Pakistan: Adequate health facilities for the earthquake affected population

Islamabad- March 1st, 2007: United Nations Resident Coordinator, Jan Vandemoortele commenting on the overall health situation in the quake zone said, "Health coverage has been adequate during the winter months in the earthquake affected areas. To respond to the anticipated needs of the population, medicines were pre-positioned in remote areas that were in risk of being cut off due to heavy snowfall".

In the recovery period (since April 1st 2006) the Disease Early Warning System (DEWS) received 273 alerts and out of these 226 situations needed investigations before they become outbreak and only 27 outbreaks occurred. These outbreaks were quickly responded and controlled by the health partners. The most common disease triggering an alert was acute jaundice syndrome (suspected hepatitis) with 74 alerts, followed by measles with 73. The most common outbreak was acute watery diarrhea, with a total of 12 outbreaks from 31 alerts. Every alert is investigated by trained surveillance officers, and interventions such as provision of water purification tablets, vaccination campaigns, and health education messages are provided.

There are 305 health facilities in the affected districts that were partially or fully damaged and out of these 165 are targeted for reconstruction within a year. Two THQ hospitals have been completed; one in Balakot and other is in Garhi Habibullah. Six (2) THQ's and forty three (43) Primary Health Care facilities are under reconstruction. Seventy six (76) prefabricated health facilities have been completed so far (56 in AJK and 20 in NWFP) of these 46 have been constructed by WHO. Fifty three (53) transitional health facilities are being operated by INGOs/NGOs providing Primary Health Care services. Two (2) Model BHUs in district Muzaffarabad and Mansehra have been constructed by JICA. However, a major gap is identified in district Shangla and Kohistan.

Dr Rayana Buhakah, Emergency Health Coordinator WHO said, "In Muzaffarabad WHO established a water-testing laboratory for water quality monitoring in the district and so far more than 700 water sources have been tested which revealed that 74% of the water sources were contaminated and require purification interventions." In all incidences remedial measures were immediately initiated in coordination with UNICEF led WATSAN partners working in various districts of the affected areas. The laboratory also serves as a reference laboratory for water samples collected from other districts in AJK. Dr. Rayana also said that "district health plans have been developed and launched for all the 9 affected districts by the DHOs/EDOs (H) in collaboration with stakeholders to revitalizing and strengthening the district health system".

According to an assessment carried out by WHO in collaboration with its partners in September last year, 28% of health facilities were being supported by an external agency (NGOs or the Pakistan Army). There are gaps in maternal health care services due to the fact that female medical officer was available only at 13% of health facilities and a LHV in 63% of health facilities. In addition, routine EPI is also being provided at 229 (77%) health facilities.

In a recent polio campaign held from 16-18 Jan. 2007, about 32 million children were vaccinated in all over the country out of which 1.27 million were vaccinated in the affected districts.

Commenting on the overall health interventions, General Nadeem, Deputy Chairman Earthquake Rehabilitation and Reconstruction Authority (ERRA) said, "Collaboration between Health and Watsan sector partners is ongoing and commendable. ERRA Watsan sector, UNICEF and other partners are implementing water schemes while WHO is addressing the water quality issues, but has been an active partner in implementation of the Health policy and revitalization of primary health care services in EQ affected areas".