Health concerns in outlying villages - WHO

Aid agencies have reiterated their concerns about injured earthquake survivors yet to be accessed in outlying areas of devastated northern Pakistan. “At this stage, we have no idea what is happening in [the] peripheries,” World Health Organisation (WHO) official Altaf Musani said on Sunday. “That’s the biggest concern at the moment because of the weather situation, because of the people trapped there and lack of systematic assessments,” added Musani, who is coordinating emergency health relief efforts in Muzaffarabad, capital of Pakistan-administered Kashmir. Over the past week, up to 4,000 injured people have been evacuated by helicopters, including about 3,200 by the Pakistan military, from the Muzaffarabad area to the capital, Islamabad, and other cities. It is estimated at least 38,000 people have died and more than 62,000 been injured. About 50 percent of buildings and infrastructure in Kashmir have been badly damaged, the districts of Bagh, Muzaffarabad and the Neelum valley among the worst affected. Health officials are trying to treat the injured locally, with field hospitals in Muzaffarabad coming into operation on Sunday. “We are trying to influence the policy of evacuation so that … families stay together here,” Musani said. “That will have a beneficial impact in making sure we don’t overload Islamabad when we do have a capacity of treating people here.” The main referral hospital, the Pakistan Institute of Medical Sciences in Islamabad, with a normal capacity of 800 beds, continued to receive hundreds of patients flown in by helicopters from remote areas. The Ministry of Health was planning to open another field hospital with 100-200 beds at Islamabad airport to reduce the delay treating the most severe cases arriving by helicopter. “In these kind of emergencies, there are three peaks of mortality,” Musani said. “The first when the situation occurs, the second when we have cases of trauma and badly injured people [who] are inaccessible and don’t have health services.” Musani said the third peak occurred when individuals did not have access to services and succumbed to epidemics or chronic illness. “A week after the earthquake, we are coming close to that second phase, as we don’t know what’s happening outside,” he said. WHO reported on Saturday that survivors continued to struggle because of the lack of adequate shelter and safe water. Cold weather and insufficient emergency care in remote areas were adding to the suffering. “The number of injured survivors in need of trauma care and surgery seems to be very high,” the report said. The injured continued to arrive at health facilities, many suffering broken and crushed limbs, others requiring urgent attention for head, spinal and chest trauma. As the days pass, open wounds are becoming increasingly infected, with many cases of gangrene reported, WHO said. “Now mobile medical teams have started moving out gradually as the roads are opening,” Musani said. In Balakot, another area badly hit by the 8 October quake, cases of diarrhoeal disease shot up to 80 on Saturday. WHO and UN Children’s Fund (UNICEF) staff, including water and sanitation experts and epidemiologists, have been rushed by helicopter to the area, carrying chlorine tablets, oral rehydration salts and medicines to help stave off infection.