New quake patients pour into hospitals

In scenes of panic reminiscent of the first, chaotic post-quake days, doctors at Mansehra's district headquarters hospital on Tuesday morning surround a small child who has just been brought in. The toddler's lips, like his hands, are blue and his wailing mother, Parveen, clearly fears the worst. But 20 minutes later, doctors bring good news. Two-year-old Omar, suffering from hypothermia and pneumonia, is still alive and will likely, with hospital care, drugs, good food and most crucially of all, warmth, recover within a few days. The child, wrapped in a red blanket, an intravenous drip pumping anti-pneumonia drugs into his frail body, is already beginning to look better, his eyes starting to lose their glazed look as he stares up at the nurses standing beside the bed. "Yesterday [Monday] was an awful night. We thought this child would die. He had become still, and we could hear rattling in his chest," Omar's father, Aziz Khan, explained. The family travelled overland to Mansehra, a large town and the capital of the Mansehra division of Pakistan’s North West Frontier Province (NWFP), 150 km northwest of the Pakistani capital, Islamabad. They have been living in a tent for over 20 days, and Parveen, the child's mother said: "It has just been miserable over the past two days. The snows falling in the hills have meant the winds blowing southwards are freezing and we do not even have a ground mat on which to spread our bedding." Parveen's two daughters are still surviving such conditions, with a neighbour. But it is already apparent the cold has taken its toll. Across the quake-affected areas, hospitals are filling up, as a new struggle begins to save lives. "Just look around the beds. We have dozens of new patients. The number will rise to hundreds soon and we must try to save as many lives as we can," said Dr Muneeb, at the Ayub Medical Complex in the northern city of Abbotabad. The hospital, itself badly damaged in the October quake, has barely seen a few days of respite. Now patients are being brought in once more, with new ones arriving every hour. "It is the elderly and the young who are most at risk from pneumonia. Children, because of their smaller body masses, are also especially susceptible to hypothermia," another doctor at the hospital explained. Doctors are stressing the need for the sick, the injured, the very young and the very old in particular to be kept warm, provided with hot food and to be kept indoors – but this is of course easier said than done. Across quake-affected areas, temperatures have begun to plummet below the freezing point. Many survivors are still housed in grossly inadequate tents – and the poor quality of the shelters has meant that after rains that fell over the past two days, bedding, clothing and the tents themselves have all become drenched. Only a small percentage of victims have received winterised tents, though delivery is being speeded up as much as possible. "There is just no way of keeping dry. Everything we own is damp or wet, even the matches to light a fire," grumbled Saeed, 32, crouched outside his small tent in Abbotabad, as he tried unsuccessfully to light a fire below a stove. Given the sheer desperation of the situation and the fact that more people are expected to die, adding to reports that three died of cold in Pakistani-administered Kashmir on Monday, doctors at all hospitals in quake-affected areas say they are attempting to admit whoever comes in, aware that if they send them back, it will be to a cold, damp tent in which they are unlikely to survive. "For the moment, we are just trying to take in as many as we can. But people will grow sicker. More will come in and then we will have to prioritise," Florence, a French nurse working at a field hospital in the Balakot area, said. Conditions for relief workers too are miserable, with areas outside tents converted into pools of slush and mud. Makeshift walkways, built with loose planks or wobbly bricks laid out as stepping stones, are visible everywhere at camps and the people who gingerly make their way along them often seem as miserable and demoralised as early on in the disaster. For victims the situation is desperate. It is now clear with the first snows and rains of winter hitting many affected areas that another disaster is looming. "We have no way of keeping warm. We cannot burn a fire inside the tents, for fear they will be set ablaze and the small fires we light from kindling have no impact outdoors, where it is too cold to sit anyway," said Rashida Bibi, 32, based in a tent village near Balakot. In other areas, where snows have already begun to fall, the situation is still worse. "Children and their families in the Allai Valley are extremely vulnerable. They face ongoing and imminent health threats - be they from exposure to the cold, quake-inflicted wounds or diarrhoea and pneumonia," said a spokesperson for Save the Children, USA. The NGO, with the US-based Americares organisation, has been setting up a 15-bed field hospital in Bana, the main town in Allai, and hopes that the facilities it provides can help save lives in an area, which is likely to be cut off by snows from the rest of the country in the weeks ahead.