Karachi: A year after the most devastating floods in living memory in Pakistan ravaged an area the size of the UK along the River Indus, affecting at least 18 million people, according to the UN, a series of reports by humanitarian organizations say victims of the disaster are continuing to suffer.
Oxfam points out that 800,000 families remain without proper shelter and says: “As Pakistan faces another monsoon season and the likelihood of more disasters, the country is not prepared. Many factors which have hampered the relief and reconstruction effort are still present, such as an inadequate disaster management system and a lack of emergency relief coordination and leadership.”
It is becoming clear that among those worst-affected by the failure to provide adequate relief are children. “Many families lost livestock in the flood; some had crops washed away and they have still not been able to make up the losses. The result is less food for families, and often small children suffer worst,” Amina Bibi, 40, a “lady health visitor” working under a government-run scheme with women and children in Thatta, one of the worst affected districts in Sindh Province, told IRIN. “People simply do not have enough food to eat themselves or give to children,” she said.
Evidence of acute malnutrition, exacerbated by the floods, had been uncovered in Sindh by the UN Children’s Fund (UNICEF) and the provincial government some six months after the floods, putting “hundreds of thousands of children at risk”, according to the chief UNICEF communications officer, Kristen Elsby. Malnutrition rates of 23.1 percent in northern Sindh and 21.2 percent in the south were reported – standing above the 15 percent emergency threshold set by the World Health Organization and on a par with some of the poorest parts of sub-Saharan Africa.
Since then, there have been efforts to try and tackle the crisis. UNICEF, with its implementing partner, the UK-based medical relief organization Merlin, is running a programme under which mobile clinics visit “even the smallest, most isolated villages” using mobile clinics which cater for the needs of malnourished children and offer basic health advice. But despite these efforts, the problems are acute.
Merlin’s health officer Rajesh Narwal told IRIN from the organization’s head office in London: “Merlin health workers are currently managing more than 9,500 cases of malnutrition throughout Pakistan, including in Sindh, where floodwater lay stagnant for up to six months, depleting the stored food sources and devastating crops.
“Malnutrition is the underlying cause of nearly 40 percent of under-five deaths. Besides exacerbating mortality and morbidity, malnutrition also leads to stunted physical and mental development, which has wider socio-economic impacts, especially in already poor and deprived areas. Malnutrition also causes micronutrient [zinc, iron, vitamin A] deficiency, which severely impairs the immune system, leaving children more vulnerable to disease and diarrhoea, which in turn exacerbates the malnutrition. It is a vicious circle.”
“My one-year-old son was refusing to eat, and constantly suffered diarrhoea. He weighed barely as much as a six-month-old. Doctors at a visiting clinic told me he was not getting the right foods, and gave us food in packets. He is doing much better now, and is more active,” Aroosa Bibi, 35, told IRIN in a village in Thatta District.
Like Oxfam, Merlin has also warned of a need for more measures to stave off malnutrition and prepare for disaster. In a press release, Merlin’s Pakistan country director Marco Aviotti said: “Malnutrition in Sindh is a humanitarian crisis on a par with some of the poorest parts of sub-Saharan Africa. The floods had a catastrophic impact on the health of an already vulnerable population.” He said the lack of food had left women, children and the elderly even more susceptible to disease.
The situation of people in the aftermath of the floods has also created other problems. One is an increase in child labour. Save the Children UK has warned, according to media reports, that “the number of children forced to work has risen by up to a third in areas worst hit by the floods. With their parents still unable to find jobs, children are being sent out to hazardous areas to scour for desperately needed income.”
Other parents say they have simply pulled children out of school. “My wife is sick. We need money for medicines. I have no crops to sell, and simply cannot afford to keep my three kids in school,” Ghulam Nabi, 35, said in a village near the town of Khairpur, Sindh Province. “Things are desperate and everyone is suffering especially the children,” he said.
“With a crisis of such magnitude, the response has been complicated and challenging, but it has also been successful as a result of collaboration, cooperation and coordination, with the Government, the UN and with other humanitarian actors working together as best [as] possible to support millions of people affected by the floods,” said a UN press release on 28 July.