PAKISTAN/NWFP CONFLICT Situation Report no. 3 19 May 2009 Highlights As of 18 May, according to the Provincial Relief Commissionerate, the number of IDPs has risen to 2182 503 from 1 716 026 on 15 May in 11 NWFP districts (287 087 in 26 IDP camps and 1 895 476 outside). A suspected measles outbreak alert reported in Labor Colony, Mardan District, which is being investigated. Formation of Acute Watery Diarrhoea Response Team is initiated in collaboration with UNICEF, Department of Health and other partners. Lt. General Nadeem Ahmed, Head of Special Support Group for IDPs informed in a meeting held on 18 May in Peshawar that the operation in Bajaur agency is completed and IDPs from this area can return home. The World Bank is planning to conduct damage and needs assessment. Health Impact • The general health situation in all IDP hosting districts in North West Frontier Province (NWFP) in camps and host communities remains stable. But rising trends in diarrhoea cases are being reported from the Jalozai IDP camps. An alert of suspected measles outbreak reported from Mardan district. Disease surveillance teams are closely monitoring the situation. Health Sector Response • UNFPA is distributing 11 000 hygiene kits to IDP families in camps. • UNFPA completed Maternal Newborn and Child Health (MNCH) situational analysis survey in the Mardan, Sawabi, Nowshera and Charsadda districts. A report is being compiled. • Measles campaigns have bee been conducted by department of health supported by UNICEF and WHO in Sheikh Shehzad, Sheikh Yaseen, Jalozai, Mazdoorabad Yar Hussain and labor colony camps and around 17051 children (9 months–13 years) have been vaccinated. District Mardan • Merlin and WHO investigated a rumour of Bloody Diarrhoea (BD) in one temporary camp in the Lund Khwar school. The rumour was found to be false. • WHO surveillance team is investigating a suspected measles outbreak alert in Labor Colony where about 500 IDP families are living. Blood samples from two suspected IDPs cases have been sent for laboratory investigation. Measles mass vaccination started immediately in the colony. • One mobile medical team of National Commission of Human Development (NCHD) offered to provide services in the area and was tasked with training on the disease early warning system (DEWS) by WHO. • In Mardan, 413 government schools have been identified where IDP families are living. • Eight mobile medical teams working in the district (3 Merlin and 5 NCHD) are providing medical coverage in the schools and spontaneous camps. WHO is providing medicines to the mobile teams. • Sheikh Shahzad IDP Camp: Merlin is providing 24/7 medical coverage and conducted 94 consultations on 17 May. Diarrhoea remained 9% (8) of the total consultations. • Sheikh Yaseen IDP Camp: UNICEF, WHO and department of health have completed the measles vaccination campaign and immunized 2167 children in the camp. The Frontier Primary Health Care (FPHC) is providing 24/7 medical coverage in the camp. FPHC conducted 718 consultations on 17 May, with 17% (132) exhibiting diarrhoea. A WHO environmental health engineer monitored the level of free residual chlorine in tankers, which was found to be within WHO standards. But a water sample from one tanker was non- chlorinated, which was communicated to municipal administration. • Mazdoorabad IDP Camp: MSF-Belgium and Center of Excellence for Rural Development (CERD) providing medical services in the camp, immunizing 666 children aged under 13 years have been vaccinated against measles. • Jalala IDP Camp: Merlin is providing 24/7 medical coverage in the camp, conducting 184 consultations on 17 May, with 14% (27) exhibiting diarrhoea. District Nowshera • The Social Welfare Department is registering IDP in the new Jalozai IDP camp. Merlin and People’s Primary Healthcare Initiative (PPHI) are providing 24/7 health services there. • 105 (19%) of 552 total consultations in the Jalozai camp's three health facilities were acute diarrhoea (AD) cases. Two stool samples were collected for AD and sent to National Institute of Health (NIH) in Islamabad for laboratory investigation. Free medicines are being provided to patients at Jalozai IDP Camp, Nowshera. Picture by Zeeshan/WHO District Peshawar • Four teams comprising a doctor, medical technician, ambulance for referral have been placed at four different IDP registration points (the Govt. School for Blind Nanakpura; Govt. School for Dumb and Deaf, Gulbahar; Agriculture Research Center University Road; and Charsadda Adda.) The teams were deployed by the executive district officer (EDO) health and district coordination officer (DCO) in Peshawar. • EDO Health Peshawar said 376 doses of anti-snake venom and 1132 doses of anti-rabies vaccine are available. The designated vaccine focal point is Mr. Dastageer who can provide the vaccination immediately based on needs in Peshawar district. • One new confirmed leishmaniasis case was reported from Kacha Ghari-II IDP camp, raising the total number of cases to 10 in the camp. • Merlin in collaboration with WHO and department of health is conducting the second round of a hepatitis-B immunization campaign in Kacha Ghari I & II IDP camps. District Charsadda • International Medical Corps (IMC) is providing 24/7 primary healthcare services in Palosa 1 (old) IDP Camp. Relief International and PPHI are providing health services in Palosa 2 (new) IDP Camp in Charsadda. • The Provincial Malaria Control Programme conducted residual spraying in the Palosa 2 IDP Camp. District Swabi • IMC, Bahria Town Trust, PPHI and Department of Health (DoH) are providing health services in Yar Hussain camp, Swabi. The camp's population has reached 5549 (1040 families). On 17 May, 13% of 228 consultations in the camp are for AD cases. • Pakistan Red Crescent Society (PRCS) is providing health services in Shah Mansoor Camp 1 and 2, Swabi. • WHO environmental health engineer tested two water samples from Yar Hussain IDP Camp, Swabi (one from a water tank and another from a household) that were found fit for drinking and chlorination. Health sector coordination • A Health Cluster coordination meeting was held in Islamabad on 19 May and chaired by the State Minister for Health and the WHO Representative. The Health Emergency Preparedness and Response Center’s focal point briefed the meeting on the current situation and response by federal and district health authorities and partners. The State Minister thanked all partners for providing services to the IDP and assured them continued MoH support. • Mapping of health services in the camps has been done. The information on health staff and services is being analyzed to identify the gaps and needs that will be discussed in the next health cluster meeting to respond. Urgent needs • Measures should be taken to stop selling of food items such as ice balls, Kulfi (home made ice cream) etc. prepared and kept in unhygienic conditions by the street vendors in the premises of camps. • Increase in number of mobile teams working in Mardan district to serve emerging spontaneous camps. • Water and sanitation conditions in IDP camps need urgent attention to prevent spread of water-borne diseases. • Working conditions for health care providers in terms of tents and shelters in IDP camps need improvement. • Better infrastructure for health clinics in camps to provide conducive environment for patients. A street vendor is selling ice balls in the Jalozai IDP • Additional female health care providers to cater to the Camp, Nowshera. Picture by Zeeshan/WHO health needs of female IDPs. • Surgical supplies for hospitals in conflict zones. Web links • WHO HQ: http://www.who.int/hac/crises/pak/en/index.html • WHO Pakistan: http://www.emro.who.int/pakistan/index.htm • Pakistan MoH: http://www.health.gov.pk 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 Population Update Source: Provincial Relief Commissionerate, 18 May 2009 S# Name of District Name of Camps No. of No. of families person 1 Lower Dir Samarbagh Stadium 18 126 Govt Degree College Timergara 0 0 Khungi Camp 0 0 GDC Jandool (Sadbar Kalay) 26 168 Munda Camp Dir. 20 140 2 Charsadda Govt Teach Trg: School Palosa 449 2744 3 Nowshera Benazir Welfare Complex 400 2495 4 Peshawar Kacha Ghari 1519 8880 Kacha Ghari No. 2 1084 6466 5 Nowshera Jalozai 7787 47738 6 Distt Malakand Sakhakot Malakand (Dargai) 540 3200 Total:- 11843 71957 The Social Welfare Department, with the assistance of UNCHR, is carrying out registration process of all IDPs living outside camps with families/friends etc. So for more than 77 516 families (462 528 individuals) have been registered as "off-camp IDPs" in 11 districts. New arrivals in Camp S.# Name of Distt Name of Camps. In Camp IDPs Families Individuals 1 Lower Dir Commerce College Wali Kandaw 322 2214 Govt Degree College Timergara 294 2185 (new camp) GHSS,Samarbagh(shifted of 361 2368 Samarbagh stadium) Sadbar Kalay 174 1037 2 Mardan Shaikh Shehzad 1354 8079 Jalala(Takht Bhai) 1200 9685 Sheikh Yaseen 1926 12834 Mazdur Abad 711 4884 3 Swabi Yar Hussain 914 4916 Anbar 180 1750 Shah Mansoor 900 5702 WW Board School Shah Mansur 102 700 4 Malakand Dargai camp 9834 96148 Palai camp 3860 27225 Rangmala Piran . 1154 7568 5 Nowshera Jalozai (new camp) 4368 27041 6 Charsadda Palosa (new camp) 124 734 Total 27778 215070 New arrivals of IDPs in off Camp S.# Name of Districts Off Camp Reg. IDPs Families Individuals 1. Mardan 93259 790026 2 Swabi 40094 241046 3 Malakand 22135 179491 4 Nowshera.