Floods Wreck Havoc in Mardan & Swabi

Frontier Primary Health Care has been called again to respond quickly to a humanitarian crisis, this time even closer to home as the recent devastating floods in Mardan and Swabi districts have played havoc in their own communities of Ismailia as well as Kagan and Baghica Afghan refugee camps. This most recent disaster comes just weeks after the Internally Displaced Refugees in camps around Mardan had been repatriated to Swat and the camps officially closed. For several weeks following the closure of the Sheikh Yaseem town camp, where FPHC had been providing 24-7 medical coverage, FPHC staff continued to provide nutritional services to other camps as well as some medical clinics in the camps until all were closed and the services no longer required.

On August 16th a heavy deluge of rain resulted in massive damage throughout Swabi and Mardan districts. Approximately 50% of the mud homes in the Kagan refugee camp were fully destroyed and the rest remain in dangerous condition. Ismailia Health Center was also badly hit with flood waters filling the clinic rooms and hall ways with mud and debris. The home of several staff members were also affected including FPHC's hardworking, stalwart administrator, Said Zaman. Luckily he and his family all escaped unscathed.

Homes in the refugee camps were especially badly affected, as they are made of mud and wattle. Many of the injuries and deaths that occurred were a result of collapse of the homes which happened suddenly and catastrophically.
As many as 27 people died in the flash floods with many more injured and thousands now without homes. Most of the deaths were reportedly due to collapse of the mud-walled houses. The Emergency Maternity Center (EMOC) in Ismailia as well as the Health Centre there, both of which have been extremely busy and active clinical sites suffered serious damage with loss of both medical and non-medical supplies as flood water tore through the buildings.

FPHC vehicles and staff assisted in Kagan with the evacuation of people from the worst of the flooded area. Hot meals were provided for those displaced. The health center at Ismailia and the emergency medical team provided emergency medical care to those injured.
Staff and community are busy rebuilding their homes, cleaning up and shifting the debris and mud that has been left behind. There remain ongoing concerns about the spread of cholera and typoid in the area.Everyone is busy now cleaning up the damage and attempting to put things right.

Photos: Kagan & Baghica Refugee camps and Ismailia.

FPHC continues Work in IDP Camp

Frontier Primary Health Care continue to be in the epicenter of one of the most massive movements of internally displaced persons on the globe as the number of people who have fled Swat, Bajaur, Lower Dir and Buner, just north of them, reaches 3 million.
As the disaster unfolded in May, FPHC was among the first to response, providing emergency and maternal care at their 14 health units. Frontier now has a formal agreement with UNICEF for provision of health and nutrition services in the Sheikh Yasin town camp, at 12,000 people the largest in Mardan district. The provincial health department has provided an ambulance and driver for use. Local and international organizations wanting to assist are asked by the government to coordinate their services thru FPHC, including specialist physicians from the large government hospitals from outside the area such as Punjab.

To continue their 24/7 coverage, FPHC have hired 90 temporary staff members including physicians, dispensers, lady health visitors (LHVs), assistant LHVs, EPI technicians and nutrition assistants. Until a formal agreement was in place, FPHC was providing care with their own staff who number only 120. In addition to emergencies staff provide general OPD care, MCH care, immunization, TB control and diarrhoeal disease control.

FPHC have also established nutrition services in six IDP camps that are screening children and pregnant women, providing nutritional supplements and sharing information about preparing healthy balanced diets. Prior to establishing nutritional services, three staff members, including Dr. Wagma received seven days of training on UNICEF’s emergency approach to nutritional support.

Frontier’s response to this humanitarian crisis have been truly extraordinary. The agreement with UNICEF does not include medical supplies so FPHC could use assistance in this regard. Tax deductible donations can be made on line thru Rose Charities Canada here.

Photo: FPHC staff respond to Mardan floods

Responding to IDPs in Northwest Frontier Province

While war wages around them, Frontier Primary Health Care (FPHC) struggles to assist in mitigating the impact of the disaster on women and children.

Frontier Primary Health Care is a small Pakistani NGO, working with 200,000 people at 14 separate sites in four districts in Northwest Frontier Province of Pakistan. They are well known to the Hillman Medical Education Fund having recently received a small grant for training and supervising traditional birth attendants. FPHC works in ten Afghan refugee camps and the surrounding Pakistani communities providing the full range of primary health care at the cost of $2 per person per year. FPHC have also had some experience in responding to disasters with the recent quakes and floods in the region.

Northwest Frontier Province has been swamped with more than 2 million internally displaced people (IDP), according to the UN. It is one of the most extensive migrations of IDPs on the planet as people take flight from intensive US and Pakistani bombing, drone attacks and fires in Swat, Bajaur, Lower Dir and Buner districts. Fleeing their homes, they are quite literally running for their lives. 80% of the refugees have arrived in Mardan and Charsadda, the target area of Frontier Primary Health Care.

As the disaster has unfolded, FPHC has been providing free medical and maternity services at all 14 of their health centers including the Ahmed Shah Abdali Hospital in Mardan. On May 7^th, 2009 Frontier Primary Health Care arranged for emergency health care services for IDPs in one camp and was planning how they could assist with emergency health care and nutrition rehabilitation services in four other camps.

In discussions with UNICEF, FPHC indicated that although they have limited resources, their staff is eager to assist. By May 10th, staff had been deputed and health posts established in two IDP camps . Community labour rooms in Mardan and Nowsherra were also taking on deliveries of the IDPs.

In a recent email, Dr. Emel Khan, executive director of FPHC, said,"The security situation is frightening. Though there is no specific threat to FPHC or its outlets, every one in our target area is at risk and scared. Noone knows when and where something wrong will happen."

Some IDPs are able to go to the homes of relatives but most look for shelter, food and health care where they can find it. The people, especially the pregnant mothers and children, have been arriving in miserable condition as the unrest and violence in their homes has been ongoing for many months. Many women and children have nutritional deficiencies. Civil society groups,government and common people are doing their best to provide relief.

Four main camps have now been established in Mardan district, Jalala, Sheikh Shehzad town, Mazdoorabad and Sheikh Yasin town. Emergency and comprehensive health care at the IDP camp at Sheikh Yasin town was officially delegated to FPHC. FPHC staff have continued to provide round the clock services with their own resources assisted by donations from friends and staff. Working in their regular health centers during the day, many staff take on additional evening and night duties at the IDP camps,extending their working days to 18 hours.

FPHC have been using their own meagre drug supplies as supplies have been slow to arrive and 700- 800 patients daily present at the clinics with diarrhea, dysentery, respiratory infections and skin conditions in addition to the pregnant women who present for delivery.

FPHC urgently need funds to continue to provide medical supplies and nutritional support to mothers and children. Check here to find out more about the Hillman Medical Education Fund and Rose Charities. Rose Charities Canada is able to accept and send donations directly to Frontier Primary Health Care and provide tax receipts for Canadians. For a USA tax receipt donate through Rose Charities US

Photos: FPHC responds to Earthquake; Lady doctors hold MCH clinic during emergency; FPHC hold emergency clinics during Floods.

2009 Recipients of the Hillman Awards in Kenya

Letter from Grace Irimu of the Kenya Pediatric Association to Prof Elizabeth Hillman

Sent: Friday, May 15, 2009 1:41 PM
Subject: FW:
Dear Prof Hillman ,

We had very successful Kenya Paediatric Association Annual Scientific Conference which was held from 22nd April to 25th April in Mombasa.

Thanks a lot for the Hillman Leadership Award. You sent funds to sponsor one person; but we were able to use the funds to sponsor 2 people- they shared a double room in the hotel and they were given money to travel by bus. Finally they added their cash and were able to take a flight to Mombasa. The two postgraduate students were:

Dr Jalemba Aluvaala - the postgraduate student who have contributed most to training of ETAT+ in the Dept and at the National level.
Dr John Ngugi- he is the outgoing Chief Resident and has demonstrated outstanding leadership within the Dept and outside the Dept.

Attached please find their picture posing with the Chairman of the Dept Prof Dorothy Mbori-Ngacha.

During the award & certificate presentation “The Hillmans and the Hillman Medical Education Fund” were introduced to the audience and people really were really touched and appreciated what Prof Hillman is doing for the medical education in Kenya.

We are in the process of developing an objective criteria for selecting the postgraduate student with the most outstanding leadership skills. A draft has been circulated to the members of staff and the postgraduate students. Once it is discussed at the Dept level then we shall forward it to you.

Prof we missed you in the Conference and we hope that you shall join us in our next year conference and meet the paediatricians from all over the country.

Grace

Newsletter March 2009

Hillman Medical Education Fund Newsletter March 2009 (click on pages below to enlarge)