Patience and distributions in Pakistan's flood zones

The overcast morning sky in Nazirabad, Peshawar, where MSF is conducting another round of relief items distribution, hints that more rainfall is probably on the way. Farida’s five year old boy tugs at her long dress impatiently. “He wants to know why we can’t go home, I don’t know what to say, so I just tell him that we’re going somewhere new,” she explained.

The floods that overwhelmed Pakistan more than two weeks ago have forced people to leave their homes with such urgency that they were able to salvage very little, some have even lost members of their family.

“The water came into our home at night and we had to swim out as quickly as possible. I carried my baby boy on my shoulders. This flood has taken everything away from me, including one of my girls. She breathed in too much water and couldn’t make it,” said Nizam Ali.

He hoists the tent, kitchen set and hygiene material above his shoulders. The packages are tailored to fit a variety of needs, and a typical MSF relief kit could include clothes, soap, toothbrush, towels, buckets, a jerry can, plastic sheeting, cotton mattresses as well as water purification tablets. Until now, MSF had distributed kits to more than 8,000 families in Khyber Pakhtunkhwa and Balochistan provinces. ?

In addition to providing people with guidance on how to set up the tents, the distributions are also now being augmented by health promotionÃ? activities that raise awareness about health risks, and in particular the proper usage of waterÃ? purification tablets (Aqua tabs). Each kit includes 20 tablets, which when used properly, means that a family of seven can have safe drinking water for a period of two weeks.

“For two weeks now, my family has been sleeping under the open sky, I’m happy that I will be able to put a plastic sheet over their heads. I keep going back to what is left of our house, to clean it, or to find anything that is useable, but the rain keeps restarting,” he continued.

In the aftermath of this disaster, millions are now left without safe water, food, shelter or medicine. Despite the growing risk of diarrheal diseases like cholera, which is endemic in some parts of the country like Khyber Pakhtunkhwa province, help is still not arriving fast enough - particularly clean drinking water. However, it is not only international aid that will meet these needs. Solidarity amongst affected communities and from local organizations has meant that a huge amount of assistance has already been provided to meet some of the most acute needs. Still much more needs to be done.

Even two weeks after the onset of the heavy and violent rainfall, MSF teams working in Pakistan to alleviate the impact of the floods on people, still face a variety of logistical challenges. In Swat district, the water has demolished 16 bridges leaving MSF teams on either side of the valley, and forcing them to find innovative ways of sending supplies via boats and even horses. In Balochistan, teams from the provincial capital, Quetta, are currently struggling to supply the MSF mobile clinics with fuel and medical materials they need to be able to provide people with essential healthcare.

When it comes to Kit distributions, the priority is finding a safe and secure site.

“We could not find a single space that was not ravaged by water in Jala Bela, so we were unable to conduct the distribution for the people in their own village,” explained Waqar Ahmad an Assistant project coordinator working with MSF in Pakistan since the Kashmir earthquake in 2005. “This is the third distribution we are holding in the courtyard of this house in Nazirabad for people from nearby villages like Agra. This man, the owner of the house, has generously allowed us to use his private space to help people from nearby villages. We are doing our best to help people, but above all they are helping each other.”

For the relief goods to reach the people who need it most, community involvement is key; meetings with elders and Imams help identify the most vulnerable families and the people’s most pressings needs. From the minarets of mosques and through megaphones, the site and time of the distribution are broadcasted, to ensure that people know where to go to get what they need.

“Each distribution gets a little more organized; people have their tokens ready and stand patiently in line until their number is called,” said Waqar. “Our aim here today is to distribute to 585 families, but Inshallah we will surpass our target, and even include unregistered people like these women of Gul Bela. We have enough kits.”

Two hours into the distribution, and Farida is still standing patiently in line. For the people in Pakistan today, patience is not just a virtue it is vital if they are to recover from what has happened to them.

“There is good water and bad water,” said Farida. “The good water is the one we need today, the one that does not make us sick. The bad water took everything away from us. I’m not going back empty handed, even if I have to wait here the whole day”.

In addition to the scale up of medical activities, MSF teams continue to focus on providing affected families with basic items and safe drinking water in order to help them attain a minimal standard of living conditions and prevent the spread of diseases.

Since 1988, MSF has been providing medical assistance to Pakistani nationals and Afghan refugees suffering from the effects of armed conflicts, poor access to health care and natural disasters in KPK, FATA, Balochistan and Kashmir. ??MSF does not accept funding from any government for its work in Pakistan and chooses to rely solely on private donations.