Emergency Aid Relief – Pakistan Floods 2010

 

Heavy monsoon rains in 2010 caused unprecedented flooding in Pakistan during July and August of that year, resulting in some 2,000 deaths and affecting 20 million people across an area the size of England. The floodwaters washed away millions of hectares of crops, submerged villages and destroyed roads and bridges. Outbreaks of cholera and other diseases were a major concern.
A team from Midland Doctors arrived on August 9th, and decided to focus on the area around Peshawar, in the north of Pakistan. Below is some of the feedback provided by the aid team as they undertook relief efforts.

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Day 3 : Time was of the essence to save lives from the ensuing high risk of Cholera and other deadly infectious diseases. All aid agencies were literally knee deep in the chaos caused by the flood and too large a task for all the agencies put together. Midland Doctors organized medical supplies and transport of these goods to Peshwar, a 6-hour ride by road from Punjab, to the affected region. The initial aim was to assess the medical need and to vaccinate 1000 people this week. Most deaths, it was thought, would occur from water borne diseases.
Dr Safiy Karim, lead Midland Doctors Flood relief team.
Day 4 : Midland Doctors Ch Riaz Ahmed would oversee the operation. In order to minimise delay, the9 CEO of kyber medical college had begun to gather intel for the group. Dr Javed Ahmed phoned the Midland Doctors hospital facility in Muzaffarabad [6 hrs road journey away] to mobilize help to the flood affected area. It became clear that where Midland Doctors were going to operate, no aid agency had yet materialized. The frail, the young children and babies were identified at most risk of severe dehydration and supplies were purchased to reflect this
Day 5 : “There were areas surrounding Peshawar and Nowshehra where dozens of villages had completely vanished Thousands of families had lost everything and were spending days and nights without any shelter and any essential supplies. Families were surrounded by pools of dirty water, breeding pools for malaria, and other communicable diseases.”
The Midland Doctors team will focus on reaching a local district hospital where they would start to focus on the relief effort. If team could bring some order to the chaos, there was hope that larger aid agencies would then come. No sign of Government or any relief efforts by NGOs. Talking to my brother who has returned from the area after some rescue operation, it seems people need food, clothing, shelter and medicines’.”Dr Irshad Soomro, Nottingham
Day 6 : The Medical team arrived in Peshawar and volunteers had been assembled and would start work at day break. Midland Doctors Ch Riaz Ahmed purchased further Medication to treat skin problems and Gastro enteritis related illness. Midland Doctors assembled starter packs for individual families who had lost everything. This pack would include a basic cooker, fuel, pots and pans, plates and dishes, water and some basic food supplies.
Midland Doctors also looked at a more sustainable clean drinking water source. The choices were either a small filtration system or tablets to make water safe for human consumption. The choice was be dependant on what’s available and workable locally. The feedback from people on ground was that people are spending days and nights without food. The offer of vaccination on its own, to prevent diseases, was not a priority for people who were starving and suffering with diseases that need treatment then rather than preventing something which they may not live to see.
Day 7 : At an intersection of 2 rivers near Charsadda, Ch Riaz Ahmed coordinated the distribution of food to affected villagers many had spent the night on the roofs of their houses. Banks of the rivers overflowed with torrential force causing substantial damage. 200 food packets were distributed that morning. Midland Doctors began to work on providing stoves in addition but they were too pricey at the destination and would need to source from elsewhere. The team on the ground consisted of 3 doctors and 4 paramedics (including 2 female personnel to oversee women’s health) who also provided medical care.
Day 8 : Working throughout the day the team provided treatment to over 400 patients and had fed 200 people on the day across the Charsadda region. Cholera threat which we for-saw had become a reality and Children were at real risk.
Day 9 : We launched our first camp at Qazi Khil in Charsadda where two doctors, Dr Gohar and Dr Enam U Ulla checked 253 patients. At our second camp Dr Ishfaq with two female paramedics set up a camp in the old Charsadda and cared for 300 patients. In total that day we distributed 70 family packs of food which we hope will last for a week each.
Day 11 :: Midland Doctors sourced life boxes containing 2000 family sized life straws from a facility in Vietnam. DHL were contacted to arrange a delivery to Karachi. Each of the family sized life straws would provide safe filtered water to a family for a year. The Midland Doctors health strategy team felt that this solution would be an effective way of managing the life threatening problem of contaminated water that is causing so many deaths. Rizwan had identified the frail nature of the clothes that people were able to escape with and so Midland Doctors have sourced 15000 salwar chameezs for men and women in the flooded areas.
Day 12 : Midland Doctors Ch Riaz Ahmed led the team with the help of local doctors. The area was so remote that vehicles had to be left to deliver the food. Midland Doctors was arriving in areas away from the central refugee camps as a large population was beyond reachable. The team have been busy in two villages “Chara Sang” and “Siri Khan”. These villages had been pinpointed by medics from Khyber medical college as they had been out vaccinating. Again we had three doctors and 300 packs of food were distributed and 400 patients were treated by the medical team along with provision of medication. Eye problems were on the rise alongside other existing health problems.
Our team had been approached to consider providing permanent water supply by funding instillation of water pumps etc. The team were pleased to know that water tanks are on the way from the UK as clean water is short. Dr Durrani CEO Khyber medical college had suggested bore holes for villages at strategic points. The surface water and seepage causes soil contamination, therefore a certain minimal depth will be required. These were desperate humanitarian conditions and the Midland Doctors is focused on food, clothing and medicine. Many were still wearing the clothes they have had to wade in mud with so Midland Doctors began assembling clothes in Karachi to be transferred to the north of the country
Midland Doctors sourced more doctors from Khyber Medical college to strengthen the Midland Doctors medical team in Peshawar and surrounding areas and began working on a system to identify the weak and vulnerable so that they may get supplies in preference.
Day 13 : Midland Doctors team spent the day sorting out logistics and arranging storage of supplies. Mr Ch Riaz Ahmed helped to secure a warehouse in Peshawar which is secure to receive the procured clothes from Karachi.
Food packs were increased in size. The visit of NGOs to villages remains erratic, random and haphazard. Therefore Midland Doctors had decided to concentrate on specific areas and to do that well. The team leader Ch Riaz Ahmed commented on serious infrastructure problems in many villages. Therefore the strategy was to have a second Midland Doctors team to look at infrastructure rebuilding. Dr Javed Ahmed drafted more doctors into the emergency strategy. An associate professor had joined Midland Doctors to help in rebuilding and to provide basic necessities such as fix broken walls and to provide bedding for families and children. Midland Doctors Engineer Rizwan was sent back to the Midland Doctors hospital project as he has provided a great deal of help and expertise to the Midland Doctors Peshawar team. In particular ideas of bore holes for water had been analyzed and costing for each bore hold leading to a hand pump is 50 000 rupees and will service a whole village. Funds had been spent on food, water filters, medicines, clothes(15 000 pieces will be ready) from Karachi.
Day 14 : The Midland Doctors had serviced 2 villages in Charsadda. Due to the remoteness of the locations the Midland Doctors team had to sleep in the flood ridden area within a village. Here the Mosquito count had been extremely high due to the presence of standing water, therefore the risk for malaria had also increased. The team had undertaken a medical camp and distributed food to a whole village today. Midland Doctors continued to focus on helping out in areas NGO’s had not reached. The Water tanks arrived today and the team were able to set up Water tanks within villages. Midland Doctors Muzaffarabad Hospital engineer gave an analysis of bore potential and a survey of potential water.
Day 15 : The Midland Doctors medical and relief teams had distributed 400 food parcels in Noshara. Midland Doctors have treated 2000 people since the start of the project and 1050 Family food packs have been distributed. Midland Doctors delivered 2 water tanks to 2 villages today where the only need was water. Dr Durrani had highlighted the 2 villages to us whose only requirement was clean water. Each tank can deliver 2000 litres of water.
Day 16 : Midland Doctors have been working closely with the PMA (Pakistan Medical Association) to ensure a partnered strategy in Sindh. The third Midland Doctors team (With UK doctors) took with them 1000 pieces of clothing and 500 family food packs and enough medicines to run a 5 day food camp.. At this stage Midland Doctors switched from an acute to a medium term strategy. Bore hole sites are being sought for wells in strategic areas. ‘There is no point in Duplicating other NGO’s – the gap now is clean water and basic amenities to sustain living in many villages’ said Ajaz Najib. It was time to develop a more focused approach to protect the more vulnerable, especially children.
Day 18 : We distributed about 400-500 clothes (shalwar kameez) to villages including Miaolay and Tholanday In Charsadda today.
Day 19 : The Midland Doctors group in Peshawar paid a visit to Pabbi medical camp where we stayed for about an hour and dropped off some needed medicines. We will also visit Nowshehra quickly today and noticed that lot of people require vaccination and some food stuff. We are going through planning and are trying to cover as much of the affected people as we can but priority is to make sure that we give the best services not just to visit them and leave them inventory.
Also, about 400-500 bags of food packs (each with 1 Kg of sugar, 2 Kg of rice, 1 kg of beans, ¼ kg of tea, 2 milk packs, and 1 litre oil) distributed to small villages of Baata Gram Charsadda, the small villages includes Saddar Gari, Kaatozai, Sreekh and Kalaa Malozai.
The main problems faced by affected people is that access to them is not easy for NGO’s and other organisation. Families don’t have clean drinking water in most of the areas, some areas need food, some need shelter as their houses have vanished. It is hard to say exactly what is needed in which specific area because of the destruction being so wide, but what has so far noticed is that most of the people are worried about clean drinking water and shelter.
Day 20 : Today we picked 250 clothes (shalwar kameez) from our store and 100 bags of food stuff as well, and we distributed to Wapda Colony Kabul river Nowshehra and Turnaab, Gogoshthoo.
Day 21 : Awaiting further medical and other supplies, teams using this time toundertake a survey of needs in the surrounding villages.
Day 22 : Today we had a medical camp in a rural area of Pabbi, where our doctor treated about 90-100 patients. Most of the patients were having skin infections and eye problems, we also got the data forms filled by about 90 patients and that shows some probable figures about some questions. Most of them are living in tents or camps near their vanished houses, they drink water from near by tanks installed by NGO or government, and they are pretty satisfied especially from the near by towns and NGO’ work. Our medical camp was for about 6 hours, we headed back to Peshawar at 4pm.
Day 23 : We are currently holding 1 medical camp a week due to low medical supplies and working on obtaining Kids Gift Packs for Eid. After Eid we would be having medical camps 3 days a week on regular basis under the new doctors.
Day 30 : Midland Doctors held a Medical Camp in a small village of PABBI, which was affected by recent floods. The name of the sub village is Choki Mumraiz and according to our analysis there were lots of people who needed medication. We had our medical camp there today and we treated about 140-150 patients. The medical camp went well, everything was properly organised the all patients were treated. We also collected patient data to understand their circumstances.
Day 32 : Today we received all the inventory for the Eid gift packs for the children and we started packing for 300 gift packs in which 150 are for girls and 150 for boys, tomorrow we are going to distribute these gift packs to two different affected villages.
Day 33 : Today we distributed three hundred gift packs that we packed yesterday for the kids of flood affected areas, the location was Pabbi and the affected people were given shelter in a government school. There were more than 50 families there, we also distributed 100 bags of flour and 110 bags of oil in these displaced families.
Day 40 : Today is the first working day after the Eid holidays. We performed a needs assessment survey to identify the needs of the local population and where we should concentrate our resources for maximum benefit. We decided to concentrate on the villages of Muhib Banda and Pabbi Nowshehra. These villages were located 500 meters from river Kabul and so were devastated by the floods and the larger NGO’s and governmental organisations had not managed to reach them.
We found almost 300 houses had been made totally uninhabitable and 163 families were taking shelter in the brick built Govt. College Pabbi.
The people want to start rebuilding their lives but the absence of NGO`s, governmental organisations, infrastructure and resources is making this monumental task impossible without our help. Over the next four days we will be holding medical clinics in these areas and conducting further needs assessment surveys to ensure that we are alleviating the most pressing problems that our resources can deal with and that we are being as effective as possible.
Day 44 : Today we revisited Chowki Drug, Pabbi Nowshehra villages and held another medical clinic. This area is about 2-3 kilometres from the main GT road and is one of the most badly affected areas. The lucky ones are living in tents, others are crammed into the brick built government schools or colleges but most have no shelter at all from the ongoing rain.
There are no roads to these villages from the main road and the ongoing rain and mud make the route very treacherous. Today it rained again and we were in imminent danger of being stranded with the villagers. So with heavy hearts we took the decision to abandon the clinic. We had been able to treat around 90 patients suffering from skin infections, eye infections and gastrointestinal problems before being forced back.
Day 46 : Today we held a medical clinic at Mahroof Khel, MC-3 Charsadda District. We have been asked by the Midland Doctors executive to concentrate on those areas where other NGO’s have not been able to reach and this was the first medical camp in the village since it was devastated by the flood. One of the major problems in these sort of disasters is that women and children are disproportionately affected and die in higher numbers in the initial aftermath of a disaster. Those who survive are more vulnerable and often experience an “aid gap” as they struggle to obtain aid from distribution points.
The Midland Doctors executive have therefore encouraged us to try and address these issues in our work and for this reason the clinic we ran today was for female patients and children and this was greatly helped by having a female doctor on our team. We were able to treat 70 patients but there are many more that still need to be treated and we intend returning to the village tomorrow and will also open the clinic to men.
Day 50 : Midland Doctors Peshawar team have been doing a marvellous job in helping to sort out logistics for reconstruction of a village in North Pakistan. I have been coordinating with our Midland Doctors Peshawar team to facilitate The rehabilitation of the village. A village near Nowshehra was selected because of it’s accessibility and the fact is that the majority of the 300 houses in that village have been affected in one way or the other.
We have employed a full time male doctor and are in the process of employing a female doctor. We hope to run our medical camps for next three months. Winter is approaching fast and these areas become very cold in winter. We have commissioned 1000 winter sleeping packages. These would be ready for distribution from next week.
Once the construction work gets underway we will carry out further surveys to identify other needs for this village to get the life back to normal including supply of clean drinking water through either tube well or hand pump.
Day 51 : Part of the Midland Doctors needs assessment surveys has been consultation with the local populace and national and international aid organisations to see how the resources of Midland Doctors can best be deployed for the local people. Increasingly Midland Doctors has been approached by organisations wishing to deploy their aid in Pakistan by using the trusted local infrastructure that Midland Doctors has developed since its inception.
The Kidmah Group in Derby wishes to use some of its finances to rebuild houses in the flood region and has decided to do this by using the local infrastructure of the Midland Doctors which has developed particular expertise in the construction field due to its experience in building their hospital in Muzzafarabad. The village identified for this project is Muhib Banda Pabbi.
Today the Midland Doctors Peshawar team revisited the village of Muhib Banda Pabbi to measure the boundary walls in preparation for the rebuilding of some of the houses devastated by the floods. The first phase will involve rebuilding the boundary walls and washrooms for an initial 15 houses. These initial houses are on the periphery of the village but it is envisioned that houses in the centre of the village will also be build once the first phase has been complete.
Day 52 : Construction work has started today in Muhib Banda, Pabbi Village Nowshehra. Basic foundations were laid for the boundary walls to enable the construction of walls tomorrow. A medical camp was also organised in Pabbi, which treated about 50 patients and free medicine was provided.
Day 64 : Today we visited village Muhib Banda to assess the re-construction work. The work is progressing well and the mosque renovation work is almost completed.
Day 74 : As the harsh Peshawar winter draws inexorably nearer Midland Doctors has been continuing it’s work in providing protection for the flood victims from the harsh upcoming elements. Today we visited Mian Walay, Tangi Charsadda where we distributed 210 sleeping packs to 210 families. Of these, 70 were from the nearby village of Tarr Lung. The token system that we have instituted in order to ensure a fair and equitable distrubution of the aid has worked exceptionally well and the villagers were happy to form orderly queues and wait patiently for the allocation. This was by far the smoothest operation we have run to date and we believe it reflects our ongoing involvement in the area and the trust and faith the villagers in this region have in Midland Doctors Association UK.
Day 81 : Today we held a medical clinic at Sir Sung, Tangi Charsadda. We were on the ground and ready to go by 11am. We were able to treat in the region of 90 patients most of whom were elderly and all of whom were without access to medical care. Whilst it was a long day, we got back to

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