SUKKUR,
SINDH PROVINCE -- In the ad-hoc child malnutrition facility at the Railway
Hospital in Sukkur, mothers cradle and nurse their toddlers, all emaciated and
weakened. A row of beds runs either side of the ward in the brown and
gray-painted Raj-era hospital.
Three
year-old Zamina was malnourished before the floods hit, but the flight from the
family farm in Thulla to this heaving city in northern Sindh worsened the tiny
girl's condition considerably, says Dr Sakina Jafri, pausing to speak as she
moved from bed to bed.
"With
the threat of disease all around, young children are most prone," she said.
"And when they are so young and are malnourished, it only adds to that level of
vulnerability."
UNICEF
Director Anthony Lake says that almost 9 million children are at risk of
disease, an alarm call rung out in tandem with World Food Program head
Josette Sheeran's warning
of a second wave of disaster looming even as flood waters slowly recede.
Authorities
have also struggled to cope with a growing number of cases of severe diarrhea
and malaria caused by dirty water that offers a perfect breeding ground for
insects and disease. More than 500,000 cases of acute diarrhea and nearly
95,000 cases of suspected malaria have been treated since the floods first hit,
the U.N.'s World Health Organization said Tuesday.
The big
fear is a cholera outbreak, given that little or no capacity is in place to
deal with what could be a devastating epidemic. Cases have been reported in
Sindh province in recent days, but the Pakistani government has not yet officially
announced anything. Cholera can kill within 48 hours if not treated, and is
highly contagious. Once identified it can be treated quickly, usually with
basic rehydration treatments.
Over 6 million people have been displaced by the floods, with over 3.5 million of
these in Sindh alone. 1.2 million homes have been damaged or destroyed -- five
times as many as the Haiti earthquake. While some of the homeless are in camps
set up by the military and NGOs, the majority are pitching down wherever
possible, constructing ad-hoc shelters and often sheltering under beds or
blankets in the baking heat.
The
Sindh Provincial Disaster Management Authority (PDMA) said that there were
almost 900,000 people in camps and spontaneous settlements in the province as
of 28 August, figures that may not be inclusive of more recent displacement. In
any case, sanitation facilities and clean water are absent from most camps,
compounding an already parlous public health environment and laying the ground
for the spread of disease. Even as the waters in Punjab and the north of
Pakistan, towns and cities in Sindh remain at risk, with evacuation orders
issued for 400,000 people in Mehar and surrounding areas.
Hunger
is a problem now and emergency rations are needed for adults and children, as
well as therapeutic feeding needed for severely affected young children such as
Zamina.
It is a
problem for the government as well, with implications for the country's
economy. After briefing the country's cabinet, Prime Minister Yusuf Raza Gilani last
week worried
aloud about food insecurity due to the damage to agriculture, and follow-on
impact on social welfare.
"The
floods have inflicted damage to the economy which may, by some estimates, reach
$43 billion (£27.9 billion), while affecting 30 percent of all agricultural
land," he said. Agriculture is the mainstay of the economy, with cotton
the main cash crop. Textiles, which are cotton-dependent, are the country's
biggest export. The next wheat harvest is at risk after the floods
destroyed more than 500,000 tons of seed stocks in Asia's third-largest wheat
producer.
Hunger
and malnutrition are major issues now, but food shortages will be a problem in
the near future as well. With millions of acres of cultivable land under water,
it is uncertain to what extent such terrain can be readied for the next
planting season, which should start in October,
or if people will be able to return home in time. With so many draught animals
drowned in the river, it will be difficult for farmers to prepare the ground,
which will be covered in heavy silt.
Zamina's
mother Zeina knows this, her head bowed and her words translated through Dr
Sakina. She nurses her youngest, an eight-month old boy, while a nurse feeds
Zamina.
Life
will be immensely-difficult for her and millions more families in the same
position from now on. "I have nine children", she says. "My husband and the
other children are in a camp. What will we do now? We just don't know," she
laments.
Simon Simon Roughneen is an Irish journalist currently based in southeast Asia; he has previously reported from conflict zones in the Africa, the Middle East, and Europe. His website is www.simonroughneen.com.
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