 |
November 2007 |
|
A MSF logistician preparing to fly to a remote village in the Kaghan Valley, north to Mansehra, to distribute relief materials.© Asako Tamura/MSF |
After more than two years of working in the area, Médecins Sans Frontières (MSF) has handed over the remaining activities linked to the October 2005 earthquake in northern Pakistan. After the emergency phase, MSF had been involved in rehabilitating and supporting local health structures. The gradual withdrawal, which started in October 2006, has culminated with the hand-over of the prefabricated district hospital in Bagh to the Ministry of Health.
Emergency Phase
On Saturday 8 October 2005, a 7.6 magnitude earthquake hit northeast Afghanistan, the north
of Pakistan and northwest India. The quake caused massive destruction, with an estimated 76,000 people killed. By far the most affected area was the mountainous region north of Pakistan where almost 80,000 people were wounded and over 3 million people were left homeless.
“Immediately after the quake, the population mobilised to rescue the injured, and local health staff were the first to treat the wounded” says Fazil Tezera, Head of Mission for MSF in Pakistan. “But many health structures had been badly affected by the quake and could not cope with the influx of wounded. The presence of an MSF women’s health project near Muzaffarabad allowed us to react very quickly”.
Within a couple of days, MSF teams were on the field and started working in four different areas: Manshera (North Western Frontier Province), Muzzafarabad and Bagh (both in Pakistani Kashmir) and Tangdar (Indian Kashmir). Initially, the main activities were: trauma care for the wounded, basic health care provision and outreach work to remote places, mental health care, distribution of shelter and hygiene items to affected families, and water and sanitation support in camps and villages.
At the peak of the intervention, from mid-October to mid-November 2005, just over 150 international and over 450 national staff were providing emergency care in 18 permanent sites in Pakistan and 3 in India.
This set up allowed MSF to contribute to the huge national and international mobilisation. The medical emergency was followed by a race against time, and more particularly, against winter. Large-scale distributions of shelter goods, tents and blankets were speedily undertaken before the winter set in. In total, MSF provided support to more than 175,000 people.
“We undertook massive distributions for people in camps near the cities as well as for people who had stayed in the mountains” recalls Fazil Tezera. “Most villages we visited were completely destroyed and in desperate need of materials to build a shelter for winter”.
Rebuilding health structures
The heavily damaged health infrastructure could not cope with the number of people wounded in the earthquake and the normal flow of patients seeking “normal” care. There was also a significant shortage of medical staff and an enormous need for medical supplies and equipment. Due to poor operating conditions and lack of post-operative care, many patients developed complications and went on to require further surgery.
These were the reasons why MSF decided to rehabilitate and staff health structures for a longer period than the immediate aftermath of the earthquake.
“The establishment of those basic health units was crucial” said Dr. Arshad Mehmood, Bagh District Health Officer. “It allowed to prevent outbreaks, to provide quality care to patients and also boosted the morale and skills of the existing Department of Health staff”.
In addition to setting up small basic health units in several villages in the mountains, MSF also undertook major construction work including a 9-module inflatable hospital in Manshera, a semi permanent structure in Hattian, and a 79 piece prefabricated container hospital to replace the destroyed district hospital in Bagh (see box 1).
 |
| MSF teams built a field tent hospital in the town of Bagh after the District Hospital was destroyed by the earthquake.© MSF |
Gradual withdrawal
When the emergency phase and winter had passed, MSF could start downsizing the intervention, especially in terms of the number of expatriates. Then, from October 2006, teams started to disengage from different places, starting in Manshera, then Muzzafarabad district. In 2007, the only programme still in place was the management of the Bagh district hospital and some support to basic health units in the district.
Although the situation is far from ideal and a great deal of reconstruction work is still needed, the situation in terms of health care provision is satisfactory. “In these circumstances, we’re convinced that it is the right time for MSF to leave and let local organisations and the Ministry of Health take care of the health structures in the area” said Fazil Tezera.
Although the earthquake related activities are now over, MSF remains present in deprived areas of Pakistan with basic health care and women’s health projects in Balochistan and tribal areas like Kurram and Malakand. MSF teams also recently provided shelter and medical aid during the floods in Balochistan See.
Box 1:
Container Hospital - DHQ HOSPITAL BAGH
The district hospital in Bagh did not escape the devastation of the earthquake in October 2005. It was destroyed beyond repair, which pushed the MSF team to build a field tent hospital next to it in the days that followed the earthquake. This structure allowed medical staff to cope with the wounded as well as the hospital’s normal activities.
To improve the field hospital, it was decided to build a semi-permanent structure made of 79 prefabricated containers.
This undertaking was a huge logistical challenge. First the teams had to find a good place to build it, which was not an easy task in the very mountainous area. Then, the containers had to be shipped to Bagh from Europe. Some were shipped by boat, others by plane and were then loaded on trucks to drive all the way up the Kashmiri mountains to Bagh.
The construction itself started in March 2006 and the hospital started functioning in July 2006 after it was inaugurated by the Minister of Health, etc...
This hospital serves a population of 350,000 people and is equipped with all the necessary facilities to ensure quality health care. It has a capacity of 60 beds, with one delivery room, two operating theatres, one emergency room, one intensive care unit, one neo-natal care unit, one laboratory, an X-ray department, two pharmacy units and more than eight consultation rooms; run until early October by both MSF and Ministry of Health staff. The total cost of the full structure was more than 1.1 million euros.
After more than a year of functioning, the new hospital is a very busy hospital. More than 150 deliveries occur every week. Every month, more than 8,000 consultations and almost 200 surgeries are performed and more than 700 patients are admitted in the inpatient ward.
MSF is now handing over all its projects in Bagh district, including the container Hospital to the Ministry Of Health. Support to the Basic Health Units (BHU) in Bir Pani, Mallot and the latest in Khalal Malayalam, was recently ended. MSF will support all the BHUs with medical supplies until the end of 2007. |
Azad Kashmir – Quick Facts
Presence: October 2005 – October 2007
Locations where MSF worked:
Muzaffarabad; Bagh; Saidpur; Kai Manja; Hattian; Lamnian; Leepa Valley; Chamukam; Paniali; Chikhar; Mallot; Bir Pani; Bedhi; Khalam Malayalam
Activities:
Medical: Basic health care; mental health; maternal health; surgery; vaccinations;
distribution of hygiene kits
Non medical: Distribution of tents; blankets; heaters; plastic sheeting; construction kits;
kitchen sets; water and sanitation activities; building and renovating health structures.
|
North West Frontier Province – Quick Facts
Presence: October 2005 – October 2006
Locations where MSF worked:
Mansehra; Kaghan; Gangwal; Balakot
Activities:
Medical: Referral hospital; surgery; mental health; physiotherapy; basic health
consultations; vaccinations
Non-medical: Distribution of tents; blankets; plastic sheeting; kitchen sets and heaters;
water and sanitation activities.
|
Islamabad - Quick Facts
Presence: October 2005 – November 2005
Activities:
Medical: Surgery; kidney dialysis
Non-medical: Coordination and forwarding of medical and non-medical staff and relief goods.
|
» Read
other articles on Pakistan
» Read about other featured
projects
|
 |
|
