Pigeons take flight amid buildings fallen to earth in the northwest Indian town of Bhauchau, the epicenter of the earthquake that took 20,000 lives in January 2001.
The earthquake occurred only a week after another major earthquake halfway around the globe in El Salvador. MSF, already present in India with projects in Mumbai and the state of Jammu and Kashmir, dispatched additional staff and relief supplies to the country, and a two-month emergency intervention began.
MSF flew in 18 volunteers and sent nearly 50 aid flights in the first month of intervention, with efforts focused on caring for survivors and providing relief items such as clean water, blankets, and tents. See box on page 80 for more on MSF aid to earthquake victims in India, El Salvador, and Peru, struck by an earthquake in June.
In the state of Jammu and Kashmir, the health problems addressed by MSF result not from nature, but from man. The region is disputed by India and Pakistan and has long been the site of conflict. Years of strife and social upheaval have left a legacy of depression, post-traumatic stress disorders, and social problems such as domestic violence and substance abuse. Health services have crumbled.
MSF established a presence in the area in 2000, with financial and technical aid to the Voluntary Health Association, an Indian NGO working to improve primary care in isolated areas of the Kashmir valley. This work has now been extended to training and support of local mental health counselors.
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In the city of Mumbai, MSF works within the Revised National Tuberculosis Control Program, which is based on the Directly Observed Treatment Short Course (DOTS) strategy. MSF's pilot project targets about 600,000 people in the southern part of the city. The program focuses on raising the level of microscopy, improving patient care, and involving the private sector in the national control program. MSF holds training workshops in communication and counseling for district medi-cal staff.
Regular patient follow-up and counseling is done through local NGOs; outreach activities include sponsoring street plays and producing newsletters and information leaflets.
The earthquake wasn't the only natural disaster in India that prompted an MSF response over the last year. In October 2000, MSF mobile clinics assisted people in flooded and isolated villages in the state of West Bengal. MSF is also planning to study the resistance of malaria strains common in the state of Assam. MSF began work in India in 1999.
International staff: 26
National staff: 14