The earthquake in Pakistan occurred on the 8th October 2005. The epicenter was Muzafarrabad where a 7.6 richter earthquake was recorded. As the world witness in disbelief on the massive destruction of the Northwest Frontier of Pakistan and part of North India and Afghanistan, the world received a call by help by the President Perves Musharraf of Pakistan. He appealed for international aid for the victims of the earthquakes. The appeal became more urgent with the coming harsh cold winter arriving in the next few weeks.
The Malaysia Orthopaedic Association (MOA) members responded to the call. The MOA members went on humanitarian relief mission with several Malaysian NGOs to different part of Pakistan. The NGOs were Aman Malaysia, Global Peace Mission Malaysia and Mercy Malaysia.
On the 10th October four Malaysia Othopaedic Association members, Dr Jamal Azmi Mohamad ((Selangor Medical centre), Dr Abdul Malik( Damansara Specialist hospital), Dr Shalimar Abdullah (Hospital UKM) and Dr Heng Aik Cheng (Sabah Medical Centre) went with a Malaysian humanitarian relief NGO, Mercy Malaysia, to Bagh in Pakistan. The team they went with included a paediatrician and an aneasthetist.
In Bagh, they joined a local Pakistan othopaedic surgeon and help to set up a small field operating theater. They received many trauma patients, i.e. limb fractures, pelvic fractures, wound and laceration. They had to do many amputations, both upper and lower limbs without the luxury of blood in reserve or proper amputation instrument. The surgeries were done mainly under ketamine sedation. Dr Jamal told me that he had to amputate an upper limb of a child within 15 minutes as to reduce the risk of blood lost and infection. Many fractures were treated with external fixators, cast and in some internal implants.
It was cold during the evening and night. The living conditions were harsh and not comfortable. The sleeping quarters were cramped and they had to share the rudimentary toilet with the patients. The team went back on the 21st October 2005.
Another team under the Global Peace Mission Malaysia (GPM) went to Balakot on the 10th October. The team consisted of a Dr Hassan, a general surgeon from Kajang Medical centre and Dr Razak , a pediatric surgeon from Damansara Specialist hospital. They managed many wounds, infected wounds and fractures which they treated with cast and some amputations. GPM also focused on distribution of tents, food and winter clothing.
I went to Balakot Pakistan with Aman Malaysia during the fourth week of October 2005. My role was to help to coordinate the humanitarian relief work in Balakot , Pakistan. Below is the report on Aman Malaysia 's mission.
Report : Aman Malaysia humanitarian and medical mission to Balakot Pakistan
Aman Malaysia's second team went to Pakistan on the 25th Oct 2005 and came back on the 31st Oct 2005. The team was led by the experienced and capable Dr Shamsul Anwar, assisted by Dr Mohamed Kassim .
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Second Aman team in Pakistan |
1. Dr Sharizan - private practitioner
2. Dr Hyzan Mohd Yusof - orthopaedic surgeon
3. Staff nurse Dayana Omar
4. Staff nurse Juwita Yatim
5. Sharulazilan-humanitarian worker
Our team met with 2 motorvehicle accidents, 2 land slides,a strong aftershock and endured the cold weather and yet still observed Ramadan.
Here is the report in brief:
1. Area affected
The main area affected was the North West frontier. Towns involved Balakot, Mansera, Abutabad, Muzaffarabad, Baagh, Batagram and many others.Official estimated death was 50 000 people. I estimated that it may be 100 000 people. Unlike Aceh, the coming cold weather and the inaccessible mountains may cause more death.
The economy activity came to a halt and the daily government services as not present.
Muzaffarabad - 600 000 population
Balakot town 50 000, surrounding mountains area -100 000 people
Bagh - 400 000 people
The majority of the population stays in the mountains. Many of these places are now inaccessible by road.
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Destroyed town of Balakot |
2.Climate
Temperature - days can be hot up to 28 degree Celsius but the night can be cold down to 7 degree Celsius. It is expected to be colder. Snow might fall in Balakot near December 2005.
Rain- Nil but forecasted to have few days of rain.
3. Earthquakes
Aftershock may be present. the last strong after shock was on the 28th Oct 2005. We were in a small hotel, Erram Hotel in Manshera , had to run out of the hotel due to a strong after shock ( 5.5 reighter).More aftershock is expected. It was safer to stay in a tent but it was too cold .Staying in tall building were not recommended.The earthquake that caused the initial destruction was 7.6 Richter.
Landslides was and is common .The roads can be blocked for hours especially the road in Balakot.
4. Accommodation
Many NGO stayed in hotels. The price ranges from USD 50 to 150 perday per room.The security by the Pakistan police, in larger hotels is tight.
Aman managed to rent a house in Basian, Balakot Pakistan. The rental is Rupee 2 000.00 per month. The rate of exchange is USD 1.00 = Rupee 59.00.Therefore about USD 33.80 per month.The house has two rooms, a bath room and a small compound. It is situated in the valley, in the middle of a plantation field. It is near a road, a small grocery shop and about 500 metres from the Aman medical camp. It has a great view of the mountains and river.
It is important to note that there is hardly any house in Balakot to rent.
5.Supplies
Food and drinks were purchased in Manshera town.Balakot has minimal food for purchase. Blankets, cooking utensils,gas for cooking, mattress and heater ( Rupee 4000.00 ) were purchased in Manshera as well.
We can purchase larger food supplies from Islamabad or Peshawar.
6.Transportation and communication
It is necessary to rent a good four wheeldrive with driver . The cost is about USD 60 to 80 per day in Manshera or Peshawar. The cost may go up.
The handphone services could be used. Although Maxis roaming services is available, it is good to buy the local prepaid card. Sometimes the mobile phone services may be jammed. A wakie talkie (RM 100 to 200 per unit) is very handy for short communication and warning. I found it useful to warn the team during the earth quake.
For sending information we could get the services of Smart Digital Berhad who offered the service of VSAT (Satellite communication) The rental and line usage is free. We might have to arrange the transportation and get one of their technician to set up the system.
The advantage of having this system is that we are able to communicate with Malaysia via phone, email and fax without distruption. The Malaysia media can use this facilities to send reports, with pictures, daily. This would help to collect more donation via the media. If Aman should set up this facility, Aman should open the the usage to all Malaysian NGOs, media and government bodies.
Please call Mr Teoh, from Smart Digital, at 013 2044 720 for further information. His email is yateoh@smartmalaysia.com .
7. United Nation
It is important to register with United Nation in the Islamabad. At the United Nation office (at Ministry of Health Pakistan) we could get information regarding the latest disease outbreaks and available hospital services. Coordination of services for NGOs and government body is done there (may not be too accurate).
At 7.00pm daily there is a coordination meeting by the United Nation at the Pakistan army camp in Balakot for updates. The updates were reported to be useful but may be inaccurate. However it is a good venue to form a network with other agencies and NGOs.
8. NGOs in Balakot
There are a few international and local NGOs in Balakot:
International NGOs and foreign government team:
1. Afghanistan medical team
2. United Arab Emirate medical team- military (the most complete with operating theater and xray facility.)
3. Korea Buddhist medical team
4. French communication centre
5. Iranian Red Crescent
6. Aman Malaysia
7. Global Peace Mission Malaysia
others
Local Government body and NGOs
1. Pakistan army camp
2. Ansar medical team
3. Zindagi Medical team
4.Others
Hospital;
There are several hospitals in town nearby that our surgeons can offer their services:
1. Ajub Medical hospital in Abutabad
2. Japan Red cross field hospital in Abutabad
3. Bach Christian Hospital 7km South of Manshera
4. Kharoon Hospital In Garbhi Habibullah (between Muzaffarabad and Balakot)
5. Malaysia Army Medical Camp.
Balakot town is totally destroyed. Many bodies are still under the rubbles. It may appear that there are many NGOs in Balakot . However the services are still inadequate and not coordinated.People in the mountains trekked down to Balakot to get supplies,tents and medicine.Medical services for women and children is much needed.
Aman could run mobile clinic to reach the patients in the mountains.
9. Aman clinic in Balakot
Aman had set up a clinic in Basian, Balakot , Pakistan in collabration with the Pakistani NGO, Ansar .The Ansar ran their own medical camp and set up about 30 tents for the eartquake victims. Together the clinics saw between 200 to 300 patients.The patients who came suffered mainly from wound infections, fractures, upper respiratory diseases, diarrhoeas and others. On the 27th Oct the Iranian Red Crescent sent emergency case to Aman medical camp. The patient was a 2 year old boy who probably had severe pneumonia. The child's pupils were already dilated when he reached us. Emergency resusucitation the Malaysian doctors failed to revive the patient. (We were quite depressed by the incident.)
Women and child clinic
Aman Malaysia started a women and child clinic service in the medical camp. The response to the clinic was good. The reason was that the Pakistan female patients were shy of the the male doctors. Dr Sharizan saw quite a number of antenatal cases, gynecological problems and depression among the women patients. I believe more women patients would come if we continue our service.
Milk for babies and children
When I went to the tents of the eartquake victims in the mountain area of Balakot I saw many children and babies. In one of the tents I saw a woman feeding a baby with a feeding bottle. She asked whether we had rubber nipple for the feeding bottle. I saw that the milk was diluted. I believe that there is a great need for powdered baby milk formula, feeding bottles and the rubber nipple. This is supported by the fact that there were no economic activities due to the earthquakes and winter, inadequate food and even the mothers were malnourished.
10. Malaysian NGOs and government support
The Malaysia NGOs in Pakistan are:
1. Aman Malaysia- Balakot
2. Global Peace Malaysia- Balakot
3. Amal Malaysia- Bagh
4. Mercy- Bagh
5. Haluan - Batagram
6. Nanyang Medical relief-Bagh-went back
7. Global Sikh- went back
8. Malaysia Red Crescent - in Batagram with the Malaysian Army Medical camp
Malaysia government support
1. The Malaysia ambassador and embassy is giving full support
2. Malaysia Army Medical camp- complete camp with theater facilities in Batagram
3. Hospital Kuala lumpur - in Batagram
11. Malaysia Army Medical services
The Malaysia Army Medical team brought their operating theater and is strenghtened by the medical team from the Hospital Kuala Lumpur. The hospital Kuala Lumpur team consisted of 3 emergencies doctors and Paramedics. The Malaysia army team consisted of surgeons,phychiarist and physicians and paramedic.Some of the doctors speaks Urdu . Later their were joined by the Malaysia Red Crescent. Colonel Johari was the Malaysian army team leader.
Note: The Malaysia Army medical camp help Aman to replenish the medical supplies.
12.Suggestion of services
1.Food and winter clothing
Food and other supplies can be purchased in Peshawar or Islamabad.
2.Tents
Tent are necessary for the survival of the victims.The tent design by the two Pakistan architects as seen in the News Straight Times dated 5th November 2005 cost about RM 600.00 would be a good shelter for the earth quake victims. Alternatively small tent for family and large tents can be purchased in Malaysia and transported by PIA to Pakistan.
For further information please contact Commodore M Amjad Zaman, Defence advisor high commision for Islamic republic of Pakistan , Kuala Lumpur at 03 2161 8877.
3.Clinics
Aman Malaysia should continue it clinic in Basian, Balakot especially the women and child clinic.Aman could also set up a waiting room (tent) for the children to play. The waiting room can be fitted with toys, snacks, papers and colour pencils for the children.
Aman Malaysia could continue its mobile clinic to serve the victims in the mountains.
The list of medicine needed as as below:
4. Formula milks for babies
The Pakistan victims that came to the clinic were mainly men as it is their culture for men to go out and women stay home. Perhaps the men were too proud to ask for milk for their children. We went to the camps and mingled with the people. There were many children and babies. I saw a women feeding her baby with diluted milk. There was not enough clean water to be used to clean the bottles.
The milk formula can either be transported from Malaysia or purchased in Islamabad.
5. Preparation for the volunteers
The volunteers have to be prepared to endure discomfort, cold weather and danger. The volunteers must obey the team leader and be able to work as a team. The objectives of the team come first before personal objectives. A briefing of the situation in the affected area before departing would be helpful.
The volunteers would benefit from the following:
1. Vaccination against tetanus and hepatitis B which can be taken in local (private or government) hospital or clinic.
2.Personal accident insurance. AIA personal accident insurance provide cover in military flights and disaster area. A cover of RM 100 000.00 would cost a premium of RM 300-400.00.The insurance also covers medical emergency flight.
Although this may look unnecessary the benefit would be greatly appreciated if any of the voluntary workers were injured.
Note:
1. The response to the women and child clinic and their needs would be great if their suffering and work done for them could be publicised. The international and local women NGOs and public would be more sympathetic when they are made aware of the suffering of the women and children. Aman could take this lead in Aman's humanitarian relief work.
2. The Iranian Red Crescent sent their ill patient to us when they saw the Malaysia flag on our tent. Malaysia medical team is highly regarded. We have no choice but to upgrade our clinic facilities. It would be an enormous boost to have the Malaysia Army medical camp in Balakot to help to treat the more ill cases. Aman, with the network of Dr Shamsul and Dr Kassim can help to relocate the Malaysia army medical camp in Balakot.
End.
Good luck and be safe for the third Aman team departing on the 15th of November 2005.
May Allah protect and bless.
Report by:
Dr Hyzan Mohd Yusof
MOA humanitarian section
Consultant Orthopaedic Surgeon
Sunway Medical Centre
First Floor, No. 5 Jalan Lagoon Selatan
Bandar Sunway,46150 Petaling Jaya
Selangor,Malaysia
Fax: 603 74910708
Tel: 012 3294 988
Note: To volunteer for humanitarian relief work kindly contact the following contact persons:
1. Aman Malaysia
Dr Shamsul Anwar
Tel: 019 3223 333
Fax: 03 5512 0800
drshamsul_anwar@hotmail.com
2. Global Peace Mission Malaysia
Shirajuddin Sirat
Tel: 0126179374
Fax: 03 6188 8470
gpmhq@yahoo.com
3. Mercy
Sharizad Shamsuddin
Tel: 03 4256 9999
Fax: 03 4251 8435
sharizad@mercy.org.my
4. Red Crescent Malaysia
Kulwant Singh
Tel: 03 4260 3242
Fax: 0342573537
kulwant498@yahoo.com
Tents from Malaysia can be purchased from Major (r) Nai Kin Chooi
Tel: 0192701789
Tel: 03 7958 3472
Fax: 03 7958 3627
suriaps@po.jaring.my
( Transportation via Pakistan International Airways (PIA) or Malaysian Military aircraft can be arranged)
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