Health services under siege in northwest Pakistan
9 July 2009 -- Two million people have been displaced by the conflict in northwest Pakistan, putting the region's health services under siege. In this episode, we report on how WHO and its partners in Pakistan are facing the challenge.
Transcript of the podcast
Veronica Riemer: You’re listening to the WHO podcast, and my name is Veronica Riemer. Two million people have been displaced by the conflict in northwest Pakistan, putting the region's health services under siege. In this episode, we report on how WHO and its partners in Pakistan are facing the challenge. [MUSIC]
Around two million people have been displaced by the conflict in northwest Pakistan, putting the region's health services under enormous strain. Dr Eric Laroche, Assistant Director-General for WHO's Health Action in Crises, reports to us from Pakistan.
Dr Eric Laroche: In early May, renewed conflict in the Swat Valley forced thousands of families to flee their homes. This has put incredible strain on the people themselves, the communities they have escaped to, the health sector that supports them and the humanitarian community trying to fill the gaps. There is a lack of health workers and, importantly, a lack of funding.
Veronica Riemer: An intense emergency health response is being carried out to protect the health of hundreds of thousands of people. 90% of these displaced people are living outside camps set up for them. They are being sheltered by families, friends, even complete strangers. Dr Said Gufhran, head of the Chaknoda basic health unit in Swabi district, describes the health problems of the displaced persons.
Dr Said Gufhran: They are coming with the complaint of gastroenteritis, diarrhoea, dysentery and the other problems, psychic problems (like) anxiety, depression, pyrexia, malaria. And the other things are acute LRTI; children are coming with ARI - acute respiratory infections.
Veronica Riemer: WHO is leading the health response to the humanitarian crisis, bringing together all NGOs and UN agencies providing health-care services. WHO has delivered supplies for close to 800 000 people and has set up early warning systems in camps and communities to detect disease outbreaks. WHO is also streamlining the delivery of life-saving supplies throughout northwest Pakistan. Dr Khalif Bile, WHO representative to Pakistan elaborates.
Dr Khalif Bile: We need to address the needs of the persons with severity so that they are not left out by the health-care services. We need to address the psycho-social and mental health needs of this traumatized population. We have to also look on how the geographical distribution of health-care services by the different partners is being cut out. So we have a more or less a coordination role. We have a substantive technical role to make sure that the overall service package is comprehensive and addresses the needs of the population.
Veronica Riemer: But much more is needed. The monsoon season is expected to start later this month and heavy rains could increase the misery for the displaced. Insecurity complicates efforts of the displaced people to return home. About 60% of health facilities have been damaged in the conflict and must be rebuilt. Dr Bile emphasizes that long-term rehabilitation should be the priority.
Dr Khalif Bile: When these communities go back to their own areas of origin, the health infrastructure, the human resource availability will pose serious challenge to the delivery of essential life-saving care. The government of Pakistan and the international community will, therefore, require to put their acts together and build up a health system rehabilitation process that will not be limited only on the delivery of imminent care but also on the medium-term and long-term rehabilitation of the facilities and the human resource development, especially with regard to female workers.
Veronica Riemer: A shortage of health staff, particularly women, means that women will be vulnerable in this culturally-sensitive region. Dr Amna Balouch, doctor with the International Medical Corps in Yar Hussain Camp in Swabi district, explains why having women doctors is so important.
Dr Amna Balouch: The women over here, our tradition doesn't allow them to talk to males and discuss their personal issues with them and the medical problems, or stuff like that. They want a female doctor so that they can correlate to them and discuss their problems, their medical issues, their social issues, economic issues, all of those sort of things. The woman-to-woman talk, they want that. Because of that they are reluctant to see a male doctor.
Veronica Riemer: Despite the challenges, Dr Bile sees an opportunity in the situation.
Dr Khalif Bile: (This is) an adversity that can be transformed into an opportunity because a large number of the population is displaced from the Malacan division are people who have little access to health-care services. This opportunity will provide the building of a behaviour transformation where the productive care services, the need for essential care and the demand for care is being built as part of the behaviours of the society.
Veronica Riemer: If you would like to find out more about Pakistan's humanitarian crisis, and other health emergencies, there are links to related information on the transcript page of this podcast episode. Look for the link to the podcast on the home page of our web site, at www.who.int
That's all for this episode of the WHO podcast. Thanks for listening. If you have any comments on our podcast or have any suggestions for future health topics do drop us a line. Our email address is Podcast@who.int.
For the World Health Organization, this is Veronica Riemer in Geneva.