Highlights
- The search and rescue phase has ended.
Emphasis now is on expanding humanitarian relief.
- Accessing the injured and other survivors in remote areas is still difficult.
- Transport of injured patients who cannot be treated in Muzaffarabad and in other accessed areas has resumed with the improvement in weather.
- No disease outbreak has been reported to date.
Health impact
- A significant number of earthquake victims have not been accessed to date due to bad weather conditions and collapsed road infrastructure. Estimates of the number of dead and injured therefore varies considerably. Agencies are concerned that many survivors whose lives could have been saved by prompt treatment will not be accessed on time leading to unnecessary deaths and disabilities.
- A triage system is in place and the transfer of severely injured patients to hospitals in other areas of the country including Islamabad has been resumed. Mapping of all medical teams and field hospitals continues, to help direct teams and mobile facilities to where gaps exist.
- The national and international surgical and medical teams are maintaining round-the-clock management of all surgical or medical consultations. The number of consultations increases daily while the volume of consultation exceeds capacities of the field hospitals.
- The cold weather and lack of basic necessities will soon form a major health threat if not resolved immediately. The need for tents and blankets is the main priority as every drop in temperature speeds the risk of hypothermia, vascular collapse and death. Tents must be dropped into the areas inaccessible due to blocked roads. So far about 15,000 tents have been brought in. Thousands of additional tents and warm blankets, and transport to bring them in, are needed in the next 48 to 72 hours.
- There are concerns on the lack of nutritious food supplies and safe drinking water for survivors as it is now 10 days after the earthquake.
- Electricity has been restored in the Abbas Institute of Medical Sciences (AIMS), Muzaffarabad, the only hospital that has withstood the earthquake and is still functioning. AIMS is carrying out 300 minor and major surgeries every day with 5 operation theatres. At this stage, there is no lack of drugs or medical supplies.
Health response
Coordination
The relief phase is gathering momentum. The Pakistan Ministry of Health and WHO have initiated health coordination activities in the affected areas to ensure adequate organization and appropriate deployment of the field hospitals, as well medical and surgical teams.
- Fully functioning WHO field offices in Muzaffarabad and Mansehra as of today will be facilitating coordination jointly with the Ministry of Health between all health partners in the field and in Islamabad. WHO has planned to set up 4 warehouses in Mansehra and 5 in Muzaffarabad with a cold chain facility in the course of this week.
- Health coordination meetings have been taking place in Battagrom, Balakot, Mansehra.
- The Ministry of Health and WHO are currently in the process of collecting and analysing all available information on the health status of the earthquake affected areas, to be shared with all health partners.
- All health partners in Muzaffarabad have agreed to use the same rapid assessments forms, disease surveillance forms, health facility assessments forms and interagency mission assessments forms.
Public Health and disease surveillance
- A WHO/UNICEF team have checked into reports of an increase in diarrhoeal cases in Balakot and the reported increase turned out to be false.
Health services delivery and health promotion
- To reduce the number of medical evacuations of patients to Islamabad, the Ministry of Health and WHO aim to establish a referral system between the different health providers in Muzaffarabad. Thanks to the efforts of international medical teams from France, Russia and Turkey the capacity in Muzaffarabad to carry out surgery is sufficient. However, the capacity to place patients in post-operation health care is not enough.
- A total of 9,000 injured people have been air-ambulanced to Islamabad and about 4,500 still remain. The Pakistan Institute for Medical Sciences (PIMS) in Islamabad is still receiving up to 300 patients daily and is sending stabilized patients to other public hospitals around the country.
- The Ministry of Health has updated their communication strategy, elaborated in coordination with WHO and UNICEF, for this specific disaster. Health messages will be shared with the media.
- The Ministry of Health and WHO will be deploying 40 teams of 5 health professionals each into the field this week to strengthen health sector support in the earthquake affected areas. As well, 17 surveillance officers have been trained for immediate deployment.
- Guidelines for establishing field hospitals were disseminated among health partners.
- UNFPA reports that the obstetrics and gynaecology ward of AIMS hospital has been made operational for comprehensive emergency obstetrics services.
- UNFPA has also deployed six mobile mother and child health care units in the districts of Muzaffarabad and Mansehra.
Urgent needs
- For the ongoing measles vaccination campaign, additional staff are required to strengthen the mobile teams.
- The overall lack of health staff will only be partially covered by the 200 medical doctors and public health experts recruited by the Ministry of Health to be mobilized in the field this week.
- An efficient humanitarian supply system needs to be put in place, to facilitate distribution of medical supplies to all health facilities.
- Large winterized tents need to be set around field hospitals that are functioning as surgical wards to cope with the large number of post-operation patients. Tents are also needed to reactivate basic health units.
- WHO urgently requests tents, blankets and food for health facilities and for the affected population still living in the open.
The lack of sanitation facilities needs to be addressed urgently and the increased availability of chlorine tablets and focused hygiene promotion campaigns are also urgently needed.
Donations
New donations:
- Government of Japan US$ 1million for WHO support to the disaster response.
Previously reported donations:
- The British Government has donated US$252,951 for WHO support to the disaster response.
- The Swiss Government has donated US$100,000 for WHO support to the disaster response.
- The Norwegian Government has donated US$250,000 for WHO support to the disaster response.
- The Principality of Monaco has donated Euro 100,000 for WHO support to the disaster response.
- The Government of Italy has donated EURO 250,000 for WHO support to the disaster response plus in-kind donations of 5 Trauma kits A, 5 Trauma kits B, 5 New Emergency Health Kits and transport.
- The Government of Australia has donated US$ 1,899,696.
- The Government of Ireland has donated EURO 100,000 for WHO support to the disaster response.
- The Government of Sweden has donated US$1,928,020 against the Flash Appeal.
- The Government of the United States has donated US$2,000,000 against the Flash Appeal.
- The Government of Canada has donated CDN 1,750,000.