extremely dire for millions of people. In Khyber Pakhtunkhwa and Baluchistan provinces, MSF is intensifying its activities, remaining focused on medical care, clean water provision, and distributions of essential goods. More assessments are also ongoing in these provinces, as well as in Punjab and Sindh provinces.

MSF teams are providing families affected by the floods with basic items and drinking water, helping them to maintain minimal standard living conditions and to prevent the spread of disease. Though August 10, MSF had distributed kits to 5,143 families?a total of 36,000 people?in Kyber Pakhtunkhwa and Baluchistan. A typical kit contains clothes, soap, a toothbrush, towels, razor blades, a bucket, a jerrycan, blankets, a mosquito net, plastic sheeting, and tarpaulins. But the kits can be modified according to specific needs at local level.

Pakistan 2010 © Ton Koene

An MSF mobile clinic in Utmanzai, near Peshawar.

?Weather permitting, we will distribute thousands of kits this week in Khyber Pakhtunkhwa and Baluchistan,? said Thomas Conan, MSF country representative in Pakistan. ?But we fear that too little is being done for affected families. Two weeks after the first floods, people?s needs are immense and are still increasing. Much more must be done for them.?

During a distribution at the Khurasan camp for Afghan refugees, people from neighboring villages came asking for kits and saying that they had not received any assistance as of yet. MSF was able to help 100 more families than it had planned to, but the general lack of aid is cause for concern.

Finding locations suitable for distributions is a major challenge. Many places are still under water. A site that is dry one day could be underwater the next. Distributions are a complicated logistical exercise involving tons of materials and dozens of trucks; there is little margin for error.

Mobile Clinics and Health Structures

Since August 1, MSF has provided more than 7,000 consultations to people affected by the floods in different areas. Of these, 1,800 were provided through eight mobile clinics travelling to remote areas and to places such as schools or camps where large groups of people are taking shelter.

Three of those mobile clinics are in Baluchistan?in Dera Murad Jamali, Khabula and Sobhatpur?while the other five are in Khyber Pakhtunkhwa, in Malakand, Swat, Lower Dir, and Charsadda, which has two. More mobile clinics will start soon, in Pir Sabak, near Nowshera, and elsewhere.

In Baluchistan, the mobile clinic in Khabula identified four children suffering from severe acute malnutrition; they were later admitted to the clinic in Sobhatpur. ?At this point, we cannot link these cases of malnutrition to the aftermath of the floods,? said Pierluigi Testa, who manages MSF activities in Baluchistan. ?But we will be keeping a close eye on the nutrition issue, as the food situation is worrying, with harvests threatened by flooded fields. Needs in many parts of remain extremely dire.?

Clean Water Desperately Needed

Provision of clean water continues in order to prevent disease. MSF water and sanitation teams are working hard to provide water to communities in places like Charsadda, Nowshera, and Swat, supporting local authorities in order to rehabilitate the existing water delivery systems while trucking in water to families who need it.

Water points have also been set up in Lower Dir and in eight localities in Swat. MSF is providing clean water to district hospitals in Lower Dir and Nowshera as well. Water points will also be installed in Totakan, Isar Baba, and Kalangai in Malakand now that the road there has been cleared.

On August 10, the water and sanitation team in Nowshera finished rehabilitating a borehole and managed to extract and distribute 35,000 liters of water to the community. The daily quantity should increase in the next few days.

In and around Charsadda, MSF is providing clean water through 21 mobile and 7 fixed water points.


Assessments continue each day in Khyber Pakhtunkhwa and Baluchistan to identify pockets of people in need of aid. Additionally, two MSF teams are assessing affected areas in the Punjab and Sindh. MSF is increasingly worried that large numbers of people?both in remote areas and in places that are supposed to be easily accessible?have yet to receive assistance of any kind.

To date, MSF has sent 110 tons of water and sanitation equipment, drugs, and medical and logistical material into Pakistan. More supplies will follow according to the needs identified. More than 100 international staff are currently working alongside 1,200 Pakistanis in MSF programs in Pakistan.