EARTHQUAKE IN Situation Report No. 2 1 November 2008

OVERVIEW

• The National Disaster Management Authority confirms 155 deaths and over 375 people injured. Media reports more than 300 deaths. • Adequate health coverage in all major hospitals and there is still capacity to accommodate more casualties. • From day one, WHO Polio and DEWS surveillance teams have participated in damage and needs assessments in and Pishin districts. • The Department of Health (DoH) dispatched 10 teams to affected districts to vaccinate children and women against measles and tetanus and provide vitamin A to children. • The DoH and Health Cluster partners ensuring provision of care in affected districts. • Emergency Health Cluster meeting on 30 October in Islamabad held to coordinate response activities. Next meeting scheduled for 3 November.

SITUATION UPDATE • The 28 October 2008 earthquake in Baluchistan caused massive destruction in Ziarat and Pishin districts, some parts of district and Quetta. The National Disaster Management Authority (NDMA) reports 155 deaths and more than 375 people injured, with media reporting more than 300 deaths. In affected areas, night temperatures have fallen below freezing. • In (130 000 people), 14 villages in Kawas and Kach Union Councils (35 000 people) are badly affected. Around 12 000 people are displaced. • In (475 619 people), Khanozai, Rod Mulazai and Dilsora Union Councils are the most affected. • Recurring aftershocks have prompted some people to move to safer places. The remaining population is living in tents or partially damaged houses. However, there are not enough tents to accommodate all of them, leaving many exposed to harsh cold weather and risk of respiratory diseases. • In Ziarat district, the Frontiers Corps (FC) have established one camp in Wham, hosting 300 people in 30 tents, and another in Warchum, accommodating 280 people in 50 tents. FC also distributed 1000 tents among the affected people.

DAMAGE TO HEALTH INFRASTRUCTURE • A joint WHO, UNDP, UNHCR, UNICEF, UNFPA and WFP rapid assessment was conducted in Ziarat and Pishin districts. Preliminary reports showed: o In Ziarat , 10 of the district’s 38 health facilities were damaged: three basic health units (BHUs) were completely damaged and three rural health centres (RHCs) and four BHUs were partially damaged. o In Pishin, three out of 57 facilities were partially damaged: the Khanozai civil hospital and the civil dispensaries in Dilsora and Rod Mullahzai. o All ’s hospitals are intact and functional.

HEALTH IMPACT • Health care services are being provided in tents or the open outside facility buildings due to aftershocks and building damage. • In Ziarat district, the Kawas RHC treated 659 patients between 29-31 October, including 148 for injuries. Fifty-four patients were referred to Quetta hospitals for further management. On 29 October, 81 dead bodies were received at the RHC. • The Ahmadoon RHC, also in Ziarat, treated 217 patients during the same period, including 17 injuries. Five were referred to Quetta hospitals. One dead body was brought to the hospital on 29 October. • The most common causes for consultation are acute respiratory tract infection, post-disaster traumatic stress and injuries. Most patients are women and children.

Earthquake injured patients in tented ward at CH Quetta WHO Disabilities Specialist examining an injured child Pictures by Saqib/ERRA

NATURE OF INJURIES RECEIVED IN VARIOUS MAJOR HOSPITALS IN QUETTA S Hospital Male Female Under Over 12 Nature of Injury Dischar Tota # 12 Years ged l Head Spinal Orthopaedic Amputa G. Others Years Injury Cord tion Surger (Urology, Injury y ENT etc) Civil 1 Hospital 65 32 7 90 8 0 78 0 6 5 67 97 Bolan Medical 2 Complex 14 10 9 1 9 0 3 2 2 24

3 CMH 21 6 6 21 0 0 12 1 14 0 7 27

Grand Total 100 48 13 111 17 1 99 1 23 7 76 148 Source: WHO/ERRA Joint Assessment of injuries

NATIONAL RESPONSE • Adequate health coverage is provided in all major Quetta hospitals that still have capacity to accommodate more casualties. • In affected districts, DoH medical teams, the People’ s Primary Health Care Initiative (PPHI) and the Pakistan Army Medical Corps are providing health services. The Government of Baluchistan has deployed 18 medical teams with ambulances and medicines. • The Provincial DoH reports having enough medicines and staff to cope with the current situation. • The DoH has dispatched 10 teams to vaccinate children and women against measles and tetanus and provide vitamin A to children. WHO and UNICEF are providing logistics support for the vaccination activities.

HEALTH PARTNERS RESPONSE

WHO • One Inter-Agency Emergency Health Kit (sufficient for 10 000 people for three months) and five mini Emergency Health Kits (each for 2000 people for three months) were received on 31 October in Quetta. Two Trauma Kits (Part A & B) will be sent directly from the UN Humanitarian Depot in Dubai to Quetta on 4 November. • The WHO Pharmacist in Quetta is supporting the DoH for drugs management and tracking supplies using the Logistics Support System (LSS). • The Disease Early Warning System (DEWS) has been activated in Ziarat and Pishin districts. • 1000 vials of Tetanus Immunoglobulin (TIG) vaccines for injured people have been arranged from . • The WHO Polio and DEWS surveillance teams have been supporting the damage and need assessments from day one. • WHO is supporting the DoH to coordinate the relief activities.

WHO Disabilities Specialists examining the injured patients at Bolan Medical Complex Quetta – Saqib/ERRA

UNICEF • New Emergency Health Kits (NEHK) and BP-5 high-energy biscuits are being moved from Karachi to Quetta. UNICEF is also supporting measles and TT vaccination and vitamin A supplementation.

UNFPA • UNFPA has mobilized two mobile service units, including staff, supplies and equipment, from its ongoing activities in Killa Saifullah and Noshki districts. The units are providing basic emergency obstetric care services. UNFPA also distributed 3000 hygiene kits.

IFRC/PAKISTANI RED CRESCENT SOCIETY (PRCS) • IFRC/PRCS sent six assessments teams to the affected districts. • The PRCS distributed emergency stocks for 300 families in Ziarat district, including 300 tents, 1800 blankets (six blankets per family), 1200 plastic sheets (four per family) and 300 coal stoves. • The PRCS sent two mobile health teams to Ziarat district. Each team includes two doctors, a dispenser, a motivator, lady health visitors and three volunteers.

ICRC • ICRC deployed surgical teams to Ziarat district.

MSF-Holland • MSF-Holland sent rescue and relief teams to Ziarat on 28 October. The teams conducted health and water and sanitation assessments. MSF-Holland is planning to establish fixed health clinics with full primary health care services in addition to the mobile medical teams, and to provide mental health support.

MSF-Belgium • MSF-Belgium is planning to address mental health needs.

Mercy Corps • Mercy Corps is providing health care services in Kawas Union Council, Ziarat district.

Balochistan Rural Support Project (BRSP) • BRSP deployed mobile medical teams in Kawas and Kach Union Councils in Ziarat district. Each team includes three male and one female physicians, and is equipped with emergency medicines.

International Medical Corps (IMC) • IMC sent a mobile medical team with a doctor, a female nurse, a dispenser, an assessment specialist and a logistician and emergency medicines. The team started activities in Ziarat district on 1 November.

American Refugee Committee • ARC sent teams for assessments and health services on 28 October.

COORDINATION • An emergency Health Cluster meeting was held on 30 October at the WHO Office in Islamabad for information- sharing and coordination of response activities. The meeting was chaired by the WHO Representative and was attended by 20 organizations working in health sector. The next meeting is scheduled for 3 November. • The first district level Health Cluster coordination meeting was held 31 October in Ziarat district under the chairmanship of the Executive District Officer for Health. • In Quetta, a provincial coordination meeting chaired by the Baluchistan Secretary of Health on 31 October discussed the overall health situation and reviewed response activities. The Provincial DoH, Provincial the Disaster Management Authority and Health Cluster partners will establish a health coordination office for Baluchistan. • Two core groups, with representatives from the Government, UN agencies and international organizations, will be established in Islamabad and Quetta to discuss information management and to ensure the timely compilation, analysis and sharing of information.

CONTACTS For further information please contact:

WHO Pakistan Country Office Dr Khalif Bile Mohamud WHO Country Representative to Pakistan e-mail: [email protected]

WHO Regional Office for the Eastern Mediterranean Mr Altaf Musani e-mail: [email protected] tel.: + (202) 26 76 50 25 mobile: + (201) 02 58 58 22 http://www.emro.who.int/eha/

WHO headquarters Mr Paul Garwood, Communications officer Health Action in Crises e-mail: [email protected] tel. +41 22 791 3462 mobile: +41 79 475 5546 www.who.int/disasters

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