ReliefWeb

- The number of health facilities reporting to the disease early warning system has increased from three on 3 November to 12 on 7 November.

- No outbreak of communicable disease has been reported to disease early warning system.

- Cases of acute respiratory infections are increasingly reported due mainly to the harsh cold weather and poor shelter conditions.

- With the coming winter, a temporary solution is urgently needed for Khanoza Hospital in Pishin.

- In Ziarat, 15 sources of drinking water were found to be contaminated with faecal coliform.

SITUATION UPDATE

- The National Disaster Management Authority (NDMA) reports 166 deaths, 357 injuries and more than 2000 houses destroyed following the 29 October earthquake.

- The Department of Health (DoH) and partners are providing health services in affected areas. Care is provided in tented hospitals where health facilities were damaged.

- In Ziarat district, 20 of the district's 38 health facilities were damaged: two rural health centres (RHCs), eight basic health units (BHUs) and four civil dispensaries are beyond repair while five BHUs and one dispensary are partially damaged. The population serviced by these facilities is more than 60 000 people.

- In Pishin district, nine out of 57 health facilities are damaged, including the Tehsil Headquarters Hospital in Khanozai, a 20-bed facility, and four BHUs. a further three BHUs and three dispensaries are partially damaged. The Khanozai hospital staff is providing health services outside the facility and there is no in-patient facility. Patients with minor ailment are admitted for day-care in an open area with limited facilities while those requiring long-term in-patient treatment are referred to tertiary level care hospitals in Quetta.

- In Harnai district, two BHUs have been destroyed.

DISEASE SITUATION

- The disease early warning system (DEWS) was activated in Ziarat and Pishin districts to monitor disease trends. WHO surveillance officers give on the-job training to healthcare providers through frequent visits to the facilities. Data is collected daily since 3 November and the number of reporting facilities has increased from three to 12 between 2 and 7 November. Initially, only the most affected areas are covered.

- No outbreak of communicable disease have been reported in the affected areas. However, cases of acute respiratory infections are rising due mainly to the harsh cold weather and poor shelter conditions.

- In Ziarat district, acute respiratory infections accounted for 19% of all consultations on 4 November and for 30% on 8 November. Acute lower respiratory infection dropped from 13% on 4 November to 6% on 8 November (Figure 1).

- Between 4 and 11 November, 6023 consultations were reported by the DEWS. Acute respiratory infections, both upper (34% of all consultations or 1998 cases) and lower (17% or 1050 cases), are the leading cause of consultation and account for 51% (3048 cases) of all consultations. Acute diarrhoea accounts for 4% (253) of consultations and bloody diarrhoea, scabies, malaria and fever for 1% each (Figure 2).