**MSF scales up distribution of relief goods as worrying gaps remain
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Two weeks after the first floods hit Pakistan the situation remains extremely dire for millions of people. In Khyber Pakhtunkhwa, Baluchistan, MSF is intensifying its activities and remains focused on medical care, clean water provision, and distribution of essential goods. Assessments are ongoing in these provinces, as well as in Punjab Sindh.
In addition to the scale-up of medical activities, MSF teams continue to focus on providing affected families with basic items and drinking water to help them attain a minimal standard of living and to prevent the spread of disease. As of 10th August, MSF had distributed kits to 5,143 families (36,000 people) in Khyber Pakhtunkhwa and Baluchistan provinces.
A typical package contains clothes, soap, toothbrushes, towels, razor blades, a bucket, a jerrycan, blankets, a mosquito net, plastic sheeting and tarpaulins. But the kits can be modified according to specific local needs.
“Weather permitting, we will distribute thousands of kits this week in Khyber Pakhtunkhwa and Baluchistan,” said Thomas Conan, MSF’s country representative in Pakistan. “But we fear that too little is being done for affected families. Two weeks after the first floods, people’s needs are immense and are still increasing. Much more must be done for them.”
During a distribution at Khurasan camp for Afghan refugees, people from neighbouring villages came asking for kits because they had not received anything. On that occasion, MSF was able to help a hundred more families than had been planned for, but the lack of visible aid is worrisome.
A major challenge in this context is finding places to organize distributions. Many places are still under water, and a zone that is dry one day might well be under water the next day. There is very little margin for error because distributions are big logistical enterprises involving tons of materials and dozens of trucks.
**Mobile clinics and health structures
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Since 1st August MSF has provided more than 7,000 consultations to people affected by the floods in different areas. Of these, 1,800 consultations were provided through eight mobile clinics travelling to remote areas or places with high concentrations of people such as schools or camps.
Three of the mobile clinics are in Baluchistan (Dera Murad Jamali, Khabula and Sobhatpur) and the other four are in Khyber Pakhtunkhwa, Malakand, Swat and Lower Dir and two are located in Charsadda. More mobile clinics will start soon in Pir Sabak, near Nowshera.
In Baluchistan, the mobile clinic in Khabula identified four children with severe acute malnutrition who were later admitted to the Sobhatpur clinic.
“At this point, we cannot link these cases of malnutrition to the aftermath of the floods” said Pierluigi Testa, who manages MSF activities in Baluchistan. “But we will be keeping a close eye on the nutrition issue as the food situation is worrying with harvests threatened by flooded fields. Needs in many parts of [the country] remain extremely dire.”
**Clean water desperately needed
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Provision of clean water continues in order to prevent disease. MSF water and sanitation teams are working hard to provide water to communities. In places like Charsadda, Nowshera and Swat, the teams are supporting local authorities to rehabilitate local water delivery systems while trucking water to families who need it.
Water points have been set up in Lower Dir and in eight localities in Swat. MSF is also providing clean water to the district hospital in Lower Dir and Nowshera. Now that the road has been cleared, three water points will be installed in Totakan, Isar Baba and Kalangai in Malakand.
Yesterday, the water and sanitation team in Nowshera completed the rehabilitation of a borehole and managed to extract and distribute 35,000 litres of water to the community with trucks. The daily quantity should increase in the next few days.
In and around Charsadda, MSF is providing clean water through a combination of 21 mobile water points on trucks and minivans and seven fixed ones.
Assessments
More assessments are taking place daily in Khyber Pakhtunkhwa and Baluchistan to identify pockets of the population in need of aid. MSF is increasingly worried that a large number of people have yet to receive any assistance --both in remote areas and in places considered to be easily accessible.
Two MSF teams are also assessing affected areas in the Punjab and Sindh provinces.
110 tons of water and sanitation equipment, drugs, medical and logistical material have arrived in Pakistan and will be followed by more relief supplies according to the needs identified.
More than 100 international staff are currently working alongside 1,200 Pakistanis in MSF programmes in Pakistan.