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Pakistan Programme Reports  


6 April 2013 - Pakistan March Humanitariam Summary

Click here to read March's Pakistan Humanitarian Dashboard.

 


 Nov 2012 - AAI and HANDS Pakistan provide emergency shelter to the flood affected families in Jaffarabad Balochistan.

As a result of recent floods and heavy rains, the District of Jaffarabad in Balochistan was significantly impacted, with 80 per cent of the District has been badly affected in four Tehsils - Sohbat pur, Jhatpat, usta Mohammad and Gandakha. Thousands of mud houses have been washed away, leaving tens of thousands of people homeless. Local authorities estimate that this flood has brought losses more in excess of those in the 2010 flood with 61% communities seeking humanitarian assistance. Agricultural and livestock infrastructure has been effectively destroyed with most of the population migrating to safer locations. During the conduct of its assessment, HANDS observed that most of the affected people have no shelter or were living in some kind of temporary shelter at road side. With the support of AAI, HANDS implemented a WASH And Shelter “IDEAS” Program to to assist 100 families of district Jaffarabad by providing emergency shelter.

 

 

 

 

2012 - Flood Emergency Response 

In September 2012 there was a a substantial increase in numbers affected by heavy rains 10 – 15 September. The latest National Disaster Management Agency (NDMA) figures indicate that the floods have affected 4.5m people, caused 370 deaths, injured 1,197 people, damaged 276,000 houses and 767,000 acres of crops, and washed away 7,800 head of cattle. Six districts have been severely affected in the province of Sindh. High levels of standing water remain in five districts of Balochistan and official information on the extent of damages those districts is still unavailable. In Punjab the MIRA team reports that people in the most-affected areas of Rajanpur District are in need of food, emergency shelter, drinking water and health services. There are fears of disease outbreaks in parts of the district and several areas remain inaccessible.

The Government has announced $64m of assistance, initial focus has been food and health support. There is a possibility of further support, including through cash transfers. The Provincial Disaster Management Agency (PDMA) Sindh is distributing food bags to the flood-affected districts every day and are working with clusters  to complete the MIRA exercise. The NDMA has provided 15,000 tents and 25,000 more are on the way to the affected districts.  

AAI has partnered with a local NGO, HANDS, to provide emergency shelter to 100 families in Sindh Province and has healthcare professionals on standby to provide medical support if required. You can read more about our partners work in Sindh Province HERE  


5 January 2012 - AAI Continues to Cooperate With Local Partners in Pakistan in 2011-12.

AAI continues to cooperate with local organisations based in Pakistan’s Sindh and Punjab provinces. After AAI’s response to the humanitarian emergency created by the 2010-11 Pakistan floods, AAI has continued its strong relationship with local partner organisation, the The Hunar Foundation.

The Hunar Foundation is setting the benchmark for vocational training in Pakistan, getting people off the streets and into employment. The Hunar Foundation’s initial model institute is situated in central Karachi with land already donated for a number of subsequent institutes in the Sindh and Punjab provinces, including a women’s institute in Karachi.

                                                                                                                                                                                                                 
  Gordon Willcock, AAI Operations Manager and Mr. Aslam Khaliq, Chairmen of The Hunar Foundation  

“The Hunar Foundation is leading the way in vocational training in Pakistan” commented Gordon Willcock, AAI Operations Manager, after his recent trip to Pakistan. Mr. Willcock went on to say that in “Pakistan there is a large population under the age of thirty and all competing for jobs. Access to good education is not always available and even with education, gaining employment is very difficult. It is for this reason that vocational training is vital for young men and women attempting to find work to support their families.”

                                                                                          
The Hunar Foundation Karachi Campus   The Hunar Foundation Karachi campus is teaching plumbing, electronics and welding

While it is essential to improve access to general education in Pakistan, it is also vital to promote practical vocational training in order to give young people the much needed skills to gain employment. In 2012, AAI will continue to work with The Hunar Foundation. Education in its entirety is a challenge for Pakistan with large numbers of children out of school and even more young adults having very little formal education or training.


1 March 2011 - AAI Successfully Delivers a Comprehensive WASH Program in Sindh Province, Pakistan for the Gottfried Thoma PTC Employees Benevolent Trust

After several months of hard work, AAI successfully completed an integrated Water, Sanitation and Hygiene (WASH) project to the flood affected areas of Jar and Keenjar, located in Sindh Province, on behalf of the Gottfried Thoma PTC Employees Benevolent Trust.

“It is a significant time to complete an important life saving project like this” commented Frank Tyler – Director of Operations for Access Aid International. “World Water Day is just around the corner on 22 March, 2011. This day is an initiative that grew out of the 1992 United Nations Conference on Environment and Development to highlight the importance on improving health of communities through preventative WASH initiatives.” Mr Tyler said.  As this day nears, AAI takes time to recognise the international contributions to improve the quality of people’s lives through WASH efforts and in particular looks at its recent efforts in Pakistan.

As part of the WASH program in Pakistan, AAI installed and refurbished water points in 150 villages. Given the location and difficulty in working in such environments, “this was a significant task” stated John Cindric, AAI’s Field Manager.

Both towns of Jar and Kennjar had flood waters reach as high as 3 meters causing significant damage to homes, livelihoods and destroying agricultural land and the majority of water sources. “The sanitation and hygiene practices in this area were extremely compromised. People do not have access to clean water and the damage from the flooding has destroyed previously existing systems. Countless children are suffering and dying due to the inadequate sanitation and hygiene,” commented Stephanie Cleary, AAI’s Emergency Manager, at the commencement of the emergency response program in Pakistan.

AAI’s water system projects consisted of drilling deep bores to reach clean water or constructing pipelines from distant water sources, connecting to hand pumps and distribution taps, which discharge drinking/potable/water. All bores were lined to prevent the influx of contaminated water and hand pumps were held in place by cement collars. Water was designed to discharge onto cement aprons approximately 3m x 3m or larger. Excess water was channelled away from the apron with drainage into soak pits situated on lower ground.


                                                                 

Newly constructed water pump

  New water pump

Prior to rehabilitating or installing water systems, AAI along with local partners and staff conducted village assessments in order to quantify the need in each community and to ensure water systems were being installed in appropriate locations. AAI engaged each community by having them involved in the monitoring process. This helped to foster transparency as well as reduce mismanagement and corruption.

Alongside the construction of water points, AAI rehabilitated three schools that were rendered unusable from the floods.  At the schools, AAI connected water systems and also re-plastered and painted school buildings, toilets and urinals.

                                                                              
Existing damaged school latrine    

AAI also provided a health and hygiene promotion initiative that was integral to the WASH program. Curative and preventative healthcare was provided to over 3000 people who would have otherwise had little access to health services. AAI concentrated on treating preventative diseases which became prevalent during the disaster and which were greatest cause of illness and death.

                                                                                                                                                                                              
AAI doctor conducting patient consultations   AAI doctor treating an infant at a mobile medical clinic

Whilst conducting health services, AAI delivered health and hygiene education to a number of communities. AAI also distributed hygiene kits, jerry cans, buckets and water purification tablets that enabled communities to have access to safe drinking water immediately.

                                                                                         
Education at hygiene kit distribution                                  Hygiene education session

AAI’s dedicated local and international staff and volunteers including, Field Managers John Cindric and Gavin Humphries, Health Coordinator Penny Sizer, and WASH Coordinator Julius Njoroge were able to manage lifesaving programs in some of the most affected and vulnerable communities. The needs in Pakistan will remain for many years however the integrated WASH program has assisted communities to re-establish their lives in the harsh areas of Sindh, Pakistan.  


4 February 2011 - AAI Rehabilitates a School while delivering WASH programs

In the midst of delivering a comprehensive WASH program in Pakistan, AAI has agreed to assist in the repair of a badly damaged school - Muhamad Samoo Boys School. Two months after the devastating floods, people started to return to flood affected areas however, the boy’s school remained unusable due to significant mud damage and smell. 

AAI has connected a new water hand pump and installed a cement apron to protect the area around the water point.  AAI also re-cemented and painted the school buildings, toilets and urinals. While construction was underway, 13 children continued to attend class. AAI is in the midst of sourcing tables and school supplies through local partners.

AAI is also in the process of rehabilitating Khariu Girls School.  A water hand pump and cement apron has been installed by AAI’s teams and AAI plans to paint the classrooms and refurbish the toilets in coming days. Children from both schools will receive hygiene kits and will be educated about hygiene. 

A gathering of the school children


30 January 2011 - AAI provides fresh water sources to vulnerable communities 

AAI continues to deliver vital Water, Sanitation and Hygiene (WASH) projects in communities that are still suffering from last year’s floods that devastated over 20 million people.  AAI has drilled 148 bores, installed 136 hand pumps and built 36 large cement aprons with drainage to help facilitate suitable hygiene practices.  AAI has focused its efforts in the regions of Jar and Keenjar as flood waters in these areas reached between 6 and 10 feet high causing major damage to homes.  The availability of clean water in Sindh Province in Southern Pakistan has been dangerously scarce since the flood waters destroyed large parts of the country.

Each water point is connected to a hand pump that discharges potable water.  A cement collar secures the hand pump in place. The large cement apron stops the water point from becoming an unhealthy mud pit and provides a clean place for locals to do washing.  Excess water is channelled away from the apron into a soak pit or to low-lying ground.

                                                                                                     

Installation of a hand pump    

 

Mr. Julius Njorge from FOAD Kenya demonstrates a newly installed hand pump                  

In Jar, AAI has had good success and the target of 98 water points has been achieved. In Keenjar, the five drilling teams have had more difficulty due to frequently striking salt water. To overcome this problem, the AAI team has put in pipelines connected to suitable bores. Even with this challenge, AAI will still install the 48 water point facilities that were originally planned.

Throughout this project, local communities have been involved in the installation of the water points.  By making communities aware of AAI’s efforts, AAI hopes to foster a sense of accountability and transparency to improve monitoring and mismanagement as well as reduce bad practice and corruption.  AAI has increased the capacity of local construction teams and all teams must adhere to appropriate construction procedures and accounting protocols.

Alongside this comprehensive water program, AAI is delivering hygiene education as well hygiene kits to families with women and children.  AAI is educating both women and children about the importance of hand washing, disease transmission and how to maintain clean water sources.

AAI has been able to deliver such a remarkable WASH program due to dedicated field teams, including John Cinders from Australia and Julius Njorge who has travelled to Pakistan from Kenya. 

                                                                                                                                                                                                                                                                                  
  Field assistance team including Mr. Wajid Ali, Mr. Fahad Hassan, Mr. Julius Njorge from FOAD Kenya, Mr. Shahzad Ali, Mr. Ghulam  Mujtaba, Mr. Hosh Muhammad, Mr. Muhammad  

 

 


2 January 2011 - AAI In Partnership with The Hunar Foundation

AAI and the Hunar Foundation and other local partner organisations conducted public health operations in the Thatta District as a response to the severe flooding during the months of August and September 2010.

Download the December flood response report. 


1 January 2011 - AAI provides hygiene education and personal hygiene kits to over 550 families over Christmas

Over Christmas, Access Aid International was able to provide education on personal hygiene as well as hygiene kits to more than 550 families in remote villages in southern Pakistan.  In particular AAI prioritized families with pregnant and lactating women.  AAI’s team of Australians and Pakistanis worked tirelessly to assess these communities and distribute the hygiene kits.

                                                       

Children with their hygiene kits

 

Hygiene education session

The kits included toothbrushes and toothpaste, bars of soap, fresh clothes, towels, combs, nail-clippers and other sanitary products.  As the focus was pregnant and lactating women, these items are providing newborn babies the clean environment they need to thrive and mature in.

Though the hygiene kits contents will eventually run out, the education of how and why to use these kits will stay forever. This education plants the seed of an idea and promotes the benefits of a hygienic environment that is essential for human-development. 

                                                                

Bucket and Jerry cans ready for distribution

 

Hygiene kits ready for distribution

 


20 December 2010 - Access Aid International working to address health needs in Sindh Province

The AAI medical team is presently conducting mobile clinics in Kenjer, Sindh Province. 

Once again the medical team was confronted with another seriously ill baby who was 25 days of age. The mother stated that the baby was full term but on appearance, the baby was very small weighing approximately 2kgs, had severe malnutrition and had an abscess or a neural defect on the lower aspect of the spine.

Due to the nature of the baby’s illnesses, the baby required immediate and comprehensive care at a major hospital in Karachi. The AAI team asked the local health care team, who is associated with a major hospital in Karachi, for assistance with the care for this baby.

The family resides in a very poor village and they have no money or means of transport for this young baby. The AAI health care asked the family to take the baby to the local hospital for care especially for treatment of the malnutrition; however, the health requirements are more than what the local hospital can provide. The AAI medical team returned to the village three days later and the baby had died. This heartbreaking story reinforces the ongoing need to support communities such as Kenjer. Young children remain the most vulnerable population and the state of health and welfare in Pakistan must remain at the forefront.

One of the most difficult aspects of providing health care to the most needed population is the lack of resources at the local hospitals and the inability to transfer patients to a large tertiary hospital where all health needs can be met. AAI continues to work with local and international partners to addressing these urgent health needs. 


10 December 2010 - AAI Continues to Provide Essential Services in Sindh, Pakistan.

AAI continues to work with some of the most affected populations in Sindh, Pakistan. AAI is providing essential primary health care to those most in need by conducting mobile clinics as well as delivering Water, Sanitation and Hygiene programs (WASH).

The objective of the AAI WASH program is to deliver safe drinking water to villages in Jar and Kinhjar in Sindh Province. Assessments have been conducted and the needs of the villages established. Villages will have their water sources improved by either providing new equipment such as hand pumps or by rehabilitating existing water sources in order to provide clean drinking water for communities.

                              

Bore hole to be rehabilitated

 

Field inspection by donors, AAI and partners

The drinking water in many villages is the source of disease and by providing clean water, AAI will help reduce the amount of diseases that our medical team’s treat.  As part of the program, AAI will provide hygiene kits to villages where the WASH program is being conducted. Training will be delivered to the villages by community mobilizers who have been trained by the AAI health team. The target population for the hygiene kits are lactating and pregnant women and children of twelve years of age. 

The AAI team is treating a large number of patients with skin disease. The supply of drugs for skin disease is very limited and at the health cluster meeting AAI was able to enlist the help of World Health Organization to meet the demand for drugs.  As well as skin diseases, the AAI team is treating a high number of respiratory and ear conditions.

AAI received a shipment of drugs and clinical supplies from Direct Relief International (DRI) that was used immediately by the health team in the treatment of patients. These drugs have relieved the need to supply drugs from within Pakistan.

The AAI health team will be conducting mobile clinics and providing health education to communities over the Christmas and New Year period. The health needs of the communities are such that the health team does not want to stop the mobile clinics. 

A young girl treated for infected wound


31 November 2010 - AAI In Partnership with The Hunar Foundation

Access Aid International (AAI) – The Hunar Foundation and other local partner organisations conducted public health operations in the Thatta District as a response to the severe flooding during the months of August and September 2010.

The Thatta District was assessed as one of the most affected and needy areas devastated by the flooding which destroyed large areas of the country. AAI has been conducting healthcare outreach, mobile medical clinics and water, sanitation and hygiene (WASH) initiatives with the view of establishing the foundations for a long-term public health project in the area.

The aims of AAI and The Hunar Foundation response are to support existing government institutions and to provide assistance for local health and community workers. These aims are being achieved through the provision of outreach and mobile medical clinics and WASH initiatives.

Download the whole flood response report.


30 November 2010 - AAI delivers essential WASH programs

AAI is delivering a Water, Sanitation and Hygiene (WASH) program at the village level in Sindh, Pakistan. This program will not only improve water security but will also have a tremendous impact on the health of the communities. The program will involve the installation of hand pumps, pipes and tanks as well as a comprehensive education and capacity building component.

Hygiene kits will distributed to pregnant and lactating women in the villages where the WASH programs are established. Hygiene kits will also be distributed to children between the ages of 10-12 yrs. The AAI team has trained community workers who are responsible for mobilising and educating the communities about effective hygiene practices. AAI will conduct regular community follow-ups as well as ongoing monitoring and evaluation to ensure that the programs are effective and the communities are receptive and involved.

Over 18 million people in Pakistan have been affected by the floods; 7 million of which are from Sindh province.  Hygiene and sanitation remains a significant priority as inadequate hygiene practices has led to poor health and disease throughout Sindh province.

AAI is also conducting mobile clinics in the same areas. The health team has encountered many health issues especially chest infections in all age groups and skin diseases in children less than 15 years of age. The clinical presentations were proving to be a challenge to treat due to limited available medications however, thanks to support from long-term partner organisation Direct Relief International (DRI) AAI has received a range of much needed medications. 


12 November 2010 - The AAI team conducts mobile clinics at the village of Rawal Kandra in Jar, Thatta Sindh Province, Pakistan.

The village of Rawal Kandra has had no medical care since the flood hit in September 2010. The village is in a state of disrepair and there are clear signs of where the water had inundated the village. In light of the hardship, the village has a strong community spirit with traditional values that will enable standards to improve over time. The power is in the process of being re-established. At present, wash areas for women are being built and further reconstruction is being undertaken.

On arrival to the village there was an overwhelming sense of willingness from the community to enable the AAI team to commence clinic in an appropriate manner so that the women and children could be seen as well as the men. Due to the community’s lack of previous healthcare, it was apparent that many of the presenting health issues would be beyond the scope and resources of the AAI team.

The complexity of medical presentations was evident when a mother brought her baby to the clinic with severe malnutrition and several other medical problems. The mother was unable to take the child to hospital as her husband was working in the fields and she required his permission to take the baby to hospital. The AAI team will conduct further clinics in the village with the aim to follow up with children such as this one.

During the clinic, a young girl by the name of Naveeda was brought in. Neveeda was only six years of age and was being raised by her grandmother as her mother had past away during childbirth. It was apparent that Naveeda was extremely unwell, she presented with pneumonia as well as a previous brain injury most likely from meningitis that has affected her physical and mental ability from the age of three. Up until the onset of the pneumonia she had been managing to eat soft food but was still severely malnourished. Upon examination, Naveeda was febrile, gasping for air and having clonic seizures. It was apparent that Naveeda required further treatment at a referral hospital. Upon discussion with the family and the AAI team, it was decided to stop clinic and to take Naveeda to the United Arab Emirates (UAE) Field Hospital in Makli. Even though this hospital does not cater for over night stays, it was felt that the initial assessment was vital for continuing care that would be provided at the local hospital.

The initial assessment conducted at the UAE Field Hospital confirmed pneumonia, malaria status was negative and she would need ongoing care for sometime. Treatment commenced at the field hospital, an intravenous line was inserted and intravenous antibiotics as well as a nebulizer of ventolin was administered to help open the airway.

As the UAE is only a field hospital, Naveeda was then transported by the AAI team to the local hospital in Makli. This proved to be a difficult admission to hospital due to the poor relationship the hospital has with the local villages. The doctor in charge was very reluctant to admit the child due to her severe condition which may have resulted in a poor outcome. This could potentially lead to endangerment to the staff at the hospital and damage to the hospital buildings.

The patient was eventually admitted when it was confirmed that the AAI team would take her to the National Institute of Children’s Health (NICH) in Karachi the following day. The condition of the hospital is extremely poor with little or no equipment and the little equipment that does exist is shared between patients. Very little further treatment was administered except the insertion of a nasal cannula for oxygen which only worked occasionally. As the initial treatment had been commenced, the AAI team was comfortable with the plan of action that had been undertaken and felt the patient would be safe for the night.

The following day, the need for long-term care as well as the immediate need for hospitalisation due to the pneumonia was discussed at length with the family. After discussion, it was decided that the patient needed to be transported by the AAI team to the NICH. Upon arrival at the NICH, the patient was further assessed and treatment commenced in a competent and professional manner.

As discussed with the family, treatment would be for one week which would include physiotherapy for her disability. The family was assisted with basic living needs which enabled them to stay with Naveeda while in Karachi.

AAI is working with some of the most affected populations and is providing essential care to those most in need. There is an ongoing need in areas such as Rawal Kandra and AAI requires ongoing international support to be able to continue to provide lifesaving care to children such as Naveeda. 

                                                                                              
Naveeda with her grandmother   This child is maybe one year old

 


31 October 2010 - AAI In Partnership with The Hunar Foundation

Public Healthcare Project in Response to Pakistan Floods

Sindh Province– Thatta District

FLOOD RESPONSE REPORT (October 2010)

Access Aid International (AAI) – The Hunar Foundation and other local partner organisations conducted public health operations in the Thatta District as a response to the severe flooding during the months of August and September 2010.

The Thatta District was assessed as one of the most affected and needy areas devastated by the flooding which destroyed large areas of the country. AAI has been conducting healthcare outreach, mobile medical clinics and water, sanitation and hygiene (WASH) initiatives with the view of establishing the foundations for a long-term public health project in the area.

The aims of AAI and The Hunar Foundation response are to support existing government institutions and to provide assistance for local health and community workers. These aims are being achieved through the provision of outreach and mobile medical clinics and WASH initiatives.

Download the whole flood response report.


21 October 2010 - Josie in Pakistan

Josie Luppi is a first-time volunteer working with AAI on its current Pakistan Operations. Here Josie gives us her impressions of working in this complex and challenging environment.

This is my first time in a Muslim country and all the insecurities and thoughts that I was previously feeling before my arrival have been far from the reality in which I am experiencing now. 

 Arriving in Pakistan as a female has been very overwhelming. Even though I am covered up, the fact that I am a white woman walking in public attracts much attention.  Stares come from every single angle – from men, women and children of all ages.  Having a local guide and two work colleagues with me has certainly made me feel more at ease.

For me, the hardest thing has been identifying when and how much of my arms, face and feet to cover up.  During the clinics I did notice that many stared, some laughed and, for those who had a phone, even took photos.  Despite all of this, most people are grateful for the care that I am providing them. 

There is so much need in Pakistan, and the more I see the more I want to give. This balancing act is no doubt a skill, which can only be learned on the job. I am very grateful for everyone at AAI in giving me the opportunity and support to be part of this experience.  It has been fantastic working with people that are as passionate about humanitarian work as I am.  I have no hesitations in making myself available for future operations with AAI.  


 20 October 2010 - Update

AAI responded to the Pakistan Flood crisis in early September 2010. AAI has focussed on the provision of much needed outreach and mobile medical clinics as well as public health initiatives as part of the initial emergency flood relief in the Sindh province. AAI has treated many people, including eight-year-old Razia.

In mid-October, AAI conducted a clinic in the Jati Union Council of Jati District to treat patients from the Allah Bux Tesn So & Mazdosan Jo Goth Communities. Amongst those treated was Razia, a young girl who was brought to the clinic by her grandmother with a skin infection.

Razia was forced to flee her village in Jati with her family, including her parents, grandmother and seven sisters, when the floods damaged their home – a katcha house, made of straw and mud built around a timber frame. The family found shelter in an Interally Displaced Persons (IDP) camp in Badin along with hundreds of thousands of other people. Whilst there, they lived in a tent with 15 other people and had limited access to any humanitarian aid – including food, clean water and medical care.

Access to medical care is an ongoing issue for Razia and her family. Razia has been chronically sick for a number of years and while she has been to the local hospital in Jati for medical treatment, her condition has never been explained or treated effectively. In remote regions such as Jati, the level of healthcare is very low and patients who are poor have little chance of being appropriately treated. Even though patients may receive prescriptions, the medicines are still costly and therefore not an option for families with low income. This problem could be alleviated in remote communities with a good functioning medical clinic.
 
Before the floods, Razia’s condition meant that should would stay at home with her mother and grandmother and help around the house during the day. As with most girls and women in poor rural areas of Pakistan a large proportion of her time was spent carrying water as the village did not have access to safe water for drinking and cooking. Razia’s condition precluded her from attending school. Fortunately, Razia’s school age sisters were able to attend school before the floods. This has now changed as the school has been damaged. The community has been unable to rebuild the school so that the children can continue their education.

Razia’s Grandmother was very thankful that AAI provided a mobile clinic for their community. Razia and her community were able to have access to medicines and medical staff and receive appropriate treatment for their injuries and illnesses.

AAI will hold regular clinics in the village to ensure the flood-affected communities will have the necessary access to high quality healthcare until the existing healthcare system is functioning once more. AAI will endeavour to rebuild the existing local healthcare system as well as build the capacity of local healthcare workers. This will help to ensure that in the future the level of healthcare will be sufficient so that children like Razia are treated for preventative illnesses, have the opportunity to go to school and have normal, happy lives.


19 October 2010 - AAI Delivers Clinics to the Most Neglected Region in Pakistan

AAI is conducting clinics in the Sub-Districts Surjjawal and Jati of the Thatta District in the Sindh Province. This area is the most neglected and poverty-stricken region of Pakistan . The Sindh province is in the delta region, a desert adjoining the Arabian Sea . Water is available and agriculture occurs due to a complex system of irrigation channels from the IndusRiver as it snakes its way from the glacial north of Pakistan to the Arabian Sea .

The Thatta district is very hot and dry and despite having an irrigation system, safe drinking water remains scarce. Women and children in remote villages spend the majority of their day collecting water.

AAI is conducting mobile medical and outreach clinics for the many thousands of Internally Displaced Persons (IDPs) who are moving back to their destroyed villages. The recent flooding has caused incomprehensible damage and a staggering 20 million people have been affected. The villages are in various states of repair and many communities have received little aid to date. Although the district level hospitals are functioning, their condition is terrible and the level of healthcare provided by government healthcare workers is of a very low standard. Patients have to travel long distances for even the most basic healthcare to only be poorly managed and sent back to their villages with rudimentary or inappropriate treatment.

                                                                                                                         
The AAI team travel by foot to conduct a mobile clinic that is isolated from roads due to flood damage.                A family washes their dishes at the only water source near their village. This water is not safe to drink. 

On average, the outreach team has to travel for 2 hrs to reach isolated villages. Many of the locations can only be reached on foot and the AAI team carry their supplies into location so that they can assess these vulnerable populations. Clinics usually run for approximately 5 hrs, during the clinics AAI triage the severely ill and those requiring urgent medical care. With two doctors, three nurses and support staff AAI can treat over 150 patients per session. The number of patients seen may reduce if cases are complicated and require more time per treatment or if only one doctor is on the team. A considerable amount of time is also spent on health promotion and educating the patients. There are always more patients than the health team can treat within a clinic session however; AAI ensures that all patients are examined by providing regular follow up clinic.AAI is filling the gap through the provision of healthcare to these remote communities. AAI outreach and mobile medical clinics provide curative and preventative healthcare to populations that would otherwise become extremely ill or die from easily treatable and preventative diseases and illnesses. AAI is targeting women, children and their families as part of the AAI public health strategy. As well as providing curative treatment, AAI is concentrating on patient education, which has been lacking in these communities in the past. AAI is providing basic health promotion to ensure patients are equipped with the skills to maintain their health.                                                                                                                      

                                                                               
An eight year old girl brings her malnourished  sister to an AAI clinic for treatment.   Director of Operations - Frank Tyler, cleans a patients wound 

The delivery of such successful and vital clinics has been possible due to AAI's partnerships. With such a complex project, other partner organisation have joined together to share resources to enable AAI to provide the urgent humanitarian relief required. Some supplies and local healthcare staff have been provided by Murshid Hospital in Karachi, support staff and logistic from the local NGO – Search and Relief Services, administrative support from the Hunar Foundation and medical officers from Doctors of the World. Without this combined effort the AAI partnership project would not be able to provide the level of services currently available.The most common presentation during the clinics include water related illnesses including skin infections, diarrhoeal disease, acute respiratory disease and malaria. There is also a high prevalence of underlying diseases including tuberculosis and malnutrition.

More work for the flood affected populations is needed and AAI has committed to remaining in Pakistan as long at there is a need for its services. 


14 October 2010 - AAI moves efforts into the town of Jati, Thatta District, Pakistan.

On the 13 October 2010, AAI in conjunction with partner organisations GlobalMedic, Islamic Help and the Hunar Foundation, visited the town of Jati , which was the last town to be devastated by the floods and where the flood waters have only just receded.

                                                                   

A female patient amongst the filth at the Jetti Hospital

 

A standard bed at the Jetti Hospital

             

A young child seeks treatment for a respiratory infection at the Jetti hospital.

 

Jetta Hosptial Emergency Room

Prior to the flooding, the hospital in Jati was in very poor condition and these conditions have since worsened. Blood, faeces, vomit, urine, sputum and betel nut are smeared on walls and floors throughout the hospital. Furthermore, patients are forced to lie on dirty and soiled foam mattresses with no covers, linen or pillows. On a daily basis, the hospital attends to 150 patients and can accommodate approximately ten inpatients. Although the hospital in Jati does not have surgical facilities, there is a labour room, which is in better condition than the rest of the hospital. However, for the more serious cases, patients are referred to the district hospital in Thatta. 

                                          
The surrounds of the Jetti Hospital   Jetta Hospital Male Ward

At present, AAI is assisting GlobalMedic and the Pakistani Health Department to move one of the GlobalMedic inflatable hospital tents onto the grounds of the hospital in Jati. This will be instrumental in providing the affected population of Jati with a sanitary environment and an improved inpatient facility. GlobalMedic and Islamic Help have agreed to donate a tent hospital to fill the needs in the sub-district, and the hospital will be installed in the coming week.  

                            
     
 

6 October 2010 - Field Assessment Thatta District

The AAI emergency team has established an office and accommodation for staff in Makli village in the Thatta District. On Wednesday 6 October, AAI Field Manager, Gavin Humphries, conducted a number of village assessments to collect information in order to support AAI's water, sanitation, hygiene and health program for displaced persons affected by floodwaters who are returning to surrounding villages.

The assessment was completed in two parts, the primary assessment was escorted by the Thatta District Deputy Coordination Officer, Captain R Anwar. The secondary assessment was conducted in coordination with a gravity fed, temporary water filtration system distribution through Canadian NGO Global Medic, and partner NGO Islamic Help. 

                                                                                
  A common sight from the road in Sarwajal, village. Population from this village remain in IDP camps until flood water recede.  

Local Background

Sarwajal is one of two flood affected areas in the district of Thatta, two and a half hours east by vehicle from Karachi . The district is the final gateway of destruction before flood waters from the Indus Delta flow into the sea just south of the district. The expansive Indus Delta extends for many kilometres, the plains of which are used by locals for agriculture, subsidence farming and survival. Six subdistricts constitute Sarwajal, known as Union Councils, which encompass 425 villages. A small proportion of these remain unusable, some 6 weeks after the height of the flood, albeit receding waters will continue in the ensuing weeks.

Agri/Aqua Culture and Livelihood

It is definitely a challenge for villages to achieve a standard of living given the murky reveal of their villages and crops as receding waters slowly seep into the ground water. The two main crops grown in Thatta district, namely Sugar Cane and Rice, have suffered greatly. Although from the roadsides, there is visual cues of healthy sugar cane crops set amongst ample water in the sweltering heat, we are told that soon these crops will rot out and if not salvaged soon. Rice crops suffered the heaviest of blows, with up to 4 metres of water covering the crops for many weeks, suffocating the plants which are now destroyed.

Aquaculture is also common in Sujjawal, with mixed species fish farms prevalent amongst the population. These farms are held in large ‘ponds' formed by concrete, and of similar size to a 25m swimming pool. With such a large flow of water, fish stocks have now been dispersed widely, as rising water significantly surpassed the height of the storage ponds carrying fish over roads, villages and aqueducts. Net fishing with ‘humanitarian supplied' mosquito nets has taken on new enthusiasm in Sujjawal.

Village Health and Water Access

As IDP camps in the district thin out, returnees to villages are to make the most amongst the damage and destruction left after the wake of flooding. The villages are of a very unhygienic standard, exacerbated by damage to local water sources. 

                                                          
Flood Damage housing and fencing in local Village Sujjawal   Livestock has moved in close proximity to households, increasing to health risks.

Villages received ‘sweet' water from number of sources prior to flooding. Hand pumps were used in some areas, pulling water from deep wells trying to bypass the brackish water only a short way down. Others used the troublesome government program of water ponds, whereby water was routed to flow passively into large concrete ponds some the size of 50meter Olympic pools. Water was pulled by buckets or jugs by village people and carried into their homes by foot, some up to 1 kilometre. These concrete pools or ‘ponds' are open topped, thick with mud and solids, covered with a green algae and scum. Beasts and livestock are able to approach these water ponds and also share the putrid water. Drinking from these ponds without adequate water filtration or treatment has resulted in many accounts of adult diarrhoea related illness, infant and child mortality and morbidity.

                                                                                                                                            
Government Scheme ‘Ponds', open topped stagnant water for long periods, accessible to livestock.   Water Pond close up.

Shelters and housing amongst villages is one of either stone / masonry (locally known as Pacca), or more commonly constructed of local brushwood for walls and roofs, packed with mud and dung (Katcha) for sealing. The high water marks are evident on most houses, with the exterior mud base washed away by flood waters, some up to 2 meters in height. This flood affect reveals the skeleton thin brush wood walls, heightening the threat to village populations for malaria. These thinned walls are easily penetrated by mosquitos.

High water mark self-evident, very common amongst this construction style.

The village assessment exposed key areas for AAI's WASH and Health program to fill the gaps between the emergent need for treated water and a more sustainable solution in the coming months.

Gavin Humphries - Field Manager, Thatta, Pakistan. 


23 Sep 2010 - Relief Response to the Pakistan Floods

Access Aid International (AAI) is a non-profit, non-government organisation committed to mitigating the double burden of poverty and poor access to quality health care in regions where health systems have either collapsed or are in crisis through the provision of emergency medical care, general and public health services and capacity building.

Over the course of the 2010 monsoon season, Pakistan experienced the worst floods in its history. Heavy rainfall, flash floods and riverine floods combined to create a moving body of water equal in dimension to the land mass of the United Kingdom.

                                                

AAI Frank Tyler offering a helping hand to one of the vulunerable IDPs

  AAI Program Manager, Steph Cleary investigating child protection issues in an IDP camp

The floods have affected more than 20 million people – one-tenth of Pakistan's population – devastating villages from the Himalayas to the Arabian Sea. More than 1,700 men, women and children have lost their lives, at least 1.8 million homes have been damaged or destroyed and more than 10 million people are currently living without shelter . In addition to a rising number of deaths, injuries and displacements, there is major damage to roads, bridges, infrastructure and livelihoods. 

The most urgent needs of the population are food, clean drinking water, emergency shelter, medical care and non-food-items . However, access continues to be a serious challenge hampering relief efforts, especially in the lower Sindh district as flooding continues to occur around MancharLake.

Latest figures from provincial authorities in Sindh, where AAI are concentrating efforts - indicate that there are almost 1.5 million people in 4,200 relief camps in the province. 

                                                   
IDPs in make shift shelters   IDPs living amongst the rubbish on the road side

The floods in the Thatta District of Sindh have caused large movements of population in the area and hundreds of thousands of people have moved from their villages to seek refuge in the higher area of the district. As the water in some areas start to recede, affected persons are beginning to return to areas that have been largely damaged and lack any functioning infrastructure.

The needs of Internally Displaced People (IPDs) and returnees in this district are urgent and considerable as many people had to evacuate from their villages rapidly and therefore have little or nothing that they own and can use. Their lives are literally dependent on the humanitarian response, and at this point in time, the response has many areas in which it could be strengthened.

Public health is also of major concern, due to the lack of usable and safe water, minimal latrines to service the IDP camps and a poor hygiene practices in the camps. 

                                                             
IDPs living under sheeting as their only shelter   IDPs using branches and rags to provide shelter. They have no tents or basic facilities

Representatives from AAI have been coordinating with the local officials to determine priority areas of need of the affected people in the district. Rapid assessments by AAI have highlighted a high potential for diseases outbreaks of epidemic potential. 


22 Sep 2010 -  AAI has been working closely with the United Nation (UN) coordination networks - including coordination with the newly UN Hub in Hyderabad - and local partners to provide disaster management expertise in areas health, water, sanitation and hygiene. 

AAI has moved its Disaster Response and Assessment Team (DART) to the Sindh Province and has undertaken the necessary assessments in lower Sindh area to enable it to commence operations targeted to those most in need. Part of the initial assessment included gathering information from local partner organisations. AAI is concentrating program activities on supporting local partners and providing support in the areas of greater public health.

                                                                                                                                                                                       
Man made river banks, the last line of defence from flooding. This village was saved however, it has been built in the flood plain.   The only type of shelter for this IDP family.

AAI has identified a number of priority projects and are assembling an international and local emergency healthcare team that will operate a field primary healthcare facility with a concentration on providing diarrhoeal treatment for expected outbreaks of infection diarrhoeal diseases, due to the lack of water for the affected populations.

AAI will use this as a platform for launching community healthcare, water, sanitation and hygiene initiatives, nutrition and emergency programs. The aim of these operations is to lead emergency interventions into longer term recovery programs which will also include, capacity building of local non-government organisations, healthcare workers, community volunteers, teachers and other community leaders, through training, equipping, resupplying, Disaster Risk Reduction (DRR) initiatives, and reconstruction of health and educational facilities.

AAI adopts an integrated approach or “survival strategy” combining Water, Sanitation and Hygiene (WASH), health and nutrition. This ensures an integrated approach to its emergency response to minimise gaps in the provision of essential services and to ensure people that wherever possible a continuum of care is afforded to those in need. 

AAI will focus on addressing the factors that contribute to the main mortality risks - acute diarrhoea, acute respiratory infections, malaria, measles, malnutrition, and maternal and neo-natal mortality/morbidity, building capacity and effecting behavioural change – having this approach is fundamental to achieving the desire humanitarian outcomes for vulnerable and IDP in Pakistan. 


19 Sep 2010 - Access Aid International (AAI) the day of 18 September at the Internally Displaced People (IDP) camps and medical facilities in Thutta, South East of Karachi.

About 400,000 people in the Sindh district have been displaced due to the flooding from the Indus River. Conditions are very difficult in the camps due to the relentless heat, lack of easy access to safe water and an astonishing lack of basic sanitation facilities being available.

                                                          
A field hospital established by the UAE in the IDP camps in Thatta   A IDP woman collects water while contaminating water through lack of knowledge re hygiene practices

AAI staff met with the local government coordinator, who stated that 60 latrines have been established to date – over 10,000 are required.

                                                                               
A map depicting the progress of the flooding throughout the district   Frank (AAI) and two boys at the IDP camp

Basic shelter has been provided to pockets of IDP, however many still remain without tents. The high number of children that are located in the camps do not have organised activities in which to engage, nor do they have access to educational sessions or materials. 

                                          
Frank (AAI) with the Administrator of the Murshid Hospital   Frank and Stephanie with government officials from the district of Thatta

AAI are working with its local partners providing technical disaster management expertise to increase their capacity to ensure services to IDP populations are targeted and effective. 

                                                                                                                 
Frank and Stephanie with village children   From left: Suzanne (a NZ volunteer nurse), Stephanie (AAI) and Frank (AAI) at the IDP health clinic

17 Sep 2010 - Access Aid International visits the Sindh Government Polytechnical College - a makeshift IDP Camp

Frank Tyler and Stephanie Cleary of AAI visited the Sindh Government's Polytechnical College, which is currently operating as a make-shift IDP camp. Students attending the Polytechnical College have not been able to continue studies since the floods as it is now required to houses the IDPs.

                                         
IDPs lacking basic shelter facilities   Medical supplies at the Sindh Government Polytechnical School IDP Camp

AAI visited the IDP camp on Thursday to determine the level of support that it could provide through its partners and directly to support camp operations. 

                                             

Mother and children waiting for nurse to treat child 

  Stephanie (AAI) is introduced to the baby girl born at the IDP camp one week ago

The IDP camp houses about 4000 people with about 2300 of those being children. Clean running water has been installed to ensure coverage for the daily needs of the IDPs.

                                                       
Farms affected by the floods    Floods impact local village affecting thousands

With the incidence of watery diarrhoea, acute respiratory disease, malaria and maternal childhood health illnesses continuing to be on the rise, AAI will continue to work with partners and the current camp coordinators to ensure there is access to healthcare to the incidence of disease post flood.  

                                              
Make-shift IDP Camp   Safe drinking water being delivered to a displaced persons camp

 


10 Sep 2010 - AAI welcomes the support of ordinary citizens in flood ravaged Pakistan

As Access Aid International staff in Pakistan continue their tireless work, Frank Tyler, Director of Operations, welcomed the support of ordinary Pakistanis in the massive effort to provide aid to the millions of people suffering after the worst floods in over 80 years. 

                       
A family displaced from the floods   Brother and sister making their way across the IDP camp

As floods continue to inundate several towns in Victoria, Australia, Mr Tyler urged Australians not to forget the 21 million displaced people in Pakistan who were already suffering from a long running insurgency and severe economic difficulties.  Even though the floods in some parts of  Pakistan have begun to recede, huge bodies of water remain, adding to the contamination of traditional water sources.  The number of casualties from the flooding continues to rise each day as more people present to make-shift clinics suffering from malnutrition, skin diseases, acute diarrhoea and respiratory infections. 

                            
Child in IDP camp   Children make the most of what little they have at the IDP camp

The large amount of water still remaining in Punjab and  Sindh Provinces  is hampering relief operations and slowing desperately needed recovery.  The World Health Organisation has warned that if water and sanitation provision is not immediate provided to the displaced population in  Pakistan , an additional six million people may suffer from life threatening diarrhoeal related diseases. 

                                              
Distributing food for dinner   IDPs waiting on relief goods

AAI's Special Assistant to Pakistan , Stephanie Cleary, has encouraged those people who have already been generous to be more so, and those who have not yet provided donations to this appeal to dig deep.  “This is an essential and worthwhile mission we are on and the scale and calamity is unbelievable” Stephanie, an experienced humanitarian, said. 

                                                          

One of the planned IDP camps 

  People gather to collect fresh water

The support that AAI has received from its local partners and friends in  Pakistan  has been tremendous. It is estimated that Pakistan will need international assistance to recover from these floods for several years.  With bridges, roads, crops and homes completely destroyed by the deluge, so many people have been left stranded, hungry and in desperate need of help.


9 Sep 2010 - Access Aid International Humanitarian Response

With the emergency continuing to unfold in Sindh, the southern most province of Pakistan, the number of people reported as having been directly affected by the floods has reached close to 21million. The death toll has risen to 1,752 and over 1.8 million houses now being reported as either damaged or destroyed. In Sindh alone, just under 7 million people have been affected, of which 1.3 million people are in government relief camps.

Access Aid International (AAI) has dispatched its initial emergency team to Pakistan. Road access to and within districts continues to be problematic. Significant needs are evident in shelter, water, health, sanitation and hygiene. It is apparent that funding continues to be the largest constraint for AAI and we would appreciate any financial support that you can provide to assist us to scale up our response to the immense humanitarian disaster. 


28 August 2010 - Flood-affected children face life saving race

The death toll from the floods in Pakistan that were caused  by uncommonly heavy monsoon rains a month ago, is expected to rise a member of the Pakistan Government has said.  There are now 72,000 children affected by severe malnutrition in flood-hit areas who are at a very real risk of death if life-saving treatment is not immediately provided.

As the  Indus   River  threatens to burst its banks in  Sindh   Province  in  Southern Pakistan, authorities have ordered the evacuation of another three towns and 400,000 people.  Singh has been particularly hard-hit with 19 of its 23 districts despoiled by floods.

New estimates put the scale of destruction at previously unseen levels with estimated repair times measured in decades. Hospitals, schools, roads, bridges and communications infrastructure has been destroyed in at least 20 percent of the country. Approximately 10,000 kilometres of roads and railways have been wrecked by the floods.  New estimates put the country's repair bill in excess of $7 million.  Every bridge in the mountainous  KPK   Province  destroyed.  The famous  Karakoram Highway  that stretches along cliffs all the way from the Himalayas to  Islamabad  is now impassable with large areas of road now missing as cliffs crumbled under the force of raging water.  Officials believe the road will be closed for years.

The intergovernmental International Organisation for Migration (IOM) estimates that 4.5 million people still require emergency shelter.

Although aid has begun to arrive in the country and humanitarian organisations continue their life-saving work, it is believed that hundreds of thousands of people will not receive the required assistance due to the scale and geographic size of this disaster.

Access Aid International continues to work with its local and international partners. 


22 August 2010 - Six million people in need of emergency food aid

As the crop-planting season rapidly approaches, it is becoming apparent that the impact of this disaster may become catastrophic as livelihoods and food security is threatened.  Ongoing analysis reveals that 7.9 million acres of crops have been lost across Pakistan .  A total of 71 percent of rice crops, 59 percent of vegetable crops and 45 percent of maize crops are now destroyed.  With farmers unlikely to be able to plant next season's crops and unable to salvage this season's, at least 6 million people will require ongoing assistance and emergency food aid for the next two years.

In the western part of  Pakistan , relief operations have continued in challenging situations.  Helicopters are increasingly finding it difficult to find suitable places to land, forcing them to drop their relief supplies from the air. This is creating secondary problems with some supplies landing in deep water and hovering helicopters creating dangerous situations, with two women killed on the weekend after a wall collapsed on them while a helicopter was hovering near by. 

Thousands of people still remain isolated by deep water and many towns are cut-off from assistance; now facing shortages of food, clean water and medical supplies.  In the West, hospitals, rural health centres and government offices remain submerged by flood waters.

Even in Khyber Pakhtunkhwa (KPK), where the response has been quicker, gaps are still significant.  Road access continues to be a challenge in many parts of KPK.  Some aid groups are also reporting that the security situation is restricting their humanitarian activities.

In  Punjab  and Sindh, greater assistance is still required.  Vast populations, spread over large geographical areas are making relief operations more difficult than usual. The head of the disaster management authority in  Sindh   Province  has said that a further 200,000 people were forced to relocate over the weekend as flood waters continued to rise.  The northern parts of Sindh have been underwater for over a week.

  

Recent imagery shows increasing damage from floods in  Balochistan Province .  The United Nations' High Commission for Refugees has already established five refugee camps in main cities.

Resuming education remains difficult with nearly 5,000 schools damaged or destroyed by the disaster and another 5,000 schools inhabited by an estimated half a million people. Unsanitary conditions and crowded living spaces are impacted by dirty water and a summer heat that is contributing to what is proving to be ideal conditions for disease.

The Australian Government has deployed a military contingent of medical and health personnel to flood ravaged  Pakistan .  The group will assist with efforts to assist the increasing health disaster in  Punjab Province .  There are approximately 800,000 people living in the area where the military will set-up their base.


18 August 2010 - United Nations urges greater assistance from the international community.

"I am here to urge the world to step up their generous support for Pakistan," said United Nations’ Secretary General Ban Ki-moon during a news conference after he visited flood affected areas in Pakistan. "This disaster is far from over. The rains are still falling and could continue for weeks”. 

Agriculture, which is a significant part of Pakistan’s economy, has suffered greatly from these floods with wheat, cotton and sugar crops affected. Nearly 20 percent of the cultivatable areas have so far been damaged or lost across Khyber Pakhtunkhwa (KPK), Baluchistan, Punjab and Sindh provinces. Many farmers have also lost their entire poultry stocks, with others reporting a total of over 200,000 livestock lost in recent weeks. In KPK alone, there are now 725,000 animals requiring emergency veterinary assistance and feed.

Recent estimates put the total number of houses significantly damaged or destroyed at 893,000. Prime Minister Gilani has said that the floods were a bigger crisis than the 2005 earthquake that killed almost 80,000 people. Visa restrictions have been eased for humanitarian workers, who can now obtain visas on arrival in Pakistan.

With river levels continuing to fluctuate, rains in many parts of the country are continuing, with KPK in the north of country still reporting fresh floods. The UN Office of Coordination for Humanitarian Affairs has indicated that 660,000 people remain marooned by flood waters in KPK and in need of assistance. The situation in Sindh Province is also deteriorating with many parts of the Province still under water. Many parts of Punjab, Sindh and KPK have no access to clean water and are in need of purification equipment, hygiene kits and food and non-food items. There are now 350,000 people in emergency centres requiring assistance from the humanitarian community. 

The United Nations estimates that up to 3.5 million children are at a significant risk of contracting lethal water-borne diseases such as watery diarrhoea and dysentery. The most recent disease surveillance data indicates that the most prominent medical conditions are skin diseases (113,045 cases), acute watery diarrhoea (86,671 cases) and respiratory tract infections (83,050 cases).


16 August 2010 - Pakistanis struggle to cope as the holy month of Ramadan begins

Ramadan, the holy month when Muslims abstain from food and drink from dawn to dusk, began last week. Although the tragedy of the ongoing disaster is almost unimaginable, most people in Pakistan will continue to observe the fasting period. The daily fast is usually ended at dusk with a family celebration where food is shared with friends and family. This Ramadan though, many families will be challenged to find enough food to feed their entire family. Ramadan traditionally ends with the Eid al-Fitr festival, which is the most joyous holiday in the Muslim calendar. With between 6 and 7 million people in need of food, and 2 million people homeless, this important Muslim celebration may be much less joyous this year.  

Large parts of the country continue to be inaccessible by road and have only received limited humanitarian assistance so far. The World Food Program is providing food to many people in remote and mountainous parts of the country on the backs of mules. Helicopters are regularly unable to fly as conditions continue to hamper relief efforts. Last week, the UN launched its appeal for US$459 million to help the victims of the floods. Less than 10 percent of that has been met by international donors so far.

The UN stated that, “There could be a second wave of deaths due to water-borne diseases if we don't act fast enough to provide safe drinking water”. Water borne and other related diseases such as diarrhoea, malaria, dengue fever and skin infections are likely to flourish as crowded and unsanitary conditions become more common as people struggle to cope with the disaster. For the first two weeks of the crisis, the most common diseases were scabies, respiratory tract infections and at least 36,000 reported cases of potentially fatal acute watery diarrhoea.  

Compounding the problem of this disaster is that over 50 health facilities have been completely destroyed and nearly 90 have been significantly damaged in the north and west of the country.

As with so many disasters, school children will continue to face the brunt, as they experience not only the physical challenges of survival, but the lack of access to proper education. In the Northern Province of Kyber Pakhtunkhwa (KPK), over 700 schools have been damaged and a remaining 900 schools are now being used as temporary accommodation for stranded families.

The long term predicament is dire. Millions of acres of crops have been destroyed and seed stocks ruined. Next season's crops are meant to be planted in less than one month, with much of KPK, Punjab and Sindh Provinces still under water.

The United Nation's Office of Coordination for Humanitarian Affairs has now established a national coordination centre that is hosting cluster meetings every second day in Islamabad and remote coordination hubs at Peshawar in PKP, Multan in Punjab and Sukkur in Sindh.  


15 August 2010 - Millions of people living in tents after devastating Pakistan floods

Pakistan hasn't seen floods of this ferocity for nearly a century. The impact has been devastating across the country with Khyber Pakhtunkhwa Province being the worst affected. According to the United Nations, 18 million people have been affected by these floods so far.

Hundreds of villages have been swept away in Khyber Pakhtunkhwa and Punjab , while Sindh, which has seen so little water for several years, is now suffering from a deluge. Millions of refugees who have left their flooded and severely damaged homes, now live in tents made of plastic and sheets. Villages weren't the only places destroyed –several major cities, dams and bridges have also been ruined.  

A total of 66 districts have been affected by floods throughout the country. Major damage includes the destruction of roads, telecommunications, bridges, civic structures, water and sanitation facilities, houses, markets, shops, and essential crops. Scores of families have been left with no where to live and no employment; life has come to a desperate standstill for millions of people.

The potential for water borne diseases is high among flood victims, particularly amongst the children. They need clean drinking water and food, medicines, tents and blankets.

Mr Azhar Ul Islam

Pakistan


11 August 2010 - The plight of children plummets as sanitation conditions deteriorate

As  Pakistan 's Flood Commission continues to respond to the devastation across nearly the entirety of Pakistan , it is estimated that approximately 14 million people are now in need of humanitarian assistance. Across large areas of Pakistan , the worst monsoon rains in memory have destroyed entire villages and devastated scores of communities. Due to continuing bad weather, many villages remain inaccessible and without clean food or drinking water.

Children are always among the most vulnerable during emergencies and this disaster is proving to be no different. With many reported cases of diarrhea, compounded by a lack of nutrition and exposure to extreme weather conditions, concern is rising for the plight of hundreds of thousands of children.  

There is a lack of sanitation facilities in much of the affected areas as government departments and aid agencies race to provide assistance. Many health posts have also been destroyed, removing the limited health care that many people relied on. Remote communities, cut off by destroyed bridges, damaged roads and swollen rivers, now face a complicated future.

Pakistan 's Flood Commission has reported that more than 14,000 cattle have perished in the last 11 days and 2.6 million acres of cropland are now under water.  So far, about 1600 deaths have been confirmed, but this figure is expected to rise.

Mr Azhar Ul Islam - Pakistan 


9 August 2010 - Monsoonal Floods Devastate Pakistan

Unusually heavy monsoonal rains in Central Asia have created a new humanitarian disaster in Pakistan . The United Nations has already said the size and scope of this disaster dwarfs the 2004 Boxing Day Tsunami that affected much of Asia .

Heavy rain in the Northern Pakistan Provinces of Khyber-Pakhtunkhwa and Baluchistan has caused flooding and damage to the houses of over 2 million people. The death toll currently stands at 1,600 with an estimated 4.5 million people affected. As the flood waters flow south Punjab and Sind Provinces increased damage is being reported and the need for humanitarian assistance increases.

The floods, which are the worst in over a generation, are now complicated by associated mudslides which have cut off thousands of people from urgently needed relief supplies and assistance. Continued rain and low cloud cover has meant that helicopters are unable to perform their essential work of delivering supplies and rescuing the now 2 millions homeless. It is anticipated that more than 13 million people will be affected by this disaster as heavy rain continues to fall throughout the country.

Mules and navy boats are now the primary vehicles for delivering aid to victims of this disaster which stretches for over 1,000km.

The WFP has provided food assistance to 13,000 families as it continues to conduct assessments throughout the region. The Government of Pakistan has urgently requested emergency shelter, drinking water and filtration systems, blankets, hygiene kits and non-perishable food to assist with the disaster response.

Access Aid International continues to remain abreast of the situation and in contact with its regional partners. 


23 May 2010 - AAI Staff Awarded Humanitarian Overseas Service Medal Awarded for Services during the Southern Asian Earthquake.

AAI was one of the first humanitarian organisations to reach some of the most devastated villages in Pakistan . AAI provided immediate emergency medical care, urgent immunisations, emergency shelters and distributed relief goods to thousands of affected individuals. After the initial emergency, AAI remained in location and developed longer term projects to aid the many millions who had been affected and displaced. Recovery projects included public health initiatives, training of maternal and community health workers, reconstruction and water, sanitation and hygiene improvements.

AAI award recipients were presented with their Humanitarian Overseas Service Medal during a small awards service led by Director of Operations, Mr Frank Tyler. Mr Tyler, a previous Humanitarian Overseas Service Medal holder himself, for his services in Northern Iraq in the early 90's, told staff that “whilst AAI likes to complete difficult work and assist people in peril in severe environments without recognition, it is always fulfilling to know that the Australian Government is aware of what small organisations such as AAI can do to provide humanitarian assistance on the international stage .”

Access Aid International is an international non-profit, non-government organisation that is committed to mitigating the double burden of poverty and poor access to quality health care in regions where local systems have either collapsed or are in crisis. This is achieved through the provision of emergency medicine, community and public health care, capacity building and other humanitarian initiatives. AAI is run by a group of like-minded and highly experienced humanitarian aid workers and volunteers who have been committed to responding to international disasters for many years. AAI has been able to provide outstanding programs due to its exceptional volunteers from all around the world.

AAI's comprehensive response in Kashmir , Pakistan came with challenges however this award recognizes the positive impact AAI had during such a devastating time. “The Humanitarian Overseas Service Medal solidifies AAI as a serious contributor when it comes to humanitarian disaster response,” said Mr. Tyler. AAI is dedicated to providing humanitarian assistance during times of disaster and crisis and AAI will continue to provide high quality programs well into the future.

Read more about the Humanitarian Overseas Medal Medal. 

 

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