Pakistan Floods Situation Report # 5
Friday 13 July 2007
Highlights • Inhabitants along Chenab river in Punjab cautioned against imminent threat of floods.
• Breach in canal running through district Dadu, in three places, leading to flood, work in progress to repair.
• Kemari town in Karachi regularly reporting to DEWS system, nine sites reporting the data.
Summary There have been no further severe rains in the flood-affected areas, allowing some recovery to begin. However, there are still a large number of displaced people in need of food, potable water, shelter, and health care. Flood waters moving southward have caused breaches in canals in Sindh, resulting in the flooding of previously unaffected areas. As yet there have been no reports of outbreaks of communicable diseases.
Baluchistan NGO partners have been providing primary health services alongside the existing staff of health facilities, and teams sent by the Ministry of Health. Though there are still gaps, particularly in addressing women’s health concerns, access to basic healthcare is improving.
Sindh A canal in district Dadu, running through talukas Mehar, Khairpur Nathan Shah, and Johi has been reported on 9 July to have breached in three places leading to flooding in Faridabad and Burera in taluka Mehar. The army and civilian engineers are working to repair the breaches. In taluka Qubo, district Kamber, people have settled in groups of 15-25 families in open yards, family camps, schools and along the Qubo-Balochistan highway. There is no evidence of established, organized camps where facilities are provided under a unified administration. The Pakistan army has distributed some tents and food rations to families. Many of the roads are still impassable.
North West Frontier Province The death toll from the floods has been revised downwards from over 100 to 53 dead and 70 injured in Chitral, Swat, Nowshera, Peshawar, D.I. Khan, Tank, and Kohistan. Pakistan Floods Health Situation Report # 5 2
Many districts are cut off from communication, so the extent of damage is not fully known.
Punjab The citizens of seven districts along the Chenab river in Punjab were warned to move to safer locations due to an imminent threat of floods as a result of the discharging of close to 16 000 cubic meters of water per second into the Chenab.
Health impact
Baluchistan A case of diphtheria was reported from Turbat. Samples have been sent to the National Institute of Health for verification.
Sindh In taluka Qubo, district Kamber, no vaccine preventable diseases were reported from any of the camps visited. Skin infections were the most common disease notified in reports by the treating health care providers, followed by respiratory problems and diarrhoea. There were no outbreaks of communicable diseases reported. Routine vaccination in the area is reported to be weak, and in the EPI teams in the field, there were some reports of a shortage of vaccine.
In district Dadu, there have been no reports of diarrhoea with severe dehydration, no snake bites, and no deaths due to communicable diseases.
NWFP There have been no reported outbreaks of communicable diseases in NWFP.
World Health Organization – Country Office, Islamabad, Pakistan 13 July 2007 Pakistan Floods Health Situation Report # 5 3
. Health response
1. Assessment and monitoring
Baluchistan Overall in Balochistan, 11 EDOs are providing data for DEWS to monitor communicable diseases.
In Noshki, two of the ten BHUs have collapsed, but four medical camps have been set up in four villages, equipped with medicine and staff
In Nasirabad, MoH relief camps are working 24 hours a day, with Mercy Corps providing three staff members in support. Two Basic Health Units (BHUs) and two Civil Dispensaries (CDs) are still under water. Almost 1000 patients have been seen by the existing facilities and the mobile teams.
In district Kalat, three dams have been damaged, posing a risk to the people in the area. No relief had been provided as of 8 July. There are an estimated 12 000 people without shelter, safe water, or food in this district, with a further 30 000 living in inaccessible areas who may be at risk.
Sindh UNICEF and WHO conducted an assessment in talukas Quba, Mirokhan, Kamber, and Warah, where they also distributed supplies. It was estimated that 10% of the total population of District Kamber/Shahdadkot are affected by the floods. Qubo taluka is the worst hit with approximately 80% of the population affected. The water level is still rising in some villages.
Most of the health facilities in Qubo (6/7) are not functioning, though there are mobile camps in the area providing services. There are several NGOs and private organizations providing health care services, though they are not coordinating their effort and some affected areas are still not well served. Among those providing health care, no detailed records are being kept, making the disease trends impossible to monitor.
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World Health Organization – Country Office, Islamabad, Pakistan 13 July 2007 Pakistan Floods Health Situation Report # 5 4
Table 1. Cumulative Data collected by WHO/UNICEF staff in various camps visited in the Kambar Shahdadcote district
UC Acute bloody Chest Skin clinical Sun Snake Dog Death Injuries Facility
Diarrhoea Diarrhoea infection infection malaria Stroke Bite Bite RHC QUBO 134 36 117 182 89 138 10 4 0 2 camp Dostali Mobile 77 36 104 118 37 25 0 0 0 0
Gabidero Mobile 15 0 15 10 11 0 0 0 0 0
CD 102 22 127 125 50 39 0 0 0 0
Total 328 94 363 435 187 202 10 0 0 0
Health Coordination
In NWFP, the cluster system has been activated for coordination. DEWS forms have been distributed to the districts.
In NWFP, the DoH requested WHO and UNICEF to help in establishing an information unit within DoH, they have accepted the challenge.
2. Filling health gaps
Sindh In district Kamber, the drugs donated by WHO previously are not yet being used; old stocks are being used up first. Routine examination rates have been low, however vaccinators have been sent into the camps and report that they have vaccinated all of the children present.
In district Dadu, a polio surveillance officer offered to set up a medical camp at Union Council Fareedabad with the help of a team of vaccinators.
Throughout district Dadu, 14 medical camps treated 595 patients on 10 July alone. There are a further 4 mobile units functioning to provide services to affectees.
CARE International established an MCH centre in Shadadcote, and saw 100 patients on the first day. They also constructed latrines for both men and women to improve sanitation conditions. A community school was set up to provide a safe space for children, and to teach them about proper hygiene.
World Health Organization – Country Office, Islamabad, Pakistan 13 July 2007 Pakistan Floods Health Situation Report # 5 5
Participants of Health education session at Johi town.
Baluchistan Malteser has provided 1000 family survival kits in Kharan, and will undertake a hygiene awareness programme in the area.
ARC is providing health care in Asiabad (Noshki) and have seen 1533 patients since beginning to provide services.
CARE International will train traditional birth attendants in safe delivery to help fill the need for skilled birth attendants. They will also provide psycho-social support for children.
Merlin has sent a mobile medical team to Jhal Magsi with sufficient medicines for 10 000 persons.
Islamic Relief has established two medical camps in Kharan and Chogi, and has plans to establish 12 medical camps within the next six weeks.
World Health Organization – Country Office, Islamabad, Pakistan 13 July 2007 Pakistan Floods Health Situation Report # 5 6
Table 2. Health Emergency Operations Cell, Karachi, Sindh
Support to worst Rain/ Flood affected Districts/ Provinces in Pakistan Location Trauma NEHK Cholera Chlorine Basic Anti Hygiene Date of Mode of Kit Kit Tablets Kit Snake Kits by Delivery Transport Venom UNFPA Baluchistan Lasbela 1 30 000 1 1-Jul-07 Road Jhalmagsi 1 20 000 1 4-Jul-07 Road Jafarabad 2 20 000 1 4-Jul-07 Road Nasirabad 1 10 000 1 4-Jul-07 Road Turbat 2 1 30 000 2 5-Jul-07 Air Sindh Karachi 109 184 20 27-Jun-07 Road Kambar 1 10 000 4 50 500 4-Jul-07 Road Thatta 10 000 4 100 500 6-Jul-07 Road Civil Hosp 40 5-Jul-07 Road Hyd
DG Hyd 1 100 000 200 5-Jul-07 Road
Larkana 500 7-Jul-07 Road
Kashmore 25 7-Jul-07 Road
Naushero 100 Feroze Badin 50
Matiari 80
Total 8 1 1 339 184 14 665 1500
3. Preserving and supporting local health systems
Urgent needs
Mother and child health support is urgently needed in the flood affected areas. CARE International reported that there were no female health workers in Shadadcote before they established their Mother and Child Health Centre.
World Health Organization – Country Office, Islamabad, Pakistan 13 July 2007