Pakistan Floods Situation Report # 4

Saturday 7 July 2007

Highlights • Another weather system is developing in the Bay of Bengal and moving in North West direction from India that would bring in moderate to heavy rains within the next 3-4 days in the upper Punjab and Kashmir region. The overall situation of dams and reservoirs remains under control.

• Flood waters are moving southward, lowering the water levels in some areas by resulting in damage to those downstream in districts Dadu and Kambar of Sindh province.

• A joint cross-sectoral assessment of the affected areas is being undertaken by the NDMA with the assistance of UN agencies and NGO partners. Preliminary assessment results are expected to be available by Thursday July 12.

• The Health Emergency Preparedness and Response Cell has created an email address for coordination with health partners: [email protected]

Summary

Cyclone Yemyin in Baluchistan

• In District Gwadar the most severely affected areas are Pasni and Ormara tehsils. Pasni is affected throughout while Ormara has six union councils badly affected. Many people are still stuck in flood areas.

• In Chaghai, one of the largest districts in , there is still no access to the affected areas and therefore there is no reliable estimate of the damages and relief requirements.

• In district 25 dead bodies have been recovered and 120 persons are still missing. Rescue operations are being carried out by Frontier Constabulary and local communities.

• Naushki town was cut off from for three days as the bridge connecting Naushki with Quetta and other parts of Chaghai district was submerged in flood water. In Naushki, no loss of life or injuries were reported, however there are reports of road and house damage in Asiabwan, Jamaldini, Mengal, Sardar Badini, Qadir Abad, Qazi Abad (Naushki Town) Gharib Abad Pakistan Floods Health Situation Report # 4 2

(Naushki Town) and many villages of Kishingi. Poultry farms and crops have also been reported as sustaining significant damage.

• Crops and agricultural land has been heavily damaged in Baluchistan. Sheep and cattle have been lost. Most of the agricultural land and standing crops have been destroyed in areas of Nagar, Dat, Killi Adul Khaliq, Cheel Garasha, Tabra and Grasha (district Khuzdar).

• The district administration in Khuzdar has distributed 200 bags of foods containing floor (20kg) Ghee, cooking oil, sugar (5kg), lentils (3kg), tea packets and rice (5kg).

• In district Chaghai the DCO office has distributed 200 packets of food in the affected people in accessible areas.

Quboo Saeed Khan Highway, district Kambar Sahahdadkot, Sindh

Rain Storm and Floods in Sindh

• More than 50 cases of Dengue Fever including 2 deaths have been reported in Karachi.

• HEOC Karachi and WHO are trying to fully establish and strengthen the Disease Early Warning System (DEWS) in Sindh.

• 10 Union Councils, comprising 25% the area of districts Kambar and Shahdadkot have been affected by the floods. About 10% of the total district population is estimated to be affected.

• Flood water from the northern parts of district Kambar are moving south and affecting new areas. Areas in the south from taluka Warah of district Kambar

World Health Organization – Country Office, Islamabad, Pakistan 7 July 2007 Pakistan Floods Health Situation Report # 4 3

to Mehar and Fareedabad in Dadu are likely to be affected by these waters within few days. The draining water from the north is also expected to reach the already filled Manchar Lake in the next few days, which could potentially affect the surrounding communities.

• U.Cs Dost Ali and U.C. Ghabi Dero in district Kambar are 67 % and 100% submerged. However, all the people have been evacuated.

Monsoon Rains in North-West Frontier Province (NWFP)

• In Tank flood water has caused damages in several villages of the District, however, no loss of life has been reported. The Tank- Pezu and Tank–D.I. Khan road is closed for traffic.

• In Haripur District, two women died as their houses collapsed and another three have been injured.

• The Relief Commissioner, NWFP has provided 100 tents in district Chitral that are being transported to the Sonoghore area by the District Coordination Officer. Food items were distributed among 120 families and another 2448 kgs of food items have been sent to Sonoghore by DCO for distribution amongst the affected communities.

• 300 packets of dry ration, 2500 kg rice and 120 tents are being transported to District Tank today from the warehouse of Provincial Relief Commissioner, NWFP.

• In district D. I. Khan, the D.C.O. has purchased and distributed food items worth Rs. 550,000/- amongst the flood affected communities. The DCO has also distributed 111 tents to the affected communities.

Health impact

Baluchistan

• In Khuzdar, eleven people have been injured and ten dead. Many houses and boundary walls have collapsed. Some areas are not approachable: Grouk, part of Hazarj Ganji and Dat.

• In Chaghai, one casualty has been officially reported by the District of a 10 years old child. Communication is badly affected with road links damaged telephone lines inoperable in the district.

• EDO (H) in district Nasirabad reports that most people have moved from their houses to Bacha Band (UC Kohna Tamboo and Baba Kot) and Magsi Shaikh. Four health units remain flooded (BHU New Mir Wah, BHU RD 50 Magsi Shakh, CD RD 40 Magsi Shakh and CD RD 75 Magsi Shakh) and access to these health facilities is not possible.

World Health Organization – Country Office, Islamabad, Pakistan 7 July 2007 Pakistan Floods Health Situation Report # 4 4

• 68 Snake Bite cases have been reported from Nasirabad, 3 from Kech 4 from Lasbela and 3 from Khuzdar. All patients have been treated, and an adequate supply of ASV is available. Dog bite cases in Jaffarabad have been limited but ARV (500 Ampules) has been requested.

• Cases of diarrhea, scabies, skin rash and malaria have been reported from various districts in Baluchistan and all patients have been treated apart from one casualty of a 5 year child in Kech.

Sindh

• WHO Sindh Operations Officer Dr. Wahid Bhurt held a meeting with Special Secretary and Deputy Secretary Public Health at HEOC to get their support of directing EDOs and THOs in Sindh to submit their DEWS reports on time. The Special Secretary has agreed to send a letter along with case definitions and DEWS forms to all EDOs in province and THOs, Karachi, for facility- wise reporting on the DEWS. Once the data is available DEWS will provide warning about priority communicable diseases in the province for appropriate and timely action.

Health response

1. Assessment and monitoring

Baluchistan

• In district Nasirabad, Fateh Abad road route is disconnected but medicines including life savings drugs and ASV have been supplied to those who have reached there on foot.

Sindh

• WHO teams have been sent to visit the worst affected areas of Kambar

• The EDO (H) in Kambar Shahdadkot has been asked to provide information on the type of support he would like to have from WHO and UNICEF. The former has indicated an immediate need of 4X4 vehicles.

• ORS was urgently requested by district Kambar Shahdadkot and local procurement is being pursued to ensure its supply as quickly as possible.

• The Government of Sindh has reported an adequate supply of ASV for current needs, but they have requested more in anticipation of greater demand. All requests for medical support are being coordinated with MoH to avoid duplication. NWFP

• A team of MoH/WHO is conducting assessments in affected areas of NWFP

World Health Organization – Country Office, Islamabad, Pakistan 7 July 2007 Pakistan Floods Health Situation Report # 4 5

Health coordination

• MSF has offered to supply Water Treatment plants, and are coordinating with the NDMA to identify priority districts in which to place them.

• UNICEF is participating in four cluster groups: Health, Education, Child Protection and Water & Sanitation.

• Partners have been asked to coordinate all requests for medical support with HEPR to avoid duplication.

• The NDMA is coordinating a 3 day assessment of the affected areas with two staging points: the southern assessment leaves from Karachi, which will cover , Gwadar, Uthal, and Larkhana, and will do a flyover of the Mirani dam and Kamber and Shahad districts. The northern assessment leaves from Quetta and covers Kharan and Dalbandian, Sibi and Jacobabad, with flyovers of Naushki and Jhal Magsi. Road assessments are also being undertaken from Quetta using the same assessment tool.

2. Filling health gaps

• WHO will share with the HEPR and NDMA a form for information collection of the health partner’s teams working in the field.

• The WATSAN cluster has targets to assist in the provision of safe water supplies and sanitation facilities for around 500,000 flood victims for 3 months under the flash appeal.

• UNICEF has already secured US$ 1.5 million from their emergency response fund to meet critical/priority WATSAN needs of the affected communities.

• The Pakistan Red Crescent Society is sending 12 teams within 10 days time for assessments that would be completed within a month’s time. They have arranged for a meeting with delegates from France and UAE and Red Crescent Societies. UAE Red Crescent is interested in establishing a field hospital.

Sindh

• WHO has sent 2 Basic Health Kits and 50 Anti Snake Venom vials to Kambar.

• Two camps/mobile teams have been established in UC Mirpur.

• A medical camp has been established at village Chandan at zero point F.P Band by the S.O, WHO for districts Dadu and Naushero Feroz.

• The S.O WHO in Dadu reports that four mobile camps have treated 131 patients in different parts of the district. No diarrhoea cases have been reported. No death has been reported due to floods or Snake Bite.

World Health Organization – Country Office, Islamabad, Pakistan 7 July 2007 Pakistan Floods Health Situation Report # 4 6

• UNFPA has sent 500 Hygiene Kits each to districts Thatta, Larkana and Kambar

• CARE International’s mobile teams have started working in Badin.

• Pakistan Red Crescent Society teams are working in Kamber Shahdadkot, and Karachi. They have dispatched 2 Tons of medicines to Karachi. Their teams are also planning to go to Kharan within the next 3 days.

Medicines being distributed in Taluka Quboo Saeed Khan, district Kambar Sahahdadkot, Sindh Baluchistan

• In district Nasirabad, two relief camps at Magsi Shaikh have been opened.

• Five fixed medical and two mobile camps are providing medical care to the affected and displaced population in three flood affected union councils in Nasirabad. All these sites are working under the supervision of DCO and EDO (H) and have treated 4137 patients for common ailments and 68 cases of snake bites between 29 June to 5 July 07. So far, no any outbreak or epidemics has been reported from the area. • The Fateh Abad road route in Nasirabad district is disconnected but medicines have been supplied on foot. ƒ CARE International’s mobile teams have started working in Turbat, Jaffarabad, Nasirabad.

ƒ Pakistan Red Crescent Society teams are working in Turbat.

ƒ Islamic Relief has positioned medical staff at Chaghai & Kharan.

World Health Organization – Country Office, Islamabad, Pakistan 7 July 2007 Pakistan Floods Health Situation Report # 4 7

NWFP

• The MoH has sent adequate supplies of anti- malarial medicines, bed nets and health education material to affected areas in NWFP. One medical team is being dispatched to the affected areas of NWFP.

• In district Nowshera medical cover has been provided to 257 families.

• Table-1 Health Emergency Operations Cell, Karachi, Sindh

Support to worst Rain/ Flood affected Districts/ Provinces in Pakistan Location Truma NEHK Cholera Chlorine Basic Anti Hygiene Date of Mode of Kit Kit Tablets Kit Snake Kits by Delivery Transport Venom UNFPA (ASV) Lasbela 1 0 0 30,000 1 0 1-Jul-07 Road Jhalmagsi 1 0 0 20,000 1 0 4-Jul-07 Road Jafarabad 2 0 0 20,000 1 0 4-Jul-07 Road Nasirabad 1 0 0 10,000 1 0 4-Jul-07 Road Turbat 2 0 1 30,000 2 0 5-Jul-07 Air Sindh Karachi 0 0 0 109,184 0 20 27-Jun- Road 07 Kambar 1 0 0 10,000 4 50 500 4-Jul-07 Road Thatta 0 0 0 10,000 4 100 500 6-Jul-07 Road Civil 0 0 0 0 0 40 5-Jul-07 Road Hospt Hyd DG Hyd 0 1 0 100,000 0 200 5-Jul-07 Road Larkana 0 0 0 0 0 0 500 7-Jul-07 Road Kashmore 0 0 0 0 0 25 7-Jul-07 Road Naushero 100 Feroze Badin 50 Matiari 80 Total 8 1 1 339,184 14 665 1,500

World Health Organization – Country Office, Islamabad, Pakistan 7 July 2007 Pakistan Floods Health Situation Report # 4 8

3. Preserving and supporting local health systems

• WHO in collaboration with the Ministry of Health is working to strengthen the Disease Early Warning System (DEWS) that has been activated in Karachi. A similar approach is to be replicated in Quetta.

Urgent needs

• In Baluchistan Helicopters are required to search for dead bodies in areas where road links have been disrupted. • In Baluchistan especially, there is an urgent requirement of Anti Snake Venom as snake bite cases are on the rise in the province. • More medical camps and vaccinations are needed in Kamber, Shadadcote, and Dadu to avoid possible epidemics in the flood and cyclone affected areas.

World Health Organization – Country Office, Islamabad, Pakistan 7 July 2007