Pakistan: Despite delayed funds, disease outbreaks averted by volunteers
ISLAMABAD-Dr. Kashif Islam knows what it cost to respond to the massive medical needs of overlooked Pakistani families displaced by the military conflict in Swat earlier this year.
It was free.
The doctor, a health project officer with Church World Service - Pakistan/Afghanistan, was one of the many humanitarian workers who spent weeks developing and sending proposals to international donors to support the millions of people caught up in the world's fastest and largest human displacement in a decade.
Yet as proposals were sent to overseas government donor agencies--with some making large financial pledges--much of the money became delayed in bureaucratic processes abroad and within Pakistan.
As needs increased on the ground, volunteer health workers from CWS-P/A mounted a shoestring-budget medical response from cash reserves that assisted more than 3,000 displaced people, while the funding delays continued up to three months in some cases.
"The doctors and staff who started working for us voluntarily knew that they wouldn't be paid for their additional work," Dr. Kashif said. "They took their own decision to volunteer themselves because they knew that they needed to help these families--with or without a salary."
He shared how one husband and wife--both doctors--worked tirelessly and for free to support the ongoing medical needs of displaced women, men and children.
Humanitarian organizations are sometimes able use their own resources to cover initial expenses, which are then reimbursed when the international funds begin to flow. However, in the case of CWS-P/A, incoming government donor funds were restricted to cover medical response activities that occurred after July 15--some two months after people were fleeing the conflict.
Despite the delays in humanitarian funding, communities and aid workers were fortunately able to avoid significant disease outbreaks, which Dr. Kashif attributes to both the efforts of volunteers and effective coordination by aid groups.
"In the beginning of the displacement, there was great fear of massive epidemics," Dr. Kashif said. "But because of the collective efforts and very good planning by non-governmental organizations and the UN agencies, we were able to avoid a far worse disaster."
"While international donors do not bear responsibility for this massive conflict and the displacement of millions, we absolutely count on their commitment to effectively carry out our mandate--to provide life-saving assistance to communities in humanitarian emergencies," CWS Asia/Pacific regional coordinator Marvin Parvez said. "How can we guarantee accountability and humanitarian quality to the people we seek to serve without key donor commitments that match the needs on the ground?"
In a twist of irony, Dr. Kashif noted, "We actually received our first funds just as some families had already returned back home to Swat."
"Innocent people suffer"
Other humanitarian groups also experienced significant funding delays for the response to the Swat displacement.
"Donors decided to fund the emergency response through UN agencies and the cluster system," one agency noted in a report. "This decision delayed funding and had a serious impact on NGOs with the capacity to deliver, significantly reducing their ability to help those in need."
(UN clusters are coordination forums that bring together UN agencies and aid groups to better coordinate humanitarian responses in areas like food, shelter, water and sanitation, protection, and agriculture.)
Parvez stressed that, despite the absence of disease outbreaks, the lack of immediate funding support from some key government donors created significant gaps. "Innocent people suffer when we don't have the resources we need," he said.
Dr. Kashif described one particularly difficult case of a diabetic 5-year-old girl in Mansehra, a few hours north of Pakistan's capital, Islamabad.
"When I saw her, I was told by her brother that she was diagnosed as diabetic when she was 2-1/2 years old," he recalls. "After being displaced, the family did not have enough resources to buy insulin."
The girl's elder brother somehow managed to get a vial of insulin, yet he did not have any means to refrigerate it, so he kept the vial in a water cooler. After meeting CWS-P/A at one of its health units in May, the brother asked if CWS-P/A could arrange insulin for the girl.
"As long as she was in Mansehra, we looked after her as much as we could," Dr. Kashif said. "But after she left for Buner, we don't know what has happened to her."
The funds coming in to the UN agencies and aid groups were mostly being used to assist the millions of displaced families in Mardan and Swabi. "However, in every emergency there are always small groups of highly vulnerable people who evacuate to other areas--who become even further marginalized only because of where they happened to flee to safety," Parvez said.
"The number of people who evacuated to Mansehra and Abbottabad may not seem like a lot when compared to the millions," noted Dr. Kashif. "But we were still counting thousands of families far from home in need of food, water, shelter and medical support."
Dr. Kashif said that these were the groups prioritized by CWS-P/A's volunteer-driven medical support program in the early days of the crisis.
"Decrease our dependence"
As humanitarian groups mount their response to a new wave of displacement from the Pakistani military campaign against the Taliban in South Waziristan, the government has slowly been granting some access to the districts of Dera Ismael Khan and Tank, where some 350,000 displaced people have fled.
CWS-P/A is responding with support from ACT International to the food needs of 660 families. An additional water and sanitation response is planned for some 40,000 people, along with the distribution of basic household items.
"As we look at this current crisis, it's difficult to measure if donor governments are moving funds faster this time, because the scale of the displacement doesn't compare to the magnitude of the Swat emergency," Parvez said.
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