/ 8 October 2010

Malaria adds to Pakistan’s misery

More than two million cases of malaria are expected in Pakistan in the coming months in the wake of the country’s devastating floods,
aid workers have warned.

Two months into the crisis, large areas remain submerged in southern Sindh province, creating stagnant pools of standing water that, combined with the heat, are powerful incubators of a disease spread by mosquitoes, which breed and hatch
in the pools.

More than 250 000 cases of suspected malaria, including some of the fatal falciparum strain, have been reported, according to the World Health Organisation (WHO). Aid agency Plan International is concerned that the figure will pass two million.

“The most vulnerable are women and children,” said its Pakistan director, Haider Yaqub. The malaria threat is part of a wider health emergency, with more than 20-million people affected by the floods struggling to cope as the winter approaches.

This week the United Nations reported 881 000 cases of diarrhoea, 840 000 cases of skin diseases and almost one million cases of respiratory disorders.

Dr Dana van Alphen of the WHO said: “There are no epidemics yet. It’s not Goma in 1994. But we have to be very careful.” Increasing British aid to £134-million recently, the international development secretary, Andrew Mitchell, warned of extremely serious public health dangers.

The floods have devastated Pakistan’s flimsy public health system. More than 500 clinics have been damaged and the government estimates that 30 000 female health workers, a programme that is the backbone of the community health system, have been made homeless.

Pregnant women are a particular concern. An estimated 50 000 flood affected women will give birth in the coming month, 7 500 of whom will require surgery for pregnancy-related complications. The floods have highlighted the poor health of many rural people even before the flood.

Doctors with the Pakistani Medical Association found that almost all women in Sindh and Punjab are clinically anaemic, half of them seriously so. Midwives at refugee camps in Karachi, housing about 50 000 people, say many women had never previously been seen by a doctor.

Pakistan has one of the world’s highest rates of maternal mortality, with 276 deaths per 100 000 live births. The UN has requested more than $2-billion to meet the humanitarian crisis, its largest appeal ever. So far about one-third of that amount has been pledged or donated.

UN agencies have treated five million flood victims but the onset of winter may make it harder to reach the remaining stricken victims.

Access to the most northerly areas will soon be restricted. In southern Sindh province wide swaths are accessible only by boat or helicopter.

Lost crops starve economy
After inundating an area larger than the Free State, the flood has crippled Pakistan’s agriculture, the heart of its teetering economy. The waters swept away 2.4-million hectares of crops — fruit, wheat, cotton and rice — and 1.2-million large animals, such as cattle, and six million poultry have died.

In the cities, food prices have soared. The flood has one silver lining — with the soil enriched by the flooding, some areas expect a record harvest in spring. But there may not be enough labour. With so many homes destroyed, many people have left. —