Facing Winter, Pakistan Earthquake Victims Struggle to Survive

ISLAMABAD, Pakistan, November 14, 2005 (ENS) - Hundreds of earthquake survivors spoke with worried relatives this week for the first time with the help of the British Red Cross. The survivors have been stranded in remote villages high up in the Himalayan mountains since the 7.6 quake struck early on the morning of October 8.

Pam Hussain, tracing delegate for the British Red Cross, accompanied relief workers distributing aid in the Jhelum and Neelum valleys and carried with her a satellite phone to allow families to contact their loved ones. Hussain flew in the helicopters to areas made inaccessible by landslides, on missions coordinated by the International Committee of the Red Cross and Red Crescent.

"The heads of households gathered with phone numbers written on pieces of paper and then they made their phone calls to relatives," Hussain said. "The people were remarkably calm," said Hussain. "Generally they were phoning relatives in the large towns or quite often family in the Middle East. As far as I know this was the first contact they had been able to make. They would say, 'We have lost everything,' and discuss what they were going to do during the winter."


The entire Qadoos family now lives in one tent next to the remains of their former home. Father Abdul Qadoos worries about the quality of the tent. With cold weather approaching, he hopes to be able to secure a new tent better able fend off the rain, snow and wind. (Photo Chris Black courtesy WHO)
The worst earthquake in Pakistanís history has killed an estimated 79,000 people, according to the latest government figures, wounded another 77,000 and devastated nearly 30,000 square kilometers, as well as leaving at least 2.8 million people homeless.

In addition to the enormous human toll, the earthquake and its aftermath will cost an estimated US$5.2 billion, which includes estimated costs for relief, livelihood support for victims, and reconstruction, according to a report released Saturday by the Asian Development Bank and the World Bank.

At the request of the government of Pakistan, a mission led by the two banks conducted a preliminary damage and needs assessment October 24 through November 5. The assessment was undertaken in the three most severely damaged districts in Azad Jammu and Kashmir (AJK) and five districts in North West Frontier Province (NWFP).

Even before the earthquake, this was a vulnerable region, the assessment team reported. "A high proportion of the population lacks basic services and facilities like clean drinking water and safe disposal of waste. The region is also an area of extreme environmental vulnerability, characterized by frequent landslides and unchecked urban development with few environmental safeguards," the team wrote.

Of the total housing stock, 84 percent was damaged or destroyed in AJK and 36 percent was damaged or destroyed in NWFP. The transport, education, and agriculture and livestock sectors also suffered "sizable damage," wrote the assessment team.

The team emphasizes the need to conduct recovery work according to guiding principles such as the rapid rebuilding of peopleís livelihoods, independence and self-sufficiency, subsidiarity and decentralization, a focus on most vulnerable and socially disadvantaged groups, securing development gains, strengthening capacities to manage the recovery process, transparency and accountability, and reducing Pakistanís vulnerability to future disasters.

The preliminary needs assessment divides the total reconstruction cost into three main sectors:

But the amount of funding pledged for earthquake recovery falls far short of the overall US$5.2 billion needed. As of Friday, according to Pakistani government reports, assistance totaling nearly US$2.5 billion has been pledged by a total of 83 bilateral as well as multilateral donors. Many provided in-kind support including logistical and manpower assistance to the relief efforts as well.


Nasleema Bibi comforts her baby, Samarine, who is ill because of the cold. Nasleema's other children were killed in their school when it collapsed after the earthquake. The rest of the family is living in a small camp near the cricket stadium in Muzzafarabad. (Photo by Chris Black courtesy WHO)
In total, civil society has mobilized nearly US$100 million in donations and has provided clothing, temporary shelter, food, medicines and other in-kind items and services to the victims.

The imminent onset of winter storms makes getting shelter and supplies to isolated quake victims at high altitudes an urgent priority for aid agencies, but in the race against winter, three nongovernmental organizations warn of the ongoing environmental dangers resulting from the quake.

The World Conservation Union (IUCN), the Worldwide Fund for Nature (WWF), and CARE International warn that aftershocks will continue for some time. "They are not predictable and can occur at any moment. There is a high risk that buildings with structural damage will collapse. Even without aftershocks, damaged buildings may collapse with the onset of seasonal rains, snow and melting ice. The public should avoid entering or staying in damaged structures, or even coming close to them."

Landslides are likely to result from more aftershocks and heavy rains and melting snow will trigger mudslides, the groups warn. Shelters and roads on foothills and steep slopes are especially at risk, the three groups warn. Temporary camps should avoid steep slopes and stream and river beds where they may be at risk from flash floods. Floods are an increased hazard as rivers, blocked by landslides, can break free. Roads are likely to be blocked by new landslides and snow.

Disease is expected to spread from poor housing and sanitation, especially in urban areas and new emergency settlements. Providing safe drinking water from clean sources, and providing proper sanitary conditions, should be a top priority, the groups say.

Debris from collapsed and damaged buildings has created garbage that now poses health hazards as well as environmental concerns. The provision of relief items has added to the problem of waste that needs to be cleared. The three groups recommend that the clearing process focus on re-use and recycling as much as possible. They say that debris which cannot be reused needs to be disposed off in an environmentally sound manner.

"Forests that were carelessly destroyed or left in bad condition before the earthquake took place might have helped to reduce the damage and loss to life from the quake," the groups suggest, and they say that the need for shelter, firewood, and wood for reconstruction, by millions of people affected by the quake now poses a new threat to the surviving forests.

"Forest products are critical to the survival of disaster victims in the coming winter. However, unsustainable exploitation of the limited forest resources will add to the risk of landslides, erosion, droughts and floods. It is essential that measures be taken to manage the forests in a sustainable manner for the benefit of the earthquake affected people and to provide alternatives that will protect them from destruction," say CARE, IUCN and WWF.

Health authorities have launched a two week campaign to immunize 800,000 children among quake victims in Azad Kashmir following concerns that infectious disease could take hold and spread in the crowded tents.

The immunization campaign by UNICEF and Pakistanís Health Ministry targets 800,000 children up to 15 years age with vaccines for diseases including measles, polio, diphtheria and tetanus, said Dr. Edward Hoekstra, a senior health adviser for UNICEF.


Dr. Bushra Shams (right) is the World Health Organization Tuberculosis Program officer for Pakistan-administered Kashmir. (Photo by Chris Black courtesy WHO)
Tuberculosis is also a problem, says World Health Organization TB program officer in Muzzafarabad Dr. Bushra Shams. "Most of the TB centers were almost completely destroyed. There are no laboratories left, no patient records and no drugs. We are having to start from scratch. Although most of the technicians and doctors survived, many are among the injured," she says.

An acute shortage of latrines in quake-affected areas will undermine health and could lead to serious disease outbreaks unless immediate action is taken, aid workers warn.

"We need to build about 200,000 toilets," said Andrew MacLeod, head of the UN Emergency Coordination Centre in Islamabad, according to IRIN, the UN's humanitarian news agency.

"We have to aim for something like that - but that goal is a long way off," Larry Robertson, project officer and chief of water and environmental sanitation for UNICEF, said in Muzaffarabad.

With an estimated four million people defecating in the open and 1,500 metric tons of human waste being produced every day, communities are at high risk of an outbreak of communicable disease, UNICEF has warned.

UNICEF is working to install latrines at a number of camps established in populated areas like Muzaffarabad, working with the UK-based nongovernmental organization Islamic Relief and Irish-based group Concern, as well as coordinating with Oxfam and Medecins Sans Frontieres Holland.

As temperatures drop, cases of acute respiratory disease among infants and children are on the rise. Unsanitary, crowded conditions in camps are making it more difficult to control communicable diseases, according to the International Medical Corps (IMC).

IMC is coordinating efforts with the Pakistan Army to reach remote areas via airlifts and is also using the armyís assistance to transport the seriously injured for inpatient treatment.

The Meteorological Office of Pakistan has said that more rains and snowfall are expected in the earthquake areas, causing extreme difficulty in reaching survivors for relief and rehabilitation.