Warnings of disease increase on border

Pakistani health officials have warned of a possible increase in infectious diseases on its border with Afghanistan as hundreds of thousands of Afghans continue to flee under the threat of US-led retaliation. "We fear increased cases of measles, polio, diarrohea, waterborne diseases and viral infections," the chief executive of Pakistan's National Institute of Health (NIH), Dr Athar Dil, told IRIN on Thursday. He said Afghans were "pouring in from all sides of the country", and that while many were stuck at the border, those who managed to cross were not staying in border areas, but moving to the cities. "We are concerned about overcrowding, lack of facilities and basic amenities, vaccination coverage and spread of any communicable diseases," he added. Pakistan, along with other countries neighbouring Afghanistan, have closed their borders to block a huge exodus of Afghans. Stressing the need for a strong surveillance programme, Dil said a disease early-warning system had been activated with the help of provincial governments in the North West Frontier Province (NWFP) and the southwestern Baluchistan Province, which border Afghanistan. The UN estimates that a million refugees will head for Pakistan, and health officials fear this could lead to disease outbreaks. Dil said another concern was the fact that refugees were bringing in tick-infested cattle, thereby facilitating the introduction into the country of viral haemorrhagic fever. "This fever causes bleeding from the face and body, and can take lives within days," Dil said. In order to keep a check on the number of refugees affected by diseases, health officials in the concerned provinces had been asked to keep stringent daily records of new patients, he said. Dil explained that doctors in the region would call on refugees to encourage others to look after their health and seek treatment straight away. He also referred to Pakistan's ongoing polio eradication programme, saying that Afghan children crossing the border into the country would also be immunised. At present there are 42 cases of polio in Pakistan, which hopes to be declared free of the disease by the end of next year. Meanwhile, fearing an influx of casualties in the event of US retaliation against neighbouring Afghanistan, the three main hospitals in the NWFP are "preparing for any eventuality". "The provincial government asked us to submit a disaster plan, as we are close to the Afghan border," the chief executive of the Lady Redding hospital in the provincial capital, Peshawar, Jamil Ahmed Khan, told IRIN on Thursday. "Our surgical staff have been told not to take leave in case any casualties are brought into the city," he said. Lady Redding is a government-run hospital and, with about 800 staff, the biggest in Peshawar. Khan went on to say that blood banks were in the process of contacting donors for extra supplies. He noted that the hospitals were instituting these measures of their own volition, and that the federal government had not yet ordered an alert status. Khan said he and other hospital officials would be meeting Pakistan's health ministry officials over the next few days to discuss the situation. He pointed out that the last time such steps had been taken was during the Soviet invasion of Afghanistan in 1979. At that time, he said, 30 Afghans were being brought to the hospital daily, with most suffering from land-mine injuries. Similar measures are being instituted at another main hospital in Peshawar, the Khyber. "We have prepared a plan, and staff are ready to receive casualties," the hospital's chief executive, Dr Zahir Shah, told IRIN. "We have a crisis management team, and we have put our staff on red alert." Shah explained that the provincial government had asked them to be prepared. He added that the smaller Hayatabad medical complex in Peshawar had adopted similar measures. The uncertainty over what may happen next in the region has prompted people in the Pakistani capital, Islamabad, to stock up on medical supplies. One of the biggest pharmacies in the city reported an increase in sales of medicines. "People are buying regular medicines in double quantities in case they have to stay indoors for a long time," the manager of Shaheen chemists, Talat Mehmood, told IRIN. He noted, however, that there were enough supplies to last at least six months. Meanwhile, an official of Pakistan's health ministry told IRIN that the ministry was not planning to place hospitals officially on high alert as there was no need for such a move yet. "Hospitals have their own emergency planning. However, we are not putting them on alert for the time being. It is far too early to predict what will happen," the ministry's director general, Mohammed Aslam, said.