As new areas of Pakistan get affected by floods daily, the zones that had received the first blow suffer fresh water-level rise. The continuous and sometimes heavy rains that fell on Khyber Pakhtunkhwa and Baluchistan provinces have significantly impeded on humanitarian and medical aid. As MSF teams on the ground battle to deal with the consequences of the initial floods, more MSF staff are now assessing the needs in the newly affected provinces of Punjab and Sindh.

In Noshwera, the MSF team had to postpone a distribution of basic relief items to around 4,500 families as the place identified had been flooded. Unfortunately, because of heavy rains in the last couple of days the desperately needed delivery of items such as soap, buckets, toothpaste and cooking utensils.

“The place we had identified to organize this major distribution is under one meter of water,” said Anthony Thouvenin, Emergency Coordinator for MSF in Nowshera. ”Two days ago it was dry, but the water rose very quickly. Now we’ll have to explain to people that the delivery of much-needed good will have to be delayed by at least one day. Our team is frustrated, but this is nothing compared with affected people who really need help”.

At the weekend, Hangu district, spared until now, was hit by flash floods affecting the hospital where MSF has a diarrhoea treatment centre and surgical activities. Houses were also destroyed and the displaced people’s camp suffered damage as well. MSF immediately donated some materials to support the local health centre. This morning, the team reported few dozen of homeless people and is still trying to get more about the aftermath of the flash floods.

In Baluchistan, the road between Dera Murad Jamali and Khabula was flooded and prevented an MSF truck from reaching the place identified and the team had to use 4x4 cars to carry out a distribution of hygiene and relief items kits to 1,000 families. The distribution will continue for all the week.

Nevertheless, MSF is continuing to provide drinking water, relief goods and medical care to thousands of people in dire need in Nowshera, Peshawar, Charsadda and in large pockets of people around Manjoshori in Baluchistan.

Medical activities

Medical activities continue nevertheless with mobile medical teams providing care in resettlement places, mainly in schools. New mobile clinics are expected to start today in Baluchistan, Malakand and Swat and Peshawar divisions, focusing on most deprived and vulnerable populations without access to health facilities. MSF continues to support health structures but the constant changes in the level of water also make families move from one place to the other regularly making the delivery of aid challenging. For example, the number of consultations at the Pabbi hospital, in Nowshera, changes from 100 to 350 per day depending of new floods alerts.

In the Nowshera DHQ hospital, the installation of generators now allows the emergency room to remain permanently open 24 hours a day. After rehabilitation, the outpatient department is now functional and has also seen a decrease in attendance during the rainy week-end but more than 320 consultations were provided last Friday. Three ambulances have also been provided, ensuring around 10 referrals per day so far.

In all health facilities ran by MSF, the most common pathologies remain linked to the living conditions. The situation is similar in MSF medical programmes which existed before the floods in Dargai, Malakand, Swat district, where the teams have started new mobile clinics.

“One out of three patients that we see here has a skin infection,” said Dr Majid, a Pakistani doctor working in one the mobile clinic north of Charsadda. “The fact that people live very closely together in wet and unhygienic conditions is a major factor. Other diseases like diarrhoea are also very common”.

Clean water desperately needed

One way of avoiding diseases is the provision of clean water. MSF water and sanitation teams are working hard to provide water to communities. In places like Charsadda, Nowshera and Swat, the teams are supporting the local authorities to rehabilitate the local water delivery system while trucking water to families who need it.

“Our priority is to provide drinking water to as many people as possible,” said Thomas Batarday who manages the water deliver programme in Charsadda. ”We are delivering more than 85,000 litres every day and that’s on top of the 21 water points we set up in the city. We’ll keep that set up until the water delivery system is functioning again”.

Water points have also been set up in Lower Dir and in eight localities in Swat (approximately 100,000 beneficiaries). In addition, MSF also provides clean water to the district hospital in Lower Dir and is working on restoring drinking water provision in the Nowshera through system rehabilitation and water trucking.

New provinces badly affected

More assessments will take place in most affected areas as it is believed many pockets of people remain isolated and have not received any aid yet. But the weather prevented MSF from carrying assessments by helicopter in the last few days.
The situation in the provinces of Punjab and Sindh is a major cause of concern. The authorities have been organizing evacuation of hundreds of thousands people as heavy rains have been pouring over the last days. An assessment team of five MSF workers, including two doctors, left today to Muzaffargarh district, Punjab province, and another team will be evaluating the needs tomorrow in Kashmor, Sindh province.
A first cargo plane carrying 60 tons of water and sanitation equipment, drugs and logistical material departed arrived in Pakistan and will be followed by 50 more tons of relief supplies in the next few days.
More than 100 international staff are currently working alongside 1,200 Pakistani in MSF programmes in Pakistan.