Recent flooding in southern Pakistan has disrupted health services in 22 out of 23 districts in Sindh province. Flood waters have resulted in 226 deaths and damaged or destroyed more than one million homes – approximately 5.3 million people have been affected.
Having already deployed to Sindh in response to the 2010 floods, International Medical Corps has been delivering services at government health facilities throughout the region since October 2010. We have mobilized our local medical teams in response to the recent flooding and will focus on assessing needs and responding as necessary.
According to the UN’s Office for the Coordination of Humanitarian Affairs (OCHA) there is an immediate need to control communicable diseases which could quickly spread by stagnant floodwaters. In addition, among the one million women of reproductive age affected by floods in the region, more than 100,000 are pregnant and may require medical assistance, according to UNFPA estimates.
Since the beginning of September, International Medical Corps medical teams in Sindh provided 6,621 health consultations. Among the most commonly reported illnesses were acute watery diarrhea, acute respiratory illness, malaria and scabies. International Medical Corps also provided psychosocial support to 39 individuals and health and hygiene education to 2,289. In the first two weeks of September, data from our field teams indicates an increase in the number of consultations of approximately 35 percent due to the recent flooding.
Medical teams are continuously providing emergency health services, including reproductive health and hygiene education. International Medical Corps is also installing hand pumps and latrines as well as providing rehabilitation of basic health units throughout Sindh.
Since immediately deploying local teams in 2010 to respond to the unprecedented flooding in Pakistan, International Medical Corps has provided more than 1.4 million patient consultations through a network of mobile and static health clinics throughout Sindh, Punjab and Khyber Pakhtunkwa provinces. A year after this disaster, International Medical Corps continues to prioritize long-term primary health care services, including mental health, to help those who remain without access to vital resources. As needs have shifted from acute emergency relief to long-term health services and capacity-strengthening, International Medical Corps has expanded existing programs in Pakistan to include Nutrition, Protection, Economic Recovery, Livelihood Activities, and Health Facility Rehabilitation.
In the humanitarian world, there are the disasters you see coming, and the ones you don’t.We didn’t foresee the massive 2010 earthquake in Haiti … the devastating floods in Pakistan… the earthquake and tsunami in Japan… or the conflicts sweeping the Arab world.But the current drought and famine in East Africa? We saw that coming. The only question was how bad would it be?
The answer: very bad and getting worse.This crisis has now affected a staggering 12.4 million people – it has killed tens of thousands, and put 400,000 children at risk of starvation. Think about those numbers. Roll them around in your head.We saw this emergency unfolding 9 months ago when the rains began to fail, the harvests were poor, and food and fuel prices shot up. Families already facing scarce food resources suddenly had to make do with much less. Throw in more than 20 years of violent conflict in Somalia and you have approximately a million refugees crossing the borders into Kenya, Ethiopia, Djibouti, seeking some sort of escape.Make no mistake, this is the worst humanitarian crisis in the world today.But that’s the macro.Here’s the micro: a nine-month pregnant Somali woman, her two-year-old son, her husband, and his brother, journey many treacherous miles by foot across arid, forbidding desert to the Ethiopia border. There they wait to be processed. They wait outside for days in 100-degree heat and high winds that whip sand across their faces. Eventually they are bused to a refugee camp about 20 miles north, inside Ethiopia, where they are given a tent and a bit of food.They come to International Medical Corps’ nutrition center in the camp, by which time the mother is so weak from severe malnutrition that she can barely keep her eyes open or speak. She cannot hold her own son in her rail-thin arms, and childbirth may very likely kill her. Her husband has been too ill to come to the center. Her brother-in-law holds her child for her, but he too is so weak that when he stands his legs and arms shake from the strain and he is forced to sit down again. The child cradled in his arms is so severely malnourished that he is non-responsive, not uttering a sound.
People should not be suffering like this. I keep saying the same phrase over and over in my head: “This is not right.”Sadly, a crisis such as this has struck the region before: the famine in Ethiopia in 1984, famine and civil war in Somalia in 1991. These are horrific cycles that plague East Africa. While the government and communities have made great strides in mitigating the impact of these cycles, this year has seen a perfect storm of factors that are especially tough to combat.I was in Ethiopia during the “global food crisis” in 2008, and witnessed a tremendous amount of starvation, pain and suffering. And yet, that crisis was not nearly as severe as what’s happening today. It did not constitute what the humanitarian community defines as “famine” – the malnutrition and mortality rates were not at the levels they are now. When 1 in 1,000 people dies of malnutrition, that is considered a humanitarian emergency; right now, in the refugee camps where International Medical Corps and other NGOs are working, the mortality rates have hovered around 14 percent. Rates of severe malnutrition have been as high as 45 percent.In the face of these grim statistics, what are our solutions?I ask my colleague, Daniel, who runs our nutrition programs in the camps. A native of eastern Ethiopia, he has seen famine unfold here before. As he meets with new arrivals at the nutrition center, he is compassionate, but no-nonsense. One teenaged mother has brought in her 3-year-old severely malnourished son. His chest and ribcage protrude sharply over his distended belly, his limbs are twigs, he lets out a persistent, desperate hunger-wail. Daniel explains to the child’s mother that if he is not admitted to a stabilization center he will not survive - that milk is not enough, he needs therapeutic feedings.As Daniel reflects on the great suffering he has witnessed recently and in years past, he also vividly remembers the victories. He recalls when he first began doing nutrition work in the early ‘90s, and himself was learning how to care for people and pass on skills. One woman in particular he remembers brought in two malnourished children for treatment – along with a third who she said was disabled, his arms and legs completely rigid and unmovable. All three children underwent therapeutic feedings. Suddenly one day, the disabled child straightened his arms and legs, and stood up. Daniel realized this child was not disabled; he was severely malnourished and needed proper nutrients to reverse the paralysis in his limbs. Witnessing and learning from this recovery proved a seminal moment for him – and to this day provides him with the hope that education can and will save lives.Fighting back tears, Daniel says simply: “That was a day when I felt really good about my work. I will never forget it. Never.”
Actress and International Medical Corps Global Ambassador Sienna Miller returned this week from visiting International Medical Corps’ nutrition programs in the Dolo Ado camps in eastern Ethiopia, an area largely inaccessible by media. More than 120,000 Somalis - 30 percent of whom are malnourished - are seeking refuge here from the crippling effects of drought, famine, and conflict. With six regions of Somalia now facing famine, Miller is calling for greater attention to the worst humanitarian crisis in the world today where more than 12.4 million people throughout East Africa require relief.
“Without immediate humanitarian intervention, more than 390,000 children are at risk of starvation,” said Miller. “International Medical Corps is on the ground providing emergency nutrition services and health care to vulnerable populations in Ethiopia as well as in Kenya and Somalia, but they will need ongoing support to meet the massive needs, which are only expected to expand in the coming months. Ongoing support will literally make the difference between life and death for thousands of children in Ethiopia, and throughout the region.”
Having worked since 1991 in Somalia, International Medical Corps is reaching affected populations with nutrition and water, sanitation, and hygiene programs to provide a multi-faceted approach to the crisis. In Sool and Sanaag regions, the organization, with support from UNICEF, screened 11,500 children and admitted 679 children in outpatient therapeutic program sites for advanced nutrition care. Teams also distributed micro-nutrient supplements for 4,850 pregnant and lactating mothers. In addition, trainings were conducted for Ministry of Health staff on community mobilization, nutrition screening, vaccination, and referrals.
At the Dolo Ado camps in Ethiopia, International Medical Corps, in partnership with the Ethiopian Government’s Administration for Refugee and Returnee Affairs (ARRA), is providing supplementary feeding services for malnourished people, including the provision of nutrient-dense therapeutic foods. To date, approximately 5,000 children and pregnant and lactating women have undergone nutritional screening and referred to the appropriate level of therapeutic care. Teams also constructed 136 latrines and washrooms with 200 more planned and launched a hygiene campaign to thwart the spread of communicable disease in the overcrowded camps.
At Kambioos refugee camp in Kenya, a part of the Dadaab Complex which is today the largest refugee camp in the world, International Medical Corps is working in partnership with AmeriCares to implement a field hospital with nutrition services and a maternity center. In addition, in Samburu, Isiolo, Tana River and Laikipia districts in Kenya, International Medical Corps has been working in partnership with UNICEF to deliver high-impact nutrition interventions in existing health facilities and at the community level. The organization is scaling up existing programs to support 154 health facilities and planning expansion of feeding points within these drought affected areas.
For more detailed information about International Medical Corps’ drought and famine response throughout East Africa, please visit: http://internationalmedicalcorps.org/page.aspx?pid=1348