Disease Stalks Pakistan's Injured, Homeless, Children After Quake

ISLAMABAD, Pakistan, October 14, 2005 (ENS) - "It's freezing cold at night, and there is a biting rain in the day. Injured people are everywhere, and everyone is very focused on caring for these people," said World Health Organization medical officer Dr. Anthony Mounts from the city of Muzaffarabad, destroyed by the 7.6 magnitude earthquake on Saturday.

Dr. Mounts was calling in to a news briefing in Islamabad on Thursday over the racket of helicopters landing with supplies and taking off with people who need medical help. He is in the region to assess the most urgent health needs for the earthquake survivors.

The official death toll has now risen to 33,000 in Pakistan and just over 1,200 in India. UN officials have produced estimates of 3.3 million homeless and around one million in need of assistance. Nongovernmental organizations are placing the death toll at close to 40,000 people.

Dr. Mounts told journalists that in Muzaffarabad bodies are still being pulled from the rubble, and that people are gathered in makeshift tents in front of what used to be their homes. He says they do not have enough clean water, food, or blankets.


An injured boy shares a cot with another earthquake survivor at a temporary medical facility in Muzaffarabad, Pakistan. (Photo by Pirozzi courtesy UNICEF)
Dr. Mounts warned that with no proper sanitation, no way to wash hands, and no clean water to drink, the health of survivors is at even greater risk.

"We are advising people to quickly build proper latrines," he said. "One person told me "we can just go down by the river." But people are also using the river for drinking water. You just cannot use it for both because of the risk of disease," he said. "We are trying to get people to think about this before an even bigger disaster happens."

President General Pervez Musharraf in an address to the nation on Wednesday that the delay in reaching the remote areas was due to the fact that "roads were blocked, there was no army and the administration itself was among the victims."

The President said now "rescue and relief activities are in full swing as roads are now opened."

He expressed Pakistan’s gratitude for the assistance of the international community. "We have been given a lot of donations. We have been assisted in relief and rescue operations and several medical teams and field hospitals have been established by various countries." He thanked by name Turkey, UAE, the United States, the U.K., Saudi Arabia, China, Germany, Russia, France, Japan, Switzerland, Spain, Iran, Azerbaijan, Hungary and Bangladesh.

President Musharraf said Indian Prime Minister Dr. Manmohan Singh telephoned him and offered "all possible assistance." Pakistan and India have been at odds over quake-stricken Kashmir for decades. "We express our gratitude to him and we have accepted Indian aid," Musharraf said.

Still, with winter just a few short weeks away, health officials worry about the short window of opportunity they have to supply clean water, blankets and tents to the survivors.

World Health Organization Crises Coordinator Rachel Lavy told journalists about the extreme situation in Islamabad, where every hospital bed is now occupied by people injured in the earthquake.

She said a constant stream of helicopters is bringing people in throughout the day. To care for them, health workers have set up a tent hospital next to Islamabad's main hospital. People need emergency surgery to repair crushed and broken limbs, head, chest and spinal injuries and infected wounds.

"We need to have field hospitals out in the places that are affected," said Lavy. "We cannot possibly transport all of the people who need surgery here to Islamabad."

She said that six field hospitals have already been set up by various donors, and now workers want to make sure hospitals and supplies get to the places where they are needed.


Relief helicopters take off from Mansehra stadium, in a hard hit area of northern Pakistan. (Photo courtesy UNICEF)
"We're very worried about people in the remote valleys. We must get field hospitals to those places by helicopter. People are still not being reached," she said.

Lavy is coordinating field hospitals and other medical supplies through the joint Pakistan Ministry of Health - WHO Donor Coordination Unit at the Pakistan Institute of Medical Sciences.

She stressed that the need for urgent surgeries is not going to end soon. "With people coming every hour, and more people walking or being carried out of the mountains for help, not to mention those we haven't even reached yet, we can expect this urgent situation to last at least a week. And at the same time, we must address the looming public health problems of epidemic disease and pneumonia."

Dr. Mounts said the next urgent move is to get people vaccinated against measles and tetanus. Measles could spread very quickly and would be deadly for children who are already suffering a lack of food and weakened immune system, he said. Just 60 percent of people under 15 in the affected area are vaccinated against measles.

Over 26 hospitals and 600 health clinics have been destroyed, WHO's Regional Director for the Eastern Mediterranean Hussein Gezairy said Thursday, calling for a tripling of the number of doctors, including general practitioners, paramedics and epidemiologists. Emergency supplies are also desperately needed,he said, including anaesthetics, antibiotics, intravenous fluids, painkillers, bandages, and medicine such as insulin.

The agency is providing emergency health kits that can cover basic health needs for 210,000 people for a month, and surgical kits for 1,000 surgeries. They will also be providing tetanus vaccines, and 100,000 chlorine tablets to disinfect water, while malaria officers will begin spraying the area against mosquitoes.

In the north Pakistan, a representative of the UN High Commissioner for Refugees, Guebre Christo, said that additional helicopters are needed to ferry victims for emergency health care.

"My heart really went out to the huge number of wounded people lying by the helipad, waiting from someone to take them to an appropriate hospital," she said, noting that the agency was negotiating for access to ambulances donated by the Republic of Korea.

Today, the U.S. Air Force conducted its first humanitarian assistance airdrop missions, delivering supplies into remote areas of Pakistan. Ten tons of food, water, blankets and medical supplies were parachuted into the most effected areas of Pakistan.

"It's rewarding to know that we can use our combat skills to drop much-needed supplies to those in need," said Major Chris Beck, pilot of the airdrop aircraft, from Eagle River, Alaska.

Since the arrival of eight U.S. helicopters Monday in Islamabad, more then 131 sorties have been flown, carrying nearly a million and a half pounds of relief supplies and moving more than 900 personnel, an Air Force spokesman said.

Many of the survivors are children, and thousands are injured, orphaned, lost or homeless. Save the Children, the U.S. chapter of the 27 member International Save the Children Alliance, is adding its voice to the appeals for funds to help the earthquake survivors.

"We need immediate support from the American public to help us save the lives of thousands of children who have lost everything as a result of this terrible earthquake in Pakistan that may have taken as many as 80,000 lives," said Charles MacCormack, president and CEO of Save the Children. "For many children in the worst hit areas, this is a life-or-death situation."

Having worked in Pakistan since 1985, Save the Children was able to respond quickly to the earthquake, sending $100,000 worth of tents, food items and other basic supplies to impacted areas over the weekend and dispatching 14 trucks filled with additional supplies to the North-West Province of Pakistan.

Bruce Rasmussen, Save the Children USA Field Office director in Pakistan, said, "Our focus is to get shelter and food immediately into the worst affected areas," he said. "There are so many people in need. So many homes, hospitals, and schools have been destroyed. Children are disoriented. They don’t know what to do. They are living outside in the cold. We must respond now.


World Food Programme relief worker offers boxes of high energy biscuits to earthquake survivors in the mountainous region near Muzaffarabad. (Photo by Martin Specht courtesy WFP)
"Keeping children who survived the devastating Pakistan earthquake alive in the days and weeks ahead must be a priority of the international relief effort, UNICEF said Thursday.

"With wintry conditions arriving in the higher elevations, children are facing a potentially deadly combination of cold, malnutrition, and disease," said UNICEF Executive Director Ann Veneman.

"Most housing has been destroyed in the hardest-hit areas, so the survival of thousands of young children is now at stake," Veneman said. "Shelter, nutrition, and health care for children must be a priority."

UNICEF is appealing for $64.3 million to help the children as part of the overall $272 million UN Flash Appeal.

The UN World Food Programme (WFP) today began expanding its food distributions to mountain villages near the epicentre of the quake. But trucks loaded with high energy biscuits on their way to remote areas were blocked by damaged roads.

"We headed south, but after 10 km, the road had gone – the tarmac was buckled like a staircase. We got a message through to the villagers and they came down on foot to collect the food," said Mia Turner, a WFP staff member travelling with the convoy. "We are going to have to use helicopters reach most of the people out there."

The remote villages that have received little or no assistance since the earthquake struck. "Even the people we have been able to reach have little more than a sheet of plastic to protect themselves against the elements. Temperatures at night are plummeting and there are now forecasts of snow," Turner said.

WFP will be using a fleet of 14 helicopters to support the relief operation – six more than originally planned, the agency said. Four are already in the country and have started airlifting food to earthquake victims in and around the town of Manshera, 30 kilometers (20 miles) west of Muzaffarabad.

People across Pakistan today offered special prayers for the earthquake victims and survivors.