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Home , Dera Ghazi Khan District, Dir (princely state), Kharan (princely state), Phulra, Rajanpur District

Floods Situation Report#F-1-2008 (Aug 3 - 5, 2008)

Tuesday, 05 August 2008

NWFP:

• On August 4, 2008, the torrential rain water flooded a local stream (Thara Khur) which flows from Landi Kotal to Charsada causing great havoc in Peshawar district. The affected area includes Shalman, Bara and Tatara, Ali Masjid, Takhtabaig, Lal China and Sur Kamar of Khyber Agency. About 50 villages in the upper part of Peshawar district were inundated which include Pir Bala, Potohar bala, Mathara, Ashab baba, Sheikhano kalay, Dag, Khushal Bagh, Warsak Road, Hassan Garhi, Babo Garhi, Alizai, Qanriza, Baram , Garhi Muqam Shah, Harayana, Khaderkhel, Bakhsho Pul, and Nasapa Bala etc.

• 15 Union Councils and 700,000 population of district Peshawar are badly affected.

• Although, unofficial media claims at least 55 deaths in NWFP but as per WHO/district administration Joint Assessment, no proper data of the deaths and casualties is available at present. Many people have been reported missing.

• As per official figures released today by the Relief Commissionerate NWFP, 12 people have died, 362 buildings/houses damaged and 1242 houses washed away.

• The evacuated the stranded people to safer places through Boats and Helicopters.

• Flood water destroyed the communication and power supply systems in the affected areas. Water supply is also severely damaged.

• The EDO-H Peshawar Dr. Mohd Ali informed today that 6 medical camps supported by 20 medical officers and paramedical staff are operational in affected areas of Peshawar. 6 ambulances are also deputed for referral services.

• A flood monitoring cell was setup by military authorities at Corps Headquarters Peshawar, where the latest flood situation was monitored and coordinated with the civil administration.

• As of today, no IDP camp is reported. Pakistan Floods Situation Report#F-1-2008 (3-5 August 2008) 2

• On the directives of the Chief Minister, Emergency has been declared in all the Tertiary Care Hospitals of the district.

• ICRC committed to provide 3 medical teams including male and female doctors and paramedics along with emergency medicines and ambulances. ICRC is also providing the Hygiene Kits.

WHO Support: • WHO team is continuously supporting the provincial district health authorities in assessments/reporting.

• DEWS is already implemented Peshawar which will be helpful in prevention of communicable disease outbreaks. So far, no alert received from any of the medical camp except a little increase in skin diseases.

• A total of 2 Cholera Kits (1 kit is for treatment of 100 severely dehydrated AWD patients, Contents and Quantity at Annex-I) have been provided to Peshawar. One kit was provided in June as part of the WHO monsoon contingency plan and one more kits is provided today to district health authorities.

• A joint WHO-UNICEF assessment team will be visiting Peshawar tomorrow with the objectives to identify the needs.

• 10,000 Aqua Tabs will be delivered tomorrow to district health authorities.

Punjab: • On Sunday, 3rd August 2008 hill torrents caused by widespread rain flooded many parts of district and of Dera Ghazi in province. Hundreds of mud houses were swept away by the flood water. People have lost their cattle. The cotton and rice crops on thousands of acres were destroyed. The rainwater has breached the Dajal Canal at many sites that comes from the Head-, and hence resulted in heavy flooding in the area. According to irrigation department, more water is likely to be entered into the area.

• About 150 villages are reported to be badly affected rendering thousands of people homeless. IDPs have taken temporary shelter on the roads, banks and other higher places.

World Health Organization – Country Office Pakistan 5 Aug 2008 Pakistan Floods Situation Report#F-1-2008 (3-5 August 2008) 3

• Dr. Shahnaz Naeem, EDO-Health Rajanpur, informed that the floods have affected Dajal, Fatehpur, Hajipur, Chak Jinda Shah, Chak Zarani, Matawa 1, 2 and 3, Dara Chakar and Chak Dilbar areas of Tehsil Rajanpur, and of the district. She also confirmed five deaths in the district. The communication system in the district is also affected due to floods.

• Today, level of flood water is receding in .

• 20 medical camps and three mobile medical teams from EDO Health office are providing medical services to affected population in 10 Union Councils (UCs).

• There is also low level flood in two UCs of District; adjacent to . Two medical teams have been deputed there from EDO Health office Dera Ghazi Khan.

• Last night there was heavy rain in ; low lying areas are filled with water but no situation of flood.

WHO Support:

• WHO team is continuously supporting the provincial district health authorities in assessments/reporting. • As of today, no request for any special need received. • As part of monsoon contingency plan, WHO has already provided two Cholera Kits to district Dera Ghazi Khan. (Details are at Annex-I).

Sindh:

Heavy rains have been reported from different parts of province including Karachi. The situation is under control.

WHO Support:

• WHO team is continuously supporting the provincial district health authorities in assessments/reporting. • As of today, no request for any special need received. • As part of monsoon contingency plan, WHO has already provided medicines to different districts of Sindh (Details are at Annex-I).

Balochistan: • According to National Disaster Management Authority (NDMA) ten deaths and five hundred damaged houses are reported in districts of Musa Khel, Barkhan, Loralai, Zhob, Bolan, Sibi, Kallat, Khuzdar, Lasebla, Nasirabad, Jaffarabad and Sherani. Coastal Highway is blocked at Por near Bela. • Flash flood occurred on 3rd August 2008 in District Bolan and Jhal Magsi. Various Tehsils of both the districts were inaccessible due to the flash floods. • The situation has calmed down as of today. • NDMA reported 10 deaths and 500 houses damaged in various districts of . World Health Organization – Country Office Pakistan 5 Aug 2008 Pakistan Floods Situation Report#F-1-2008 (3-5 August 2008) 4

• No major health related issues reported.

WHO Support:

• WHO is implementing CERF project (floods 2007) in 10 flood affected districts of Balochistan. DEWS is already functional in these districts and essential medicines have been provided to districts health authorities. WHO is also supporting PHC services in 4 districts through partner NGOs. • WHO team is continuously supporting the provincial district health authorities in assessments/reporting. • As of today, no request for any special need received. • As part of monsoon contingency plan, WHO has already provided medicines to different districts of Balochistan. (Details are at Annex-I).

FLOOD SITUATION AND WEATHER FORECAST FOR NEXT 24 HOURS SOURCE: FLOOD FORECASTING DIVISION, LAHORE August 5, 2008

I. FLOOD SITUATION: River Indus at Tarbela, Kalabagh Chashma, Guddu & Sukkur and River Ravi at Balloki are in low flood. River at Nowshera is in Medium flood. All the other major rivers are flowing below low flood level.

II. HYDRO METEOROLOGICAL FEATURES: 1. Westerly wave over Northern parts of the country continues to persist. 2. Seasonal low lies over Balochistan. 3. Moist current from Bay of Bengal and Arabian Sea is reaching Punjab and Kashmir upto five thousand feet. 4. Yesterday’s monsoon low over Northwest Bay of Bengal has moved West Northwestwards and today it lies over Southeast Madhya Pradesh.

III. FORECAST: Widespread Thunderstorm/Rain with moderate to heavy falls at isolated places is expected over North Punjab, (Rawalpindi, Gujranwala, Lahore, Faisalabad & Sargodha Divisions) and Kashmir. Thundershower/Rain is also expected at a Scattered places over NWFP, South Punjab and Balochistan.

IV. RAINFALL MORE THAN (05MM) RECORDED DURING THE PAST 24 HRS (UPTO 0900 PST): Sharqpur=93, Shinkiari=78, Lahore(Airport=71, City=23), Ghariala=57, Noor Pur Thal=45, (Airport) & Ravi Syphon=37 each, =35, Mianwali=32, & Barkhan=30 each, Dara-e-Tang=26, Oghi=25, Dhokpathan=23, Rohtas=22, Islamabad(Airport & Dhamial=21 each, Bokra=11), Shamsabad=08, Zeropoint & Saidpur=03 each, Golra=02), =20, Toba Tek Singh=19, Okara=18, Jhelum, Gawader & Marala=16 each, Jhang=13, Joharabad=12, Cherat & Baba Shah Jalal=11 each, Jassar=10, Kotli & Kalat=09 each, Sialkot (City=08, Airport=03), Pattan, Sahiwal & Ganda Singh Wala=08 each, Rawalakot, D.G.Khan =07, Kohat & Rohtas=06 each.

V. WEATHER OUTLOOK FOR NEXT 48 HOURS: Wet spell is likely to decrease.

World Health Organization – Country Office Pakistan 5 Aug 2008 Pakistan Floods Situation Report#F-1-2008 (3-5 August 2008) 5

Annex-I DISTRIBUTION OF KITS / CONSUMABLES / EQUIPMENT Dated 5-8-2008 Italian UNFPA Cholera FLCF Consumable Medical Surgical S/# District Kit A & Health Kits Kits Items Equip KIT B Kit EQ Area 1 Muzaffarabad 4 2 Neelam 3 3 Bagh 4 4 Poonch 3 5 4 6 Abbottabad 3 Battagram / Shangla 4 7 Kohistan Total 25 NWFP 1 Peshawar 2 2 Charsada 1 3 Swabi 1 4 Mardan 1 5 Nowshera 2 Total 7 Punjab 1 Lahore 2 2 Rawalpindi 1 3 Khushab 2 4 Gujranwala 2 5 Faisalabad 2 6 Kasur 2 7 Bahawalnagar 2 8 Multan 2 9 Muzaffargarh 2 10 DG Khan 2 Total 19 Sindh 1 Kamber 2 17 1 1 1A+2B 1 (7 Boxes) 2 Dadu 2 22 1 1 2B 1 (7 Boxes) 3 Nawabshah 1 4 Sukkur 1 5 Hyderabad 1 6 Larkana 1 7 Badin 1 12 1 1 1B 8 Thatta 1 Provincial Epidemic 9 1 Investigation Total 11 51 3 3 1A+5B Balochistan 1 Quetta 2 2 Zhob 1 3 Loralai 1 4 Panjgur 1 12 1 1 1B World Health Organization – Country Office Pakistan 5 Aug 2008 Pakistan Floods Situation Report#F-1-2008 (3-5 August 2008) 6

5 Lasbella 2 14 1 1 1B 6 Gwadar 2 10 1 1 1B 7 Kech (Turbat) 2 17 1 1 1B 8 Awaran 2 5 1 1 1B 4 1 (7 Khuzdar 2 10 1 1 1B 9 Boxes) 1 (7 2 14 1 1 1A+1B 10 Boxes) 11 Jhal Magsi 2 10 1 1 1B 2 12 Jaffarabad 2 17 1 1 1B 13 Nasirabad 2 14 1 1 1B 14 Bolan 2 12 1 1 1B 15 Washuk 5 1 1 1B 16 Sibi 7 1 1 1B 17 Chaghi 12 1 1 1B Provencial Epidemic 18 1 Investigation Total 26 159 14 14 2A+19B FANA 1 Gilgit 1 2 Ghizer 1 Total 2 Total Delivered 90 210 17 17 2A+19B 3 6

World Health Organization – Country Office Pakistan 5 Aug 2008 Pakistan Floods Situation Report#F-1-2008 (3-5 August 2008) 7

Annex-I

CHOLERA KIT PACKING LIST Item Packaging 1 Cholera Kit 1 Doxycycline Capsule Oral 100mg 780 2 Erythromycin Tab, Oral 250mg 1000 3 Ciprofloxacin Tab, Oral 500mg 750 4 Co-trimoxazole Tab 480mg 2000 9 Co-trimoxazole 240mg/5ml, Susp. 50ml 100 5 IV Cannula 18G 132 6 IV Cannula 20G 132 7 IV Cannula 22G 45 8 IV Cannula 24G 45 10 IV Set with air inlet + needle Set 538 11 Ringer's Lactate, without set 1000ml 790 12 Ringer's Lactate, without set 500ml 264 13 ORS Sachet 2400 14 Sodium dichloroisocyanurate Tab (Aquatab) 8.5mg 2000

Quantification for One FLCF kit Qty for one Medicine Formulation kit Injection, 2%(hydrochloride)in 10 -ml Lidocaine 10 ampoule Lidocaine Topical 2% 10 Preoperative medication Adrenaline (Epinephrine) Inj. 1mg/ml 10 Diazepam Injection, 5 mg/ml in 2-ml ampoule 10 Non -opioids Diclofenac Sodium Injection 75mg/3ml 50 Paracetamol Tablet,500 mg Strip/blister 1200 Paracetamol Syrup, 120 mg /5 ml 160 Ibuprofen Tablets 400mg Strip/blister 500 Ibuprofen Syrup, 100 mg /5 ml 60 Antiallergics and drugs used in anaphylaxis Chlorpheniramine Syrup, 2 mg /5 ml 230 Dexamethasone Inj.4mg/ml, 1ml 25 Hydrocortisone Powder for injection , 100mg 10 Promethazine Tab. 25mg 140 Antiepileptics /anticonvulsant Carbamazepine Scored tablet, 200 mg 50 Anti-infective Drugs Intestinal anthelmintics Mebendazole Tablet,100 mg Strip/blister 120 Pyrantel(Pamoate) Tab. 250mg 20 Antibacterial drugs/Antiprotozoal Capsule or tablet, 250 mg (anhydrous) Amoxicillin 1000 Strip/blister Amoxicillin Powder for oral suspension, 250 mg/5ml 200 World Health Organization – Country Office Pakistan 5 Aug 2008 Pakistan Floods Situation Report#F-1-2008 (3-5 August 2008) 8

Capsule or tablet 100 mg (as hyclate) Doxycycline 200 Strip/blister Metronidazole Tablet, 400 mg Strip/blister 400 Metronidazole Oral suspension, 200 mg (as benzoate)/5 ml 60 Sulfamethoxazole + Trimethoprim* Tablet, 400 mg + 80 mg Strip/blister 1000 Sulfamethoxazole + Trimethoprim* Oral suspension 200mg+40mg/5ml 70 Ciprofloxacin Tab. 250mg 300 Erythromycin Tab. 250mg 600 Flucloxacillin Cap. 250mg 580 Antifungal Drugs Clotrimazole 1% 20 Nystatin Tab 500,000 iu 24 Nystatin Pessary 100,000 iu 30 Nystatin Drops 20 Antimalarial Tablet, 150 mg (as phosphate or sulfate) Chloroquine 500 Strip/blister Tab. Sulfadoxin500mg+ Sulfadoxin + Pyrimethamine 80 Pyrimethamine25mg Drugs affecting the blood Antianemic drugs Ferrous sulphate/Fumerate+ Folic Tablet , equivalent to 60 mg iron+ Folic acid 600 Acid 0.5mg Folic Acid Tab. 5mg 600 Scabicides and pediculicides Benzoyl benzoate Lotion 25%, 60ml 300 Disinfectants and antiseptics Povidone iodine Solution , 10%, 60ml 3 Chlorhexidine+Cetrimide Sol.,Topical 1.5%,Hospital Conc.,1 Ltr 1 Diuretics Furosemide Tablets 40 mg Strip/blister 100 Antihypertensive Nitroglycerin Sublingual Tab.500mcg 100 Isosorbide dinitrate Isosorbide dinitrite 10mg 100 Methyldopa Tab. 250mg 100 Digoxin Tab. 250mcg 25 Enalapril Tab, 5mg 20 Gastro -intestinal drugs Antacids and other anti-ulcer Ranitidine Tablets 200 mg 320 Aluminium Tablet, Aluminium Hydroxide250mg+Magnesium Hydroxide250mg+Magnesium Trisilicate 2000 Trisilicate 500mg 500mg Anti-emetic drugs Dimenhydrinate Tab.50mg 300 Dimenhydrinate Syp.12.5mg/4ml 20 Prochloperazine Tab. 5mg 70 Antispasmodic drugs Hyoscine butyl bromide Inj. 20mg/2ml 150 Oxytocics 10 Syntocinon Inj., 5iu/ml, 1ml

World Health Organization – Country Office Pakistan 5 Aug 2008 Pakistan Floods Situation Report#F-1-2008 (3-5 August 2008) 9

Oral Rehydration Oral Rehyderation salt, Glucose- Dry mixture (WHO Formula) in sachet for 1 160 salt solution liter of solution Antidiabetic Glibenclamide 120 Metformin Tab 500mg 100 Insulin Inj. 100iu (regular) 5 Insulin Inj. 100iu (70/30) 5 Antihypertensive Atenolol Tablet, 50mg 100 Topical Antibiotics Polymyxin B Sulphate 10,000iu + Bacitracin PolymyxinB+Bacitracin Zinc 14 Zinc 500mg/gm Ophthalmic preparation Chloramphenicol Eye drops 0.5% 10 Chloramphenicol Eye-oint. 1% 2 Drugs acting on the respiratory tract Antiasthmatic drugs Respirator solution, for use in nebulizers, Salbutamol 20 5mg (as sulfate)/ml, 20ml Salbutamol Tablet 4mg 240 Vitamins and minerals Vitamin A Tab. 50,000iu 80 Parenterals Dextrose Infusion 5% 1000ml 20 Sodium chloride Injectable soln. 0.9%isotonic1000ml 20 Ringer's Lactate Injectable solution 500ml 20 Disposables Syringes 1cc 20 Distilled Water 5cc 100 I.V.Sets (Ministry of health 60 approved) I.V.Cannula No. 20 5 I.V.Cannula No. 22 5 Surgical Gauze 40M Thaan, 1mx40m 30 Cotton Bandages 6.5cmx2m 24 Absorbant Cotton Wool 500gm 20 Examination Gloves Box (100's) 600 Masks Face Mask 5 Slides 5 Blood Lancets 5 Clean delivery kit 5

World Health Organization – Country Office Pakistan 5 Aug 2008