Islamabad, Pakistan - The massive influx of an estimated 300,000 people who fled the fighting in South Waziristan is straining the capacity of hospitals in Dera Ismael Khan district, in Pakistan, to meet the needs of the displaced and resident population. Despite the assistance provided by the authorities, acute medical needs are not being met in D.I. Khan hospitals. The private international medical organization, Médecins Sans Frontières (MSF), is ready to set up an emergency medical programme to provide free treatment to patients, and is requesting authorization from the Pakistani authorities to be able to do so. Last week, an MSF team was able carry out a rapid assessment of the medical needs in three of the main hospitals in D. I. Khan district, and two rural health centres situated in areas where many of the displaced families are living. “We saw real needs for staff ,medicines, hygiene and materials which are essential to respond adequately to emergency care, notably in the emergency rooms, maternity and surgical departments of the main hospitals,” said Thomas Conan, MSF country representative in Pakistan. Over the last weeks, the district hospital has seen an increase of 30 to 40% in the number of emergency room admissions. Currently, people needing a surgical referral outside D.I. Khan are mainly referred to Peshawar hospitals. While medical expenses and costs of transport are manageable for some, they represent an insurmountable barrier for the numerous vulnerable families within the displaced and resident population in D.I. Khan. “MSF has the capacity to send medical teams composed of international and national staff to provide free surgery and emergency care to the people most in need in the region. But so far the presence of international staff is being refused by authorities,” explained Thomas Conan. Between May and July 2009, MSF received authorizations, and was about to send an orthopaedic surgical team to treat trauma cases, as there was no local infrastructure providing free treatment to patients who need specialised surgery. In July, military authorities asked MSF to leave the area for security constraints. For the past two months, MSF has been requesting authorisations for an independent access in the area to provide emergency medical care with a team of national and international staff. “As an international private medical organization, we believe that the presence of an international medical team reinforces the independence of our work,” said Thomas Conan. “We are asking authorities to allow us to provide similar support to the population in D. I. Khan as we have done in other areas of the country.” Currently, a team of international and national staff provides support to health structures in Lower Dir district, where displaced people have been arriving from Bajaur agency. Earlier this year when over one million displaced people fled to the Mardan district, MSF teams supported local health structures by running a 40-bed inpatient department, two emergency rooms, and a maternity service open 24 hours a day, providing health care for several thousands of patients. . MSF does not accept funding from any government for its work in Pakistan and chooses to rely solely on private donations. Since 1998 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 NWFP, FATA, Balochistan and Kashmir.