Thousands still in need one month after Peru earthquake

One month after a massive earthquake injured thousands and destroyed or damaged more than 60,000 homes in southern Peru, residents are still trying to rebuild their lives. The steady stream of aftershocks that followed the June 23 quake have kept people living in fear, while cold weather has increased the risk of health problems. Médecins Sans Frontières (MSF) has been providing emergency relief since the initial quake, which measured 7.9 on the Richter scale. The organization is focusing efforts in the Arequipa, Tacna, and Moquegua regions, where already impoverished, rural communities have been devastated by the natural disaster. Mountainous terrain and damaged roads — some blocked by avalanches set off by the aftershocks —have obscured access to populations in need and left remote villages without any aid at all. MSF has been working steadily to gain access to these outlying populations, traveling on foot or by horse or donkey where transport by vehicle is not feasible. . Liz Steele, MSF emergency coordinator in Peru, described MSF's relief effort as a "global intervention." Aid workers are ensuring that the affected population has rapid and free access to functional health services by providing damaged medical structures with medicines and medical equipment; running psychosocial activities to address the emergence of post-traumatic stress disorder; rehabilitating water systems to ensure an adequate supply of potable drinking water; building latrines to prevent outbreaks of water-borne communicable diseases common in emergency situations; and providing temporary shelter and blankets to those who have lost their homes. . Steele explained that providing shelter has been a priority, especially for populations at high elevations where freezing conditions pose a health threat. As of July 20, MSF had donated more than 700 tents and 9,000 blankets. . "Some places are at altitudes of 11,000 to 14,000 feet which, during the day, are quite hot but the temperature can fall below freezing at night," Steele explained. "Concerns have been for health risks associated with the cold, especially when children and the elderly are the most vulnerable. We've seen an increase in respiratory diseases such as bronchitis and pneumonia. By providing adequate shelter we help to alleviate the suffering people have endured and prevent a further increase in these diseases." . In areas where people have lost everything and aftershocks keep them in a perpetual state of fear, MSF is providing psychosocial support to address post-traumatic stress disorder. . In CamanÃ?¡ province on the coast of Arequipa, MSF has been focusing on setting up a psychosocial support program for the displaced population that was hit not only by the earthquake but also by a tsunami. At least 2,000 people are living in temporary camps. . "The destruction is pretty impressive," Steele said. "A lot of fisherman were living on the beaches and everything was washed away. There's a real sense of trauma. People are afraid to go back to where they originally lived. Children aren't speaking or eating. There is a general collective psychosis here." . In Camaná, MSF is running informational workshops in the camps to raise awareness about the symptoms of post-traumatic stress — such as flashbacks, difficulty sleeping or loss of interest in usual activities — and providing consultations. MSF psychologists have also begun reinforcing the counseling skills of local health professionals with regard to the prevention and treatment of post-traumatic stress disorder. Teachers are being trained so they will be able to spot the effects of post-traumatic stress in their students when schools reopen. . MSF is also using less traditional approaches to psychosocial support by identifying camp residents' individual skills — such as bread-making or carpentry — and encouraging those individuals to use their abilities to help the local population. . As Steele explained, "These people have lost everything - their homes, jobs … - this gives them some hope, some activities to build towards the future, to feel useful." . In addition to the intervention in Camané, MSF is providing psychosocial support in Moquegua and in Locumba district in Tacna, where destruction has been widespread, with over 90 percent of the population having been directly affected by the earthquake. . MSF currently has 16 international volunteers and 15 national staff working on the earthquake relief effort.