REVIEW OF HEALTH SITUATION floods -2010

 Overall Situation  Disease Threats  Response  Recommendations

Pakistan: Flood Affected Districts

ProvinceTotal affected districts Districts affected AJK7Bagh, Kotli, Mirpur, Muzaffarabad, Neelum, Poonch, Sudhonti Balochistan6Barkhan, Bolan, Jhal Magsi, Kohlu, Naseerabad, Jaffarabad, Sibi Gilgit- Baltistan4Diamer, Ghanche, Ghizer and Skardu KP/ FATA19 Bannu, Battagram, Buner, Charsadda, Chitral, Dera Ismail Khan, Haripur, Kohat, Kohistan, Lower Dir, Mansehra, Mardan, Nowshera, Peshawar, Shangla, Swat, Tank & Upper Dir, Mohmand Agency Punjab18 Attock, Bhakkar, Chakwal, Gujrat, Hafzabad, Jhang, Khushab, Lahore, Leiah, Mianwali, Multan, Muzaffargarh, Nankanasahib, Rahim Yar Khan, Rajanpur, Sargodha and Sialkot Sindh19 Badin, Benazirabad, Dadu, Ghotki, Hydrebad, Jacobabad, Jamshoro, Kambar, Kashmore, Khairpur, Larkana, Matiari, Naushero feroz, Shikarpur, Sukkur, Tando Allah Yar, Tando Muhammad Khan, Thatta and Umerkot Total73 Source: NDMA, PDMA

ProvinceDeathsInjuredHouses DamagedPopulation Affected Balochistan459875,261672,171 Khyber Pakhtunkhwa1,0681,056179,8744,365,909 Punjab ,0008,200,000 Sindh ,2513,684,267 AJK69836,472245,000 Gilgit Baltistan183602,8208,561 Total1,5392,0551,226,67817,175,908 Source: NDMA, PDMA

Total population *17.1 million Male8,379,000 Female8,721,000 Women of CBA3,762,000 Pregnant Women513,000 Children Under five2,907,000 Above 65684,000 *Source: NDMA

Province Population Affected Affected under 5 years of age Maternal Health Services Expected Diarrhoeal Cases Expected Malarial Cases Balochistan672,171114,26920,16667,21746,916 KP4,365,909742,205130,977436,591654,886 Punjab8,200,0001,394,000246,000820, ,000 Sindh3,684,267626,325110,528368,427552,640 AJK245,00041,6507,35024,50036,750 Gilgit Baltistan8,5611, Total17,175,9082,919,905515,2781,717,5912,522,477 Source : WHO

ProvinceNo. of Assessed HFPartially damagedFully damaged KP Sindh Balochistan Punjab Total Initial damaged status of assessed health facilities Source: WHO

Number of cases PunjabKhyber Pakhtunkhwa SindhBalochistanTotal Total Consultations958,951318,032292,97326,0061,595,962 Diseases/Conditions Acute Diarrhea99,05651,82247,1036, ,044 Bloody DiarrheaNR1,5788,5531,138 11,269 Acute Respiratory Tract Infections 105,35047,20048,2623, ,647 Suspected MalariaNR 2,05931,6545,493 39,206 Skin Infections151,70355,78051,6414, ,356 Unexplained fever83,2408, ,038 Snake bite332 NR Dog bite691 NR Source: WHO

ProvinceAlertsOut breaksDeaths KP Punjab330 Sindh826 Balochistan102 AJK100 Total5419

ProvinceCholera Kit IEHKEH kitMedicines (Tons) Basic surgical kit Anti Snake Venom Coverage population wise Balochistan ,550 Gilgit-Baltistan ,000 KhyberPakhtunkhwa ,032,120 Punjab ,173 Sindh ,700 Grand Total ,8002,677,543

ProvinceBCGOPVPentavalentMeaslesTTVit. A Balochistan3874, , ,105 KP3,183199,7464,442187,56223,404167,969 Punjab6,92843,11717,35639,2658,06310,270 Sindh4,69920,7098,51013,5845,78812,831 Total15,197268,20130,431245,98138,145192,175

 Current passive surveillance into active surveillance  Federal task force on diarrheal disease activated  Establishment of Diarrheal Treatment Center (DTCs)  Cholera kits being prepositioned at Multan, Sukkur and Peshawar hubs  Distribution of 2 million water purification tablets  47 water purification units functional (0 Balochistan, 14 KP, 17 Punjab,15 Sindh,1 AJK)

ProvinceNo. of District Total DTCEstablishedIn progress Under discussion KP Sindh Balochistan88044 Punjab Total

 Establishment of 180 MNCH service delivery points  Antenatal services  Skilled Birth services  Postnatal services  Family Planning  Challenges  Malnourishment: high rate of abortions and miscarriages  Lack/retention of trained Human resource  Lack of referral mechanism/services

 Federal task force activated- National and International experts  Distribution of 200,000 primaquin anti malarial tablets  Anti malarial medicines delivered in all kits  Distribution of 40,000 LLINs  Long lasting impregnated nets, larvicidal, rapid diagnostic kits being procured  Mosquitoes repellents are made part of Medical kits being distributed  Arial spray to be commenced shortly

 All the coordination of Foreign teams being carried out at NHEPRN  UAE, Sri Lankan, Jordanian and Palestinian teams on ground and deployed at Multan, Nowshera, Multan and D I Khan  Turkish Field Hospitals deployed at Sibbi and Khairpur  Saudi Team arriving on 25th of August  Spanish, Italian, Bangladeshi, Saudian and Australian teams have committed  MoH through PIMS (KP) and JPMC (Sindh)

 Launched on 19 th Aug 2010  Mobile teams with medicines  40 most affected districts  Male and female doctors, LHVs & nurses, dispensers and attendant  840 applications received in three days  Logistics and deployment to be finalized in coordination with Provincial Governments

 National Steering Committee on Health Emergency Management  Strong Coordination Mechanism  Federal, Provincial & District - NHEPRN  Immediate nomination of coordinators- Provincial & District  Establishment of active disease surveillance (DEWS)  Prime Minister’s National Health Volunteer Programme – Coordinated implementation with the Provinces  Establishment of Diarrheal Treatment Centers at district level