By Thorir Gudmundsson in Islamabad
With tens of thousands of Afghan refugees crowding against the border with Pakistan, unable to get in and a possible million that could head that way, a monumental humanitarian challenge is facing aid agencies. The International Federation is gearing up its response by establishing a relief pipeline to assist up to 500,000 refugees that could arrive in countries surrounding Afghanistan, including 250,000 of them in Pakistan. Here, the Pakistan Red Crescent has already begun its work to aid new refugee arrivals.

At the North West Frontier Province branch of the Pakistan Red Crescent, Secretary Syed Ali Hassan is starting up a familiar operation in an office that has coped with more than 20 years of Afghan refugee flows.

The branch has a 24 hour crisis centre and staff are working seven days a week. As tents are being moved about a warehous adjacent to the branch office, Hassan is negotiating for the use of a bigger warehouse, consulting with airport authorities for incoming relief flights and scouting for vehicles that will have to be procured for the impending operation.

"Refugees are already coming in but they are unregistered," says Hassan. "We don't know what will happen but this week is nevertheless crucial."

Meanwhile, concern is growing for the tens of thousands of Afghan families who are already pressing at the border with Pakistan. Men, women and childen in crowded conditions with no sanitary facilities is a recipe for disaster.

"We are already running 28 Mother and Child Centres, which is a programme funded by the German Red Cross," Hassan says. "This will continue, but we will need to consider what health assistance incoming refugees will need."

Meanwhile, several hundred volunteers - in particular Red Cross Youth members - are being put on notice that their services may be required. Health staff are preparing plans to extend an existing vaccination programme against Hepatitis-B to the incoming refugees and establish vaccination points in any new camps that are set up as well as establishing fully staffed basic health centres there. Other elements of the action plan devised by the North West Frontier branch include the provision of mobile medical care and tracing services to link up families separated by the crisis.

In Pakistan's other province which lies adjacent to the Afghan border, Baluchistan, the Pakistan Red Crescent is also making preparations for any new refugee arrivals. At the Chaman border crossing, around 300 people gather each morning trying to cross the dividing line. Those without visas are turned back. A recently-installed barbed wire fence stretches several kilometres in each direction from the border post in order to discourage would be refugees from trying to get into Pakistan illegally. But that could change if there is the expected rush of hundreds of thousands of refugees at the border in the coming weeks.

Relief supplies, including 20,000 family tents, tarpaulins, kitchen sets and water and sanitation equipment will be sent to the provincial capital, Quetta, in the coming days. This includes a shipment of nearly a million water purification tablets as well as soap, water containers and latrines for up to 10,000 people. Last week, the Pakistan Red Crescent dispatched 17 truckloads of tents, blankets, jerry cans and other relief supplies to the city. It is also planning to set up basic health centres in any camps that may need to be set up in Baluchistan's border areas.

While the current focus is on Pakistan, the International Federation is, nevertheless, planning for a relief operation for up to 500,000 people in total.Although half that figure is for refugees who could come to Pakistan, the remainder is to aid those fleeing to the other four countries surrounding Afghanista - Iran, Tajikistan, Turkmenistan and Uzbekistan. Watchwords for the entire operation are speed and flexibility to ensure refugees don't lose their dignity and suffer as little as possible.