WHO launches emergency preparedness programme for NWFP and Balochistan

The World Health Organization (WHO) has developed a three-tier health emergency preparedness plan to increase the capacity of Pakistan's two disaster-prone western provinces of North West Frontier Province (NWFP) and Balochistan. "In the first phase, we are going to conduct four training workshops for the hospital staff from five districts of both provinces. The primary focus will be on the preparation of 'hospital emergency plans' at the district level along with the development of a 'disease surveillance system'," Dr Quaid Saeed, a WHO emergency medical officer, told IRIN from the northwestern city of Peshawar, capital of NWFP on Monday. The provinces of NWFP and Balochistan and the adjoining belt of Federally Administered Tribal Areas (FATA) have frequently suffered emergencies and disasters, partly because of their strategic location adjoining war-torn Afghanistan, with which they share a border of about 2,400 kilometres. Added to this are the earthquakes, floods, droughts and frequent disease outbreaks in the rough hilly terrain. "In Balochistan, the hospitals, even some big ones, lack any emergency response system so we are focusing on the hospital disaster management and disease early warning system, involving the relevant medics and executives," Dr Sher Ahmed, a WHO emergency medical officer, told IRIN from the southwestern city of Quetta, capital of Balochistan. According to WHO, the two provinces share a high prevalence of communicable diseases, mainly water borne, and malnutrition, with no existing system to respond to those affected. Around 60 percent of the population living in rural areas have no direct access to health care facilities. "Many public hospitals are not prepared to deal adequately with the daily emergencies. The situation is characterised by a partial lack of basic equipment, drugs and skilled staff," Dr Ahmed said. "The situation is further aggravated in the case of the FATA, where the patients are referred sometimes to the tertiary care hospital of Peshawar, a 10-hour journey by road from some places," Dr Quaid noted. "Such training workshops are very useful and needed for our hospital staff, as they lack [experience of] daily emergency handling like in case of any bomb blast or traffic accident. We've not a proper response system in place," Dr Isa Khan, provincial coordinator of a primary health care unit, told IRIN from Quetta. Khan added that only three hospitals in Quetta have the emergency units. In 25 other districts of the province there are district-level hospitals but only a few of them have separate emergency units. WHO conducted some emergency preparedness workshops from late 2001 onwards in eight districts of Balochistan bordering Afghanistan. All the staff, including medics and paramedics, were trained along with some NGO staff working in the areas. "Under the programme, we also upgraded a hospital in Qilla Abdullah District while equipping several healthcare facilities with emergency apparatus and drugs," Dr Masood Nosherwani, in charge of the provincial branch of WHO, told IRIN from Quetta. "This time, we are particularly focusing on the frequent outbreak of leishmaniasis, a skin infection, in Balochistan as well as NWFP and tribal areas," the WHO official said. The area of NWFP and FATA is also prone to major earthquakes. "The Geophysical Centre of Pakistan has identified four seismic zones, placing this region in zone one," Dr Quaid pointed out. In the long run, the WHO will help the health departments of the two provinces to acquire a complete system of emergency preparedness and response in two districts of each province. "At present, we are having problems with the implementation of this phase, as to put a whole emergency response system in place, to purchase a bulk quantity of medicines, to store them, updating laboratories, training paramedics, all needs a lot of resources," the Peshawar-based WHO medical officer said. "Under the third phase of the plan, we'll monitor the efficiency of responding to any future emergency," he said.