Relief workers battle as winter descends

The winding, mountainous road to Balakot in Pakistan’s North West Frontier Province (NWFP) is slow and dangerous, clogged with landslides and mounds of rocks that still shower down from the mountainside almost a month after the devastating regional earthquake that has claimed at least 73,000 people. Clusters of tents are dotted along the route, many homemade from a patchwork of old blankets and clothes. Balakot is now a centre for the relief effort in the region. Sitting in the lush Khagan Valley, thick with pine trees and encircled by snow-capped mountains, the settlement no longer resembles the town it once was. Ninety percent of it was razed by the 8 October earthquake and, apart from a hotel tipped on its side and a few small, precariously standing lopsided buildings, all that remains is a mass of rubble, corrugated iron and twisted metal. The population of the town and surrounding villages was 250,000 but the death toll is unknown, as many villages are too remote to reach. Survivors in these villages have been reluctant to make the journey to nearby towns for help. "They want to stay as long as possible in their villages," said Irja Sandberg, head of the Red Crescent Pakistan delegation. "This is because they own the land and have lived there for generations. Their dead are buried there, their crops are there, their cattle...and they are worried that if they come down here they won't be able to return," she said. For the aid workers it is now a race against time to reach as many survivors as possible before the bitter winter weather descends. "Protecting against the winter months is our main concern. Providing sufficient shelter, winter-proof tents and heaters," said Markku Niskala, Secretary-General of the International Federation of Red Cross and Red Crescent Societies (IFRC), visiting Balakot. Already the cold is beginning to affect survivors. "Our biggest problem is the cold, it's freezing at night and it's horrible," said 14-year-old Ulfat Unwurshah, who lost more than 20 members of her family in the earthquake. Nothing is left of her family house and she now sleeps in a tent in a small camp overlooking Balakot's once clear river, now a deep, muddy red. There are not enough precious helicopters to reach the more than 3 million survivors, so aid workers have now resorted to the arduous and painfully slow method of using mules to reach otherwise inaccessible villages before the snows arrive. Some 140 mules are being used by the Red Cross to negotiate the steep mountain passes that lead to hundreds of isolated villages. It can take the mules all day to reach a village and one animal can carry only two tents. Aid workers are also battling against donor fatigue. "It's still a bit early to say, but it does seem that governments have been rather slow. It's the end of the fiscal year for governments and they've already given a lot to the tsunami," Niskala said. Niskala also said the Red Cross was still waiting to receive 75 million Swiss Francs (US $57 million) in donor money. Tight budgets mean that aid is simply not getting to survivors quick enough. The best method of transport is by helicopter as many roads have disappeared in landslides. But the costs are high. "Officials say helicopters cost $11,000 per hour, that's excluding fuel - for this reason we need to get the public's attention as we need more generous donations," said Arzu Ozsoy, an IFRC information officer. There is also a shortage of female doctors. Some aid workers say that female survivors in need of medical attention are suffering as they are not prepared to be examined by a male doctor. "We're having difficulty in finding female doctors. The reality is that women are not allowed to see male doctors. We need more female doctors, especially from Muslim countries," Ozsoy said. A steady stream of wounded and ill survivors trickles in to the Red Cross field hospital, including women, for one of the two doctors working here is female. The hospital treats more than 100 patients a day and Inigo Vila, team leader of the Spanish Red Cross that runs the field hospital, said that the number of patients with injuries directly related to the earthquake was decreasing. "We're still changing dressings and patches but more survivors are suffering from indirect injuries such as diarrhoea, coughs and respiratory infections," Vila said. He added that coughs and respiratory infections were due to the cold weather and that the field hospital had treated many survivors who still did not have tents. "Respiratory infections are very dangerous because the final step is pneumonia and you can die from that if it is not well treated," he said. About 30 percent of patients are suffering from scabies, which is caused by a lack of hygiene and from contaminated water. Another major medical issue is amputations, due to lack of facilities. "We see a lot of amputations. It's become a matter of saving a life and amputating a limb as there are not the facilities to treat wounds as there's such a risk of infection and gangrene," said Mr Azmadullah, acting head of the Red Crescent Pakistan delegation. Azmadullah estimates there are already 10,000 adults and children with amputated limbs and that the figure will rise to 20,000. But nearly one month on, there are signs that Balokot is slowly coming back to life. Now that the roads are easier to traverse, food is beginning to arrive and small stalls have opened among the ruins, selling fresh fruit and vegetables. But just as the town is improving and the residents are still hopeful that Balakot can be reconstructed and rebuilt, officials are debating whether the city should be rebuilt at all and whether the inhabitants should be moved somewhere else. "We need shelter, it is seriously cold at night. It's going to get harder when the rains and snow come. Accommodation is our main problem," said Mohammad Gulfam, a 28-year-old trainee accountant who shares a tent, measuring about three metres by two, with seven members of his family. "But Balakot is our home. We want it rebuilt," he said. "And if it's not going to be rebuilt, we want to know what the plans are. These were once our homes. We deserve to know our future."