GENEVA/ISLAMABAD -- As the information flowing from some of the worst-hit areas in Pakistan increases, the specific health needs are becoming very clear. The number of health workers must at least double, hundreds of thousands of litres of clean water and blankets are just some of the most immediate needs for earthquake survivors who are exposed to cold, infectious disease and who need surgery as well as basic health care.
The estimated number of dead is 22 000. Of the four million affected people over one million are in acute need of humanitarian assistance and tens of thousands suffer from injuries. Wounded people, with broken limbs, head and spinal trauma, and open wounds need urgent attention. Without help, people risk death and severe illness from infection, unnecessary amputations and life-long disability.
Hundreds of thousands of people have no shelter, blankets or clean water. Those people crowded together with poor water and sanitation risk pneumonia, water-borne diarrhoeal diseases, as well as infectious diseases such as malaria and measles. A measles vaccination campaign for everyone under 15 is already underway. WHO is helping to set up a disease surveillance system in the worst affected areas.
Water is especially critical. People need it for basic survival, and to reduce the risk of infectious disease. Unsafe water will lead to epidemics. WHO calls on all donors to provide chlorine tablets, bottled water or field water production facilities. Hundreds of thousands of litres of safe water are needed.
26 hospitals destroyed
WHO reports that 26 hospitals including three specialized tuberculosis hospitals have been destroyed or are too dangerous to keep open. Most of the 600 health clinics in the affected areas are also thought to be destroyed or severely damaged. Engineers are assessing whether some of the damaged health buildings can still be used.
After visiting Mansehra this morning, WHO's Regional Director for the Eastern Mediterranean region, Dr. Hussein Gezairy reported that the situation there was "very worrying, given that the thousands of people who are gathered have no shelter and no safe water to drink. He called for "a doubling or even tripling" of doctors, particularly general practitioners with experience in emergencies and basic surgical skills. Paramedics, primarily health care specialists and public health specialists including epidemiologists are also desperately needed.
Other immediate needs include anaesthetics, antibiotics, intravenous fluids, basic painkillers, respiratory equipment including ventilators, along with disposable supplies such as bandages. Insulin for people with diabetes is also urgently needed, and adequate amounts cannot be bought in Pakistan. WHO is sending a full list of urgently needed supplies to donors today.
Improving coordination
Much aid is arriving from within Pakistan as well as from international agencies and non-governmental organizations.
WHO reports that coordination of health supplies is improving, with a fully operational donor coordination unit run by the Ministry of Health and WHO. The Unit, with a hotline number and email address, encourages all donors to advise of the supplies and people which can be made available. The Unit will then advise where the donations and people can be put to best use. *
"When time is of the essence, we cannot afford to have the life-saving supplies going to the wrong places. All health-donors should check-in with the Donors Coordination Unit so we can track what is available, and quickly decide on the best place to send it," said Dr Alwan, the WHO Director-General's Representative for Health Action in Crises. Dr Alwan travelled to some of the affected areas with Dr Gezairy this morning.
WHO is working in three important areas. One is to assess and communicate the overall health needs and damage to the health infrastructure. The second is to provide essential supplies and health experts. The third is to help coordinate the health response. WHO is sending enough 10 000-person Emergency Health kits to provide basic health needs for 210 000 people in one month, and enough surgical kits for 1000 surgeries. WHO already has four teams on the ground, and in total 60 WHO staff are working full-time on earthquake relief.
WHO is also sending trucks with medical supplies, generators and fuel to run health facilities. WHO reports that tetanus vaccine is being made available, and that malaria officers are beginning to spray to control the mosquitoes which carry the disease. 100 000 chlorine tablets are also being sent to disinfect water. A full situation report and other information is available at www.who.int