Pakistan: Eyewitness - Making an impact on the lives of thousands of quake survivors

Merlin set up its first field clinic at Panjkot during its emergency response to the 2005 earthquake.

Ben Twitchin, Assistant to Merlin's Country Director in Pakistan, describes his first visit to the camps and mountain villages where Merlin is continuing to provide health care for thousands of people affected by the October 2005 earthquake:

After working at Merlin's Islamabad office for five weeks, it was time for me to pay a visit to our field sites. The trip north to our office in Muzaffarabad in Pakistan-administered Kashmir is a three hour long car journey. The road, as you can imagine, is no M1 in terms of road quality but the views from the car window are certainly more breath-taking than those on the drive from London to Leeds!

Our office there has a very different atmosphere to the one in Islamabad. There is a real sense of action as staff and supplies move back and forth to our field clinics and camps all day. Our first visit was to Mera Tenolian, one of 40 camps where Merlin is providing medical aid for people whose homes were destroyed by the earthquake. This is a large camp on a hill overlooking the city, housing 2,610 people. The living conditions left much to be desired, but the camp is well organised, and with Merlin providing for their health needs, people do at least have access to some of the facilities which we all take for granted.

The following day we set off for our clinic at Panjkot in the remote Neelum Valley. As Merlin's first clinic established in response to the earthquake, Panjkot has earned itself some status, not least because it has a meeting room named after it in our London head office! The clinic is not like your average doctor's surgery. Set up next to the rubble of the original clinic which was flattened by the earthquake, Merlin's facility comprises of a pre-fabricated building used for consultations and the dispensary, a couple of tents used as treatment rooms and a waiting area, male and female tented accommodation, a kitchen and bathroom facilities. This may not sound like much, but to the community, this clinic is their only local health facility, and all services provided are free. One of the cleaners told me how difficult life was with the lack of service provision, especially during the cold winter, but he broke into a smile when he looked over at the clinic and said: "But we do have Merlin. We love Merlin."

That evening as we sat down for dinner, Merlin doctor Ahreema Hashmi was called to examine a three-month-old baby brought in by her parents. She had been suffering from diarrhoea and had been dehydrated for a number of days. I stood quietly at the back of the tent as the doctor treated the tiny baby and delicately inserted an intravenous line to give her the fluids that she desperately needed. Sadly when I woke up the following morning, I was told that the baby had passed away during the night. She was simply too dehydrated. What made her story even more desperate is the fact that her parents had twice made the long journey to Muzaffarabad to pay for medical consultations and antibiotics. If she had been brought into Merlin's clinic slightly sooner, she would probably have recovered, but the false impression that paying for treatment will ensure the best care is still quite prevalent here. This is a part of the culture that Merlin cannot change overnight.

My visit left me with two overriding impressions. Firstly, I was impressed by the level of impact that some well trained staff and a handful of tents have on this community. Without Merlin's presence, mothers would have nowhere to get their children vaccinated; pregnant women would receive no maternal care; children who injure themselves would have no doctor to dress their wounds. All of this seems obvious, but I found it remarkable to think that what is a relatively simple service has such a vast impact on the day-to-day lives of thousands.

Secondly, it was humbling to see the dedication of the Merlin team who work and live there. I thoroughly enjoyed my short stay but I would imagine that after a while, some of the 'quirks' of living there might start to grate a little: the remoteness of the location; the possibility of being cut off for days due to landslides caused by rain; the cold (particularly when trying to get to sleep); not to mention the wash room which comprises of a bucket of water and little else!

The last few days have given me a clearer idea of how much Merlin has achieved in some of the most remote and difficult to access areas of Pakistan. It's also been personally rewarding as it's enabled me to see how the work I do in an office in Islamabad is helping to deliver life-saving medical care for people affected by one of the most devastating earthquakes of recent times.