Pakistan: Trying to Meet the Needs of the Displaced

“Although they are afraid, they are waiting for just one thing - to go back home.”

In August, 200,000 people fled fighting in the tribal area of Bajaur Agency, in the northwestern region of the country. Fabien Schneider, head of mission for Doctors Without Borders/Médecins Sans Frontières (MSF)in Pakistan, describes the situation.

What is the current situation in the country’s northwestern regions?

In just a few days hundreds of thousands of people fled fighting that broke out in the tribal area of Bajaur Agency, where land and air attacks targeted inhabited regions. The terrorized population fled the region en masse. In the camps we visited, we were told about bombings and people who died. Most of those who fled were unable to bring anything with them. Although they are afraid, they are waiting for just one thing - to go back home. Part of the population returned to their homes at the end of August, but most were forced to flee again as violence continued.

Today, the number of people who fled Bajaur Agency and the Swat region is estimated at around 350,000 though figures vary. Many of these displaced persons are in Lower Dir, in the Malakand region, Mardan, Charsadda district and Peshawar. Mosques and schools across the region have been converted into shelters. However, 75 percent of the displaced persons are living in private homes, which constitute a considerable burden for their hosts, some of whom are very poor. Little, if any, of the necessary aid reaches them.

What are conditions like for people who have fled the violence?

Conditions in the camps vary. Local and international organizations, the Pakistani government and political and religious groups mobilized quickly. However, initial aid efforts are starting to flag and with the arrival of new displaced persons, the camps have filled quickly. As a result, some camps are less well-organized than others and water and sanitation needs are only partially met, if at all. Rampant diarrhea is a real concern. For this reason improving access to water and proper sanitation is a priority for us.

The authorities are considering opening camps that were previously used to house Afghan refugees and making them available to Pakistanis displaced by violence. There may be more displaced persons coming from Mohmand Agency and Bajaur, but also from the Swat region. We are ready to assist them if the security situation allows.

What has MSF done to launch its operations?

In late August, we went to Charsadda, where 750 families had taken refuge in host homes and another 150 families were staying in a school. We kept seeing pick-up trucks arriving with more displaced persons. Today, nearly 600 families have taken refuge in the school. Tents were distributed, but installed haphazardly leaving little room in the camp, people have no room to cook and no way to store water. Many were sleeping on the ground, without blankets. The extreme crowding and lack of privacy also poses a problem, particularly for women. The water and sanitation situation there was a catastrophe. Fifty-three percent of camp residents who sought medical care complained of watery diarrhea.

To meet the needs of the displaced persons, we provided access to drinking water and set up toilets and showers. We distributed hygiene kits, blankets and plastic sheeting. While primarily health care consultations are carried out by health authorities and a local organizations, we’re supporting them by treating people with diarrhea. Now that the water system has been set up, the number of cases of diarrhea has fallen in recent days.

Similar interventions have been carried out by other MSF teams for the displaced in Mardan and in Lower dir.

What is the security situation for humanitarian aid workers?

The violence extends from the West towards the East, with fighting, killings, attacks and kidnappings throughout the North West Frontier Province (NWFP) of northern Pakistan. NGO members are targeted and threatened with kidnapping. In the last three weeks, four members of local NGOs were kidnapped in Shapqadar, a city only 20 minutes away by car from Peshawar and a few minutes from Charsadda. In some areas, such as Lower Dir, MSF has been unable to send foreign workers due to security threats on foreigners, so teams are composed solely of Pakistani staff.

Aid in overall terms is seen as part of a political and strategic game. We must emphasize our independence and ask the actors in the field to help us obtain access to populations in need. We have to learn more about the context, improve our responsiveness and strengthen our teams by adding experienced staff so that we can do a better job in this region.