Pakistan has temporarily eased restrictions on national and international aid groups seeking to carry out relief work in the cash-strapped country as it confronts the deadly coronavirus.
Non-governmental organisations stepped up efforts to bolster the anaemic healthcare infrastructure after restrictions were eased on 26 and 27 March. Pakistan confirmed 5,988 coronavirus cases from 26 February through 15 April, including 107 deaths, according to official statistics. The government has limited resources to handle the pandemic, including an acute shortage of ventilators, personal protective equipment such as masks and gloves, and hospital beds.
Aid groups had faced enhanced government monitoring since 2015, when strict regulations were introduced requiring so-called no-objection certificates for any new relief project. The policy essentially required government approval for each and every aid endeavour and led to the government shuttering operations of 18 international NGOs, including Action Aid, Plan International, World Vision, and the Danish Refugee Council.
Local banks were also prohibited from transferring money from foreign donors without the permission of Pakistan’s Economic Affairs Department.
“The government has given space, after a long time, to the international community to work on the COVID-19 crisis,” said Syed Shahid Kazmi, country coordinator of the Pakistan Humanitarian Forum (PHF), which represents 43 international aid groups working in the country.
“It took at least four to five weeks to get the permission,” Kazmi said. “Now, the government has defined a coordinated structure for COVID-19 emergency response, enabling us to work quickly. But we are facing a major lack of funding. It wasn’t available before, and still isn’t since the government eased restrictions.”
“The country’s weak healthcare infrastructure is unable to bear the influx of COVID patients without the support of aid groups and philanthropists.”
A 2018-19 survey recorded 1,279 public hospitals in Pakistan; 5,527 basic health units; and 686 rural health centres. The latter two categories cater to a rural population of 132 million. The nation has one doctor for every 963 people, compared with 2.8 physicians per 1,000 people in the UK. Sajid Shah, spokesperson for the Ministry of National Health Services, told The New Humanitarian that public sector hospitals in the capital city of Islamabad have just over 2,100 beds to serve a population of more than two million.
“The country’s weak healthcare infrastructure is unable to bear the influx of COVID patients without the support of aid groups and philanthropists,” said Dr. Qaisar Sajjad, secretary-general of the Pakistan Medical Association, which works to protect physicians’ rights.
Doctors and paramedics have repeatedly appealed to the government to provide proper medical gear and PPE. Every day, physicians call the medical association for help, sometimes threatening to walk off the job if they don’t get it, Sajjad said.
According to official statistics, two doctors and one other healthcare worker have died after handling coronavirus cases. At least 100 doctors and 28 more healthcare workers and related staff have tested positive for the virus.
Work gets underway
International and local aid groups are working to build quarantine centres and set up isolation wards within existing hospitals, schools, colleges, hotels, and expo centres.
UK-based Muslim Hands converted its educational complex near Wazirabad in the eastern province of Punjab into a four-hectare treatment facility with capacity for 600 patients. It’s fully equipped with protective and medical equipment, as well as being set up to prevent further spread of the virus. The organisation also donated healthcare equipment worth about $240,000.
Helping Hand for Relief and Development, an NGO headquartered in the United States, is also building an isolation ward for COVID-19 patients at the Rawalpindi Institute of Urology in Punjab. In addition, the international NGO distributed 5,000 PPE kits to district governments and is procuring another 8,000. It’s also planning to provide ration packs to 2,000 families.
Other aid groups are also donating face masks, gloves, personal protection suits, head scarfs, shoe covers, and temperature-sensing devices, as well as educating the public about coronavirus through radio ads, pamphlets, banners, and in-person information sessions for small groups.
“This is a trying time for all of us. We are doing our best,” said Syed Javid Gillani, director of operations for Muslim Hands in Pakistan. “This is a coordinated effort, and we are trying to help the government meet its healthcare requirements.”
One big-ticket item is still elusive, however: ventilators.
Pakistan’s National Disaster Management Authority is the government body overseeing the coronavirus response. Saqib Mumtaz, its deputy director for media, told TNH the agency is looking to multiply its stock 10-fold during the crisis. In March, the country had just 1,000 working ventilators. It is looking to increase that number to 10,000 by the end of May, he said.
Humanitarian organisations are using Pakistan’s recent decision easing restrictions on COVID-19 aid work to press for more general leniency.
Sana Zulfiqar, coordinator for the National Humanitarian Network, an organisation that works on behalf of local NGOs, said the recent changes have made a big difference in their ability to use foreign assistance.
While some initially had difficulty redirecting resources to COVID-19 relief work, they’re now designing projects to combat the crisis and are able to get funding instantly.
But non-coronavirus projects still need to go through prior approval at the district and provincial level – a process that can take at least four months. And some aid groups have seen donor support dwindle as NGO restrictions have mounted in recent years.
“The environment is still tough,” said Rizwan Baig, deputy country director of Helping Hand for Relief and Development. “Easing restrictions has created a conducive environment for aid groups to carry out their relief work… but a lot still needs to be done on the part of the government.”