(Jalozai camp Nowshera Health district Cluster- Photograph Pakistan by Syed Haider Ali) Floods in Pakistan Situation Report 4 3 August, 2010 WHO PAKISTAN-park road, Chak shazad, Islamabad - [email protected] - T: +92 051-9255184/5 Fax +92 051-9255083 (Disease surveillance by diseases early warning system’s team in Nowshera district) Highlights: Infrastructure damage is hampering public access to health facilities in multiple locations. Diarrheal diseases are among the most reported health conditions in multiple locations. Tehsil Headquarter hospital in Balakot, Mansehra, which was newly constructed after the earthquake and was providing health services to the whole of Tehsil, has been washed away by the floods, leaving the area without any health service infrastructure. Basic Health Units Jog, Dubair, Moni Khel, Thoti and Jashi in Kohistan district have also been washed away. Another 12 health facilities were destroyed in Dera Ismail Khan in Khyber Pakhtunkhwa. WHO, government and Health Cluster partners are continuing the health response, particularly through mobile medical teams. Health Cluster, Pakistan The health cluster is underfunded to sustain the health needs of flood affected population all over the country, So far it is mobilizing its resources from Internally displaced persons funds, which will affect the health sector support in both of the crises Situation Overview and Current Scope of Disaster The National Disaster Management Authority (NDMA) has reported nearly 1000 deaths, with nearly 1 million people affected. The Metrological Department has forecast more rains, including heavy monsoon rains over the flooded areas of Khyber Pakhtunkhwa(KPK) during the next 18 hours (Peshawar, Kohat, Lakki-Marwat, Bannu, Tank, D.I.Khan, Nowshera, Swabi, Charsada, Mardan, Swat districts) and southern/western Punjab (Mianwali, Bhakkar, Layyah, DG Khan, Rajanpur, R.Y.Khan, Muzafargarh districts). These widespread, at times heavy rains may generate further flash floods in the local rivers/nullahs of Khyber Pakhtunkhwa and the hill torrents of Dera Ghazi Khan and Rajanpur areas. The flood situation in Khyber Pakhtunkhwa and Punjab may further be aggravated due to the monsoon rains. In Punjab the river Indus banks have been breached in at least seven districts (Mainwali, Bhakkar, Layyah, Mauzaffargarh, DG Khan, Rajanpur, RY Khan as the flood waters from North of the country(Khyber Pakhtunkhwa) rushed to the South. NDMA has reported 47 deaths with 990 villages affected and some 15,000 houses damaged. The Sindh province is also affected with the worst floods in the last 34 years. It is expected that I million cusec water will be passing by Sukkur Barrage by the end of this week. The District government Ghotki has declared an emergency in all its important departments keeping in view the increased flow of the Indus River. There is no change in the flood situation of Baluchistan since yesterday. The floods have damaged a total of 34 health facilities in KPK, 5 in Baluchistan and 5 in Azad Jammu and Kashmir Health impact Increasing cases of diarrheal diseases have been reported in the past two days in affected areas, but no large-scale outbreaks have been confirmed. Almost 9,713 consultations, including 11% for cases of acute, were reported to 3 August in Peshawar, Mardan, and Charsadda and Nowshera districts of Khyber Pakhtunkhwa and 1177 consultations during 29 July to 2 August in Baluchistan Province. See further details below. Health Cluster partners have speeded up emergency health support activities in the country. Health sector response In Khyber Pakhtunkhwa, Seventeen (17) mobile health teams have been providing health services in different flood-affected areas of Peshawar district. These include seven (7) teams from the executive district health office (EDO-H), one (1) from the Population Welfare Department, one from Hayatabad Medical Complex, three from the Khyber Teaching Hospital, one from the Lady Reading Hospital and four from the People’s Primary Healthcare Initiative (PPHI), Peshawar. Two of these 17 teams were sent to Charsadda district and two to Pabbi, Nowshera. Two static teams are providing health services to internally displaced people in Government High Schools No. 1 & 2 in Peshawar district. Pabbi Hospital has been made operational on the directives of Secretary Health Khyber Pakhtunkhwa with the support of Medicines Sans Frontiers. The mobile teams and static clinics have conducted 5839 consultations, of which acute diarrhoea (AD) accounted for 562 patients (14%) with no dehydration. Health Cluster, Pakistan In Nowshera district, a Medical Mobile team has been dispatched to Tharkhey area. Two Medical Mobile teams will be dispatched to Akora Khattak from EDO (H) Swabi. In Charsadda 21 Medical Mobile teams are in the field. Two Medical teams have been dispatched to Shabqadar area. A total of 1700 patients have been treated, of whom 340 were suffering from acute diarrhoea. In Mardan district a total of 320 consultations were recorded from four health facilities. A total of 50 patients have been treated for acute diarrhoea. Another three were treated for bloody diarrhoea. In Kohistan district, one medical camp has been established at Rural Health Centre (RHC) Pattan and Rural Health Centre (RHC) Dassu, where it is providing health services to the flood victims round the clock. Health staff conducted 1864 consultations in Jalozai IDP camp, Nowshera district, on 3 August. Of these, 74 were for acute diarrhea without dehydration. 16 Tube well sources in District Swat, 6 in Batkhela, Malakand district and 8 in District Charsadda are operational and ready to be used for water supplies to the affected communities through tankers. Save the Children conducted 692 consultations at five health facilities in Swat, DI Khan and Buner on 1 August, 2010. Two ambulances have been deployed from Buner to Swat, district to assist in the relief and rescue efforts. In Allai, Batagram district, Save the Children staff conducted a rapid assessment of seven Union Councils. The assessment confirms that over 200 houses have been damaged or destroyed, 47 roads have been damaged, 51 water mills and 48 drinking water systems have been rendered useless. The assessment also confirms that in the seven Union Councils, over 2000 kanals of agricultural and plantation land has been destroyed. Pakistan Red Cross Society (PRCS) in Pir Payee, District Shangla, examined 569 patients. On 2 August in Nasapa (District Peshawar) it examined another 775 patients. International Medical Corps Mobile Medical Unit at Government Higher Secondary School No. 1 in Peshawar City, where 2100 flood affectees are residing, has treated 110 patients. Church World Service is conducting an average of 288 consultations per day to flood-affected populations of Mansehra district in Tehsil Balakot. The organization is also running a mobile clinic and has treated 150 patients. In Naseerabad district of Balochistan province, a total of 1177 patient consultation have been reported from 29 July to 2 August. Clinical malaria was the leading cause of morbidity with 286(24%) cases, followed by 231(19%) cases of Acute diarrhea and 202(17%) of scabies. WHO Response In Charsadda district, WHO provided one diarrhoeal treatment kit to the district headquarters and one mini-emergency health kit (MEHK) to the PPHI. In Swat district, WHO provided three MEHKs, 3 diarrheal treatment kits, and three surgical kits to the executive district health office, plus 1600 Oral Hydration Salts to MERLIN INGO in the same district. Health Cluster, Pakistan In Nowshera district, WHO provided two MEHKs to the Executive District Office-Health. WHO is also supporting the disease early warning and response system throughout the flood- affected areas. WHO team trained the Tehsil Municipal Administration, Department responsible for water and sanitation of Charsadda district staff, and nominated a focal person for chlorination of the tankers. WHO trained this focal point on dosages of chlorine stock solution and on record keeping, and has provided ready handouts on chlorination and monitoring. Annex A Medicine legend Items/Kit Name Coverage MEHK (Mini Emergency Health Kits) (6,000 population for one month) IEHK (Interagency Emergency Health (30,000 population for one month) Kits ) Diarrhoeal treatment Kits (400-500 interventions) Trauma Kits (100 severe interventions) For further information please contact Dr Hendrikus Raaijmakers Emergency Preparedness and Humanitarian Action Coordinator e-mail: [email protected] Syed Haider Ali Communications Officer mobile: 0092 3004005944 e-mail: [email protected] Health Cluster, Pakistan .