http://www.irinnews.org/irin-fp.aspxUpdated everydayen-gbTue, 17 Nov 2009 12:34:06 GMTKARACHI Tuesday, November 17, 2009 (IRIN) - As temperatures get closer to freezing in Pakistan's South Waziristan tribal agency near the border with Afghanistan, some people affected by fighting between government troops and militants have begun to move further from the conflict zone.KARACHI Tuesday, November 17, 2009 (IRIN) - As temperatures get closer to freezing in Pakistan's South Waziristan tribal agency near the border with Afghanistan, some people affected by fighting between government troops and militants have begun to move further from the conflict zone.

Some 30-35 families of internally displaced persons (IDPs) from South Waziristan had recently arrived in Majeed Colony in the port city Karachi where many people originally from North West Frontier Province (NWFP) live, said local residents. Most had moved in with relatives or rented accommodation.

Most IDPs are staying with host families in NWFP's adjacent Dera Ismail Khan and Tank districts and, according to the UN Refugee Agency (UNHCR), 350,000 have now been registered in those areas. Anticipating that they will not be able to return until winter is over, some are heading to larger cities.

"There are people going to Bannu and Zhob [in the southwestern province of Balochistan], but as the UN is not on the ground - only our implementing partners - we don't have any more info," Billi Bierling, a public information officer with the UN Office for the Coordination of Humanitarian Affairs (OCHA), told IRIN from Islamabad.

The UN earlier this month requested safe access for IDPs from South Waziristan. The authorities have denied this to international humanitarian agencies citing security concerns in the area. However, through its implementing partners UNHCR started the distribution of some 35,000 tents [http://www.unhcr.org/4af845be9.html] to IDPs in Dera Ismail Khan and Tank districts last week.

Meanwhile, those in big cities are trying to fend for themselves. "We need to find work to support ourselves. Karachi is a large city and perhaps we can earn a livelihood here till it is safe to go back to our homes," Alam Khan Mehsud, 30, an IDP from South Waziristan, told IRIN. He is currently looking for work as a labourer, after which he hopes to enrol his two sons, aged nine and seven, at school.

His cousin, Farooq Khan Mehsud, who travelled to Karachi with Alam Khan, said: "Rented rooms may also be cheaper here than in Dera Ismail Khan. The cost of accommodation has soared there, and we were paying nearly Rs 2,000 [US$24] a week for a two-room flat."

The journey took the families over a week. While a bus trip from Dera Ismail Khan to Karachi, a distance of over 1,000km, would normally take 24 hours by road, Farooq Khan said: "We had 22 people in our group, and the fare was expensive - so in some places we walked and ate whatever we could find, either anything growing by the roadside or in cheap cafes."

Tribe matters

Alam Khan explained another reason for the decision to move on: "Our tribe is Mehsud. Members of rival tribes have also moved there [Dera Ismail Khan] and we wanted to avoid any clash."

Some IDPs have moved to other cities. "I have two families now living with my chauffeur, who is from South Waziristan. I have allowed them to place beds in the courtyard of my house because these people have nowhere else to go," said Rehan Ahmed, a businessman based in Rawalpindi, Punjab Province.

Some of the IDPs, including Shahzeb Wazir, 40, now in Rawalpindi with his family, said: "Work for us is not hard to find. Due to the terrorist threat many people are hiring security guards, and because many of us can use guns we can earn a living this way until we are able to go home."

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http://www.irinnews.org/report.aspx?ReportId=87079MUZZAFARABAD Sunday, November 15, 2009 (IRIN) - Rameesha Butt, 12, remembers being trapped in her classroom as the horror of the October 2005 earthquake that killed at least 73,000 people in the North West Frontier Province (NWFP) and Pakistan-administered Kashmir unfolded around her.MUZZAFARABAD Sunday, November 15, 2009 (IRIN) - Rameesha Butt, 12, remembers being trapped in her classroom as the horror of the October 2005 earthquake that killed at least 73,000 people in the North West Frontier Province (NWFP) and Pakistan-administered Kashmir unfolded around her.

“Our school was very old, and many of the walls collapsed. I was not hurt badly, but it was terrifying to see bricks and mortar fall all around us. Some pupils were trapped under the rubble,” Rameesha told IRIN.

According to government estimates, the quake damaged or destroyed 6,000 schools – making up around 52 percent of schools in the quake-affected area. Some 17,000 students and 900 teachers were killed in classrooms.

For years after the quake, children have studied in makeshift classrooms. Now, under an initiative by the UN Children’s Fund (UNICEF) and the Earthquake Relief and Rehabilitation Authority (ERRA) in conjunction with the Ministry of Education, 100 new schools have been built and handed over to provincial authorities.

The new schools are more spacious than the ones they replace, with at least one square metre of classroom space per child. Hand-washing stations have also been set up to promote good hygiene. Under the ‘build back better’ motto adopted after the quake, the new schools are also designed to be earthquake resistant and to offer a more child-friendly learning environment.

“Our aim is to ensure children receive the best possible education,” Syed Fawad Ali Shah, emergency education officer for UNICEF Pakistan, said. He said teachers at the schools had been trained in child-friendly teaching methods and corporal punishment had been banned.

“Not scared anymore”

Pupils of Government Girls Primary School Mohajir Colony in Muzaffarabad, capital of Pakistan-administered Kashmir, are among those who now have a brand new school. The girls, who for months after the quake had huddled in a freezing tent-school, were visibly excited about their new earthquake-resistant building.

“We are not scared anymore because this is a new building, not like our old school,” Shahzia Ali Lone, a fourth grade student, said.

Parents across the area hit by the quake are also relieved that their children can go to school in safety. “For over a year after 2005, I was scared of sending our three children to school. So many children had died in classroom collapses, but now there are better schools for them and we are confident they will receive a good education,” Aziz Ahmed, 40, said.

“There is no greater investment in the future of a country than an investment in the education of the children” Luc Chauvin, deputy representative for UNICEF Pakistan, said. “In partnership with ERRA, the Ministry of Education and provincial authorities, we have not just constructed schools, but have taken an important step toward ensuring that children in the areas affected by the 2005 earthquake have access to a higher quality education than ever before.”

kh/edhttp://www.irinnews.org/report.aspx?ReportId=87042BANGKOK Friday, November 13, 2009 (IRIN) - A recent spate of natural disasters in Asia has further underscored the importance of breastfeeding during emergencies, with a need for additional policies to support this.BANGKOK Friday, November 13, 2009 (IRIN) -  A recent spate of natural disasters in Asia has further underscored the importance of breastfeeding during emergencies, with a need for additional policies to support this.
 
Hundreds of thousands were displaced and forced into evacuation shelters following a series of deadly typhoons in the Philippines, Cambodia, Vietnam and Laos, and an earthquake in Indonesia in the past two months.
 
But according to experts, during such disasters, support for mothers to breastfeed is often overlooked and not given the priority it needs, despite its life-saving function.
 
Besides raising awareness of the importance of breastfeeding, aid organizations need to have policies on infant feeding, they say.

“You have to have a strong policy in place, and make sure all the actors and all the staff in that organization know about this policy,” Anna Winoto, a nutrition specialist with the UN Children’s Fund (UNICEF) in Indonesia, told IRIN.
 
In emergency situations, poor water and sanitation and security situations contribute to a heightened risk of disease among children, who are vulnerable to diarrhoea, malnutrition and pneumonia.
 
Practices such as using infant formula milk, when water may be contaminated and feeding bottles cannot be sterilized, contributes to the risk and has been shown to lead to an increase in diarrhoeal disease in infants.
 
“Breastfeeding is actually even more crucial under emergency conditions because children under five, and infants in particular, are at an increased risk of infection, disease and malnutrition,” Winoto said.
 
“Breastfeeding should be seen as a life-saving intervention,” she said.
 
In an emergency situation, establishing private spaces for mothers and infants, one-to-one counselling and mother-to-mother support is needed to encourage breastfeeding, say UNICEF and the World Health Organization (WHO).
 
“As part of emergency preparedness, hospitals and other healthcare services should have trained health workers who can help mothers establish breastfeeding and overcome difficulties,” said WHO Director-General Margaret Chan in a statement to mark World Breastfeeding Week in August.
 
Both UNICEF and WHO advocate exclusive breastfeeding for children up to six months of age, and continued breastfeeding and complementary feeding until age two.
 
Dangerous donations
 
But one obstacle to breastfeeding during emergencies is unsolicited or uncontrolled donations of breast-milk substitutes, which undermine breastfeeding, according to UNICEF and WHO.

Following a 7.9 magnitude earthquake in West Sumatra on 30 September, UNICEF Indonesia, worked with the country’s Health Ministry, and contacted local and national radio stations to broadcast requests to stop milk-substitute donations.
 
“It’s a huge problem, and the problem lies in the lack of knowledge among the donors on the potential harm,” said Winoto.
 
Meanwhile, coordination in emergencies also remains a challenge, with little capacity to locate only those children who truly need infant formula and not disrupt breastfeeding practices, she said.
 
“In our experience, it’s gotten better but it’s still a huge challenge because there are so many actors when an emergency comes, and so many donations,” she said.
 
Helping with trauma
 
Besides the health benefits, breastfeeding advocates underline the psycho-social benefit of maintaining the activity during an emergency, which is traumatic for babies and young children, experts say.
 
“In an emergency, keeping the baby on the breast is not only about nutrition, it is giving the child that security and closeness when it is scared,” Elvira Henares-Esguerra, director of the Philippine NGO Children for Breastfeeding, [http://breastfeedingphilippines.com/cfb.html] told IRIN.
 
In the aftermath of Typhoon Ketsana, which caused massive flooding in the Philippines in September, Henares-Esguerra and a handful of breastfeeding mothers with their children visited an evacuation centre.
 
They demonstrated breastfeeding practices, and encouraged displaced mothers to do the same.
 
“We discovered that infant formula was being given out by the government at evacuation centres,” said Henares-Esguerra.
 
“We wanted to encourage the mothers to breastfeed,” she said.

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http://www.irinnews.org/report.aspx?ReportId=87020DUSHANBE Thursday, November 12, 2009 (IRIN) - Even as world food production grows, hunger is on the rise in many poor countries, according to the Global Crop Prospects and Food Situation report for November, published by the Food and Agriculture Organization (FAO) on 12 November.DUSHANBE Thursday, November 12, 2009 (IRIN) - Even as world food production grows, hunger is on the rise in many poor countries, according to the Global Crop Prospects and Food Situation report for November [http://www.fao.org/docrep/012/ak340e/ak340e00.htm], published by the Food and Agriculture Organization (FAO) on 12 November.

The report highlights a contradiction: world cereal production is at its second-highest level ever, yet food prices remain very high. It identifies 77 countries that are both low-income and food deficit.

In East Africa, cereal prices range from 68 percent to 177 percent over the 2007 numbers. In southern Africa, prices are 58-200 percent higher than in 2007, and in most of Asia prices are up 40-70 percent. Since most low-income food deficit countries are food importers, they lose far more from high prices than they gain from steady crop production.

Hunger, in most cases, is caused by lack of money rather than a shortage of food production, according to the World Food Programme (WFP). [http://www.wfp.org/hunger/causes] In 2008 the number of undernourished people in the world increased by 40 million, despite record harvests. [http://www.fao.org/news/story/en/item/8836/icode/]

The new FAO report suggests that 2009 is likely to see a similar increase in hunger.

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http://www.irinnews.org/report.aspx?ReportId=87006LAHORE Thursday, November 12, 2009 (IRIN) - People living along the busy Temple Road in Lahore, the capital of the eastern Punjab Province, are accustomed to some unusual sights.LAHORE Thursday, November 12, 2009 (IRIN) - People living along the busy Temple Road in Lahore, the capital of the eastern Punjab Province, are accustomed to some unusual sights.

“Every now and then we see blood or parts of an aborted foetus floating in the drain that runs past the houses and shops,” said Rubina Bibi, a housewife.

The street in Lahore is home to a dozen or more illegal “abortion clinics”, known as ‘Safia clinics’. Run in most cases by midwives, the clinics are visited by a large number of women seeking an abortion but having difficulty getting one in a society where the practice is highly stigmatized - and legal only under extremely limited circumstances.

“The [abortion] rate is rising because in these times of high inflation fewer families can afford many children,” Uzma Parveen (not her real name), who runs one of the clinics, told IRIN. She said that until two or three years ago around 10 women visited her clinic each month seeking an abortion, whereas “there are now 15 or 20.”

According to a May 2009 report [http://www.guttmacher.org/pubs/IB_Abortion-in-Pakistan.pdf] by the government’s National Committee for Maternal and Neonatal Health (NCMNH) and the New York-based Guttmacher Institute, which works worldwide to advance sexual and reproductive health, “a nationwide study estimated that 890,000 abortions took place in 2002. This amounts to 29 abortions per 1,000 women.”

About 30 percent of married women use contraception, although a quarter of them, an estimated 6.6 million women in 2007, have an unmet need for contraception, the NCMNH-Guttmacher study found. Opposition from husbands, a belief that God alone should decide if a child is to be conceived or not, and a lack of awareness are all factors in the low levels of contraception use.

The report noted that abortion rates were substantially higher in the North West Frontier Province (NWFP) and Balochistan, the most rural of Pakistan’s four provinces. In NWFP an estimated 37 abortions take place per 1,000 women aged 15-49 and in Balochistan the rate was 38 per 1,000. The lower rates of 25 per 1,000 women in the Punjab and 31 in Sindh were linked to higher contraception use in urban areas.

Research by the US-based Population Council [http://www.popcouncil.org/projects/RH_PakPilotStudyContrAbort.html] in rural Punjab found women resorted to abortion when contraception was unavailable. It stated: “Women attempt to abort pregnancies that are unwanted by all means even if their husbands are not supportive.”

Most women seek abortions to avoid surpassing a desired family size, on average around three children: poverty is another factor.

Poverty link

“I am coming here for the second time, to have an abortion. I know it’s a bad thing, but what can I do? I already have four children and we simply cannot manage to care for more,” said Amna Bibi (not her real name), outside a clandestine abortion clinic. The clinic is based in a dingy room; the equipment used by the `dai’ (traditional midwife) looks primitive; there are no facilities for sterilization and the sheet on the bed is badly stained.

“What choice do I have but to come here? No one else will help me though I am terrified about going through this, and all the pain it will cause,” said Amna, who estimated that she was about three months pregnant. She said she expected to pay around Rs 2,500 (about US$30) for the abortion. Prices for abortions run from around Rs 1,700 (US$21) to Rs 4,150 (US$50)

Amna’s sister Naseem Bibi (not her real name), who accompanied her, said: “I use birth control pills given to me by a nurse secretly, because my husband would be angry if he knew. Men think pills could encourage us to have intercourse with other men, as there would be no fear of pregnancy.” Naseem has two young sons, and does not want more children for now.

“Many practitioners know abortions are illegal, and refuse to perform them. Therefore women turn to quacks who perform abortions in unsafe conditions. This can lead to complications and many women end up in hospitals. Some of them even die due to these complications,” Marium Waqas of NCMNH told IRIN. “Abortions in unsafe circumstances do affect the health of women.”

Post-abortion care

According to the NCMNH-Guttmacher report, the 2002 national study estimated that 197,000 Pakistani women were hospitalized for complications after unsafe abortions. Only about 50 percent of poor women who need treatment for severe abortion complications receive hospital-based care. A study in a large Karachi hospital over a 21-month period reported that 10 percent of women admitted for post-abortion care died of serious complications.

“We see women regularly who have suffered acute post-abortion complications. Many are brought in very late because their families are scared. Few admit they have had an abortion. Infection and heavy bleeding are the most common problems,” Rubina Ahmed, a gynaecologist at a community clinic, told IRIN.

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http://www.irinnews.org/report.aspx?ReportId=86999JOHANNESBURG Wednesday, November 11, 2009 (IRIN) - A move by donor countries to provide aid agencies with cash, allowing them the flexibility to source cheaper or more appropriate food in the region or beneficiary country and save on transport and warehousing costs, is not addressing nutritional needs, according to a new report.JOHANNESBURG Wednesday, November 11, 2009 (IRIN) - A move by donor countries to provide aid agencies with cash, allowing them the flexibility to source cheaper or more appropriate food in the region or beneficiary country and save on transport and warehousing costs, is also not addressing nutritional needs, according to a new report.

Food aid should include foodstuffs fortified with micronutrients and animal protein. "The emphasis is more on quantity rather than quality, and rarely does the food aid target the most vulnerable groups: children under five, pregnant women and lactating mothers," said Stéphane Doyon, of the international medical charity, Médecins Sans Frontières (MSF), a co-author of the organization's report, Malnutrition: how much is being spent?

"Barely 1.7 percent of interventions reported as 'development food aid/food security' and 'emergency food aid' between 2004 and 2007 actually address nutrition needs," he said.

The MSF report was published ahead of a new UN Children's Fund (UNICEF) report, which points out that the level of child and maternal undernutrition "remains unacceptable" throughout the world; 90 percent of the developing world's chronically undernourished or stunted children live in Asia and Africa.

jk/he http://www.irinnews.org/report.aspx?ReportId=86993PESHAWAR Monday, November 09, 2009 (IRIN) - The huge bomb blast in the western Pakistani city of Peshawar on 29 October which left 117 people dead, many more injured and an unknown number of trauma victims was the most deadly this year.PESHAWAR Monday, November 09, 2009 (IRIN) - The huge bomb blast in the western Pakistani city of Peshawar on 29 October which left 117 people dead, many more injured and an unknown number of trauma victims was the most deadly this year.

According to the New Delhi-based Institute of Conflict Management, the blast was the latest in violence that claimed 6,715 lives in Pakistan in 2008 (2,155 civilians, 3,906 “terrorists” and 654 security forces personnel) and at least 650 so far in 2009.

“I fell to the ground with the impact, and could not see anything for some minutes. All I heard were screams and cries for help,” said Muhammad Idrees, 40, who sells bracelets at the market. Many of those who died were women and children out shopping.

Most of the dead and injured were taken to the government-run Lady Reading Hospital, the largest public-sector medical facility in Peshawar. Doctors at the hospital said they struggled to cope.

“The thing is no hospital in the world is equipped to deal with the kind of situation you see when over 300 seriously injured people are suddenly brought to a hospital. Naturally problems occur,” Hamid Afridi, head of Lady Reading Hospital, told IRIN.

With 86 consultants and over 800 other doctors available, Afridi said they were not lacking staff and that support from nurses and medical students living on the premises was at hand, but there was a need for “more formalized trauma care”.

While the hospital has a large accident and emergency care department, staffed by 62 doctors and headed by a trauma care specialist, “we need even more expertise given the situation we now face”, Afridi said.

Panic attacks

Hundreds of people who were not injured are psychologically affected. “I suffered panic attacks for days, even though I was not injured in the blast but just heard the enormous boom some distance away,” said Azhar Khan, 30.

Adnan Hussain, 14, lost all his immediate family members in the blast - including his parents, four sisters and a three-year-old brother. He suffers a far deeper sense of loss. “He weeps when he is alone, so we try to keep him busy,” Adnan’s paternal uncle, Ayaz Khan, said. The family - from the town of Rawalpindi in Punjab Province - were shopping in Peshawar when the bomb struck.

Others suffer in different ways: “My son was a shopkeeper at a stall selling clothes in this market. I know he is dead, but it would give me some sense of mental peace if I could see his body,” Ameera Bibi, 60, told IRIN. Accompanied by her daughters, Bibi still regularly visits the site of her only son’s death.

“The survivors of such incidents need counselling, but there is not much awareness of the need. More and more victims of terrorism are, however, now seeking help and that is a good sign,” said psychologist Asif Khan.

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http://www.irinnews.org/report.aspx?ReportId=86937ISLAMABAD Sunday, November 08, 2009 (IRIN) - As concern over the lack of access to internally displaced persons (IDPs) from South Waziristan grows among humanitarian workers, UN agencies have called for measures to ensure the security of all civilians caught in the conflict, including relief workers.ISLAMABAD Sunday, November 08, 2009 (IRIN) - As concern over the lack of access to internally displaced persons (IDPs) from South Waziristan grows among humanitarian workers, UN agencies have called for measures to ensure the security of all civilians caught in the conflict, including relief workers.

“All those who are involved in the military operation in one way or the other should ensure human safety and security to aid organizations to reach out to the affected population,” Martin Mogwanja, UN Humanitarian Coordinator for Pakistan, said in a joint press conference with the UN Refugee Agency and the World Food Programme on 5 November.

Authorities have reassured international agencies about the welfare of IDPs and have said it is still too dangerous to allow relief workers access to the area.

“The Pakistan military is meeting the needs of displaced people,” Lt-Gen Nadeem Ahmed of the army’s Special Support Group told the media.

Mogwanja said assistance would continue to IDPs whether they were from Malakand Division or South Waziristan. International agencies, including UN organizations, are currently working with local partners to assist the displaced.

“We are providing assistance of all kinds despite the lack of access,” Billi Bierling, spokesperson for the UN Office for the Coordination of Humanitarian Affairs, told IRIN.

Mogwanja said it was “the responsibility of the government to ensure security”. He said so far no camps had been set up for IDPs, but “if the government of Pakistan decided to establish camps, the humanitarian community would assist with tents, site preparation, water and sanitation and other services”.

Authorities have cited security concerns as a reason for not setting up camps. Most of the 240,000 displaced from South Waziristan are staying with host families. Others have rented accommodation. While some of the displaced are stuck in South Waziristan, most have fled to the neighbouring Tank and Dera Ismail Khan districts of North West Frontier Province, which are considered too insecure for aid workers.

kh/edhttp://www.irinnews.org/report.aspx?ReportId=86929KARACHI Wednesday, November 04, 2009 (IRIN) - Anecdotal evidence suggests breast cancer is on the rise in Pakistan but budgetary constraints, bogus healers and a lack of awareness is hampering early diagnosis, according to healthcare professionals.KARACHI Wednesday, November 04, 2009 (IRIN) - Anecdotal evidence suggests breast cancer is on the rise in Pakistan but budgetary constraints, bogus healers and a lack of awareness is hampering early diagnosis, according to healthcare professionals.

“While we do not have any official data on breast cancer, from my experience I have seen the numbers go up,” said Rufina Soomro, consultant general and breast surgeon at the Liaquat National Hospital (LNH) Breast Clinic in Karachi, one of the country’s leading breast cancer treatment centres.

LNH records shows that in 1994, 1,574 patients visited the clinic and 28 breast cancer surgeries were performed, whereas in 2008, 11,644 patients visited the clinic and 244 surgeries were performed.

A 2008 report [http://www.pinkribbon.org.pk/index.htm] by the Pink Ribbon Campaign Pakistan said 90,000 new breast cancer cases are detected annually, and the disease caused 40,000 deaths a year in an estimated population of about 172 million.

Entitled A Life Worth Living, the report said Pakistan had the highest rate of breast cancer in Asia and spent the lowest percentage of its gross domestic product on health - 0.57 percent. In Pakistan, about one in nine women is likely to get breast cancer at some point in their lifetime, while in India it is one in 22, the report said.

According to information gathered by IRIN at two of the biggest government hospitals in Pakistan - the Civil Hospital Karachi and Jinnah Postgraduate Medical Centre (JPMC) - one in five female patients screened for breast cancer was positive.

The LNH’s Soomro said there was an alarming rise in the number of breast cancer cases and that the situation was made worse by alternative treatments and misconceptions.

“People shy away from this topic. When I came back to Pakistan and joined a public sector hospital, I was stopped from using the resource material I had brought from the UK as it was deemed culturally unsuitable… Things are better now but still there’s a long way to go,” she said.

Soomro said the government needed to do more to promote breast self-examinations and the usage of mammograms. She also recommended that gynaecologists, lady health visitors and general practitioners guide women on how to examine themselves.

Faith healers

“Breast cancer is a disease that is physically, psychologically and financially draining. The whole family unit is hit hard if a female is diagnosed with it. In the long run for treatment to be successful, a patient needs the maximum support of her family. But people generally are so scared they resort to alternative treatments. Going to a `pir’ [faith healer] is very common and so is the use of homeopathy. By the time women come to us, the cancer is in later stages,” Soomro said.

‘Pirs’ are believed to be intermediaries between Allah and the community. There are thousands of them across Pakistan, with millions of followers, particularly in poorer rural areas.

Breast cancer survivor Suriya Suleman, 45, said when she first felt a lump in her breast she ignored it until the pain became unbearable, even with painkillers.

“My mother took me to a `pir’ who gave me some herbs and an amulet saying that the pain would go away. It never went away and then I moved on to homeopathy for a while. I finally went to a doctor when the breast started looking really bad and that’s when my worst fears were confirmed,” she said.

Having breast cancer proved to be more than a health problem for Suleman. “Our finances drained and I could not undergo a breast reconstruction. Moreover, my husband found a younger, `complete’ wife, although he insists that it was kindness on his part that he did not divorce me. I made it through thanks to my children and the support of my doctor,” she said.

Taboo

While `hakims’ (traditional doctors) and homeopathic practitioners distribute pamphlets claiming to cure breast cancer, the disease continues to be taboo in Pakistan’s mainstream media.

A content producer for a private TV channel, who requested anonymity, said breast cancer was a sensitive issue for TV. “Breasts are a very sexual part of the anatomy and it’s hard to get away with talking about them. On TV shows when issues like pregnancy are discussed, people call us up and complain,” he said.

But slow progress is being made. Throughout October, the internationally accepted breast cancer awareness month, TV stations dedicated segments to breast cancer awareness in their morning shows.

Breast cancer survivor Suleman feels much more should be done. “I wish the media was open about this issue. We show people fondling in soaps and music videos, so why is it that a woman touching her breast for detecting a lump is considered a no-no?”

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http://www.irinnews.org/report.aspx?ReportId=86869PESHAWAR Tuesday, November 03, 2009 (IRIN) - Around 240,000 people have fled South Waziristan since early October, according to UN agencies, and those that have escaped say little is being done for the civilians trapped there.PESHAWAR Tuesday, November 03, 2009 (IRIN) - Around 240,000 people have fled South Waziristan since early October, according to UN agencies, and those that have escaped say little is being done for the civilians trapped there.

“My sister is there, in Wana [the principal town in South Waziristan] and there are people who are sick or injured but they have received no help,” Shaheena Bibi, 40, who left the tribal territory a month ago with her family, told IRIN. “No one is doing anything about the people who have lost everything in South Waziristan,” she said, comparing their treatment unfavourably with those displaced from Swat Valley earlier in the year.

“We can’t understand why more of these Western agencies and NGOs are not helping the people of Waziristan,” she said.

Despite the readiness of aid agencies to help internally displaced persons (IDPs) - and even people in their homes in South Waziristan - access has been consistently denied by the military.

“We want to go to aid people and have even tried to do so, but the military guards the entry points and turns us back,” Ronnie Palomar, deputy head of mission of the Paris-based Médecins Sans Frontières told IRIN, adding: “South Waziristan is a very highly militarized zone. People coming out of it are going into other areas guarded by the military.”

MSF, like other international organizations has been denied access to either IDPs or people in South Waziristan. “The only people offering humanitarian aid are the military,” said Palomar.

While some local NGOs have been allowed to work with IDPs based in Dera Ismail Khan and Tank, the North West Frontier Province (NWFP) districts that border South Waziristan, staff say military control is tight.

“Sometimes it is very hard to talk freely to people about their situation, because of the heavy police and military presence,” said a female NGO worker who asked not to be named. She said security personnel often “tried to help” but “their uniforms intimidate people.”

“The government is not encouraging foreign NGOs to directly assist IDPs from South Waziristan due to security concerns,” Lt-Gen Nadeem Ahmed of the military’s Special Support Group told a press conference in Islamabad on 1 November. He also said it was “possible” militants were mingling with IDPs.

Bombings

A spate of recent bombings across Pakistan has prompted the UN Secretary-General to announce heightened security measures in NWFP and the Federally Administered Tribal Areas for its staff.

According to a UN press release, [http://docs.google.com/gview?a=v&pid=gmail&attid=0.1&thid=124b38f1368f4f0c&mt=application%2Fpdf&url=http%3A%2F%2Fmail.google.com%2Fmail%2F%3Fui%3D2%26ik%3Dbcb2e461d2%26view%3Datt%26th%3D124b38f1368f4f0c%26attid%3D0.1%26disp%3Dattd%26zw&sig=AHBy-haphFf_YvCx9i5V8AAPqMzikusOWA] the new security measures will mean: “reduced international UN staff members in NWFP and FATA, with [the] presence of only those vital for emergency, humanitarian relief, security operations or any other essential operations as advised by the Secretary-General.”

“They seem to fear we may be kidnapped or something,” Sebastien Brack, spokesperson for the International Committee of the Red Cross (ICRC), told IRIN.

He said access was being denied and security cited as the reason for this, despite the fact that the ICRC “has received guarantees of safety from all groups involved in South Waziristan and has conveyed to [the] authorities [that] we are in a unique position to help.”

New York-based Human Rights Watch (HRW) has called for help for civilians trapped in the zone of fighting. [http://www.hrw.org/en/news/2009/10/28/pakistan-get-aid-civilians-caught-fighting] “If aid agencies can’t reach these people, it could be a catastrophe,” Ali Dayan Hasan, senior South Asia researcher for HRW, said.

Those who have fled the conflict-hit areas are worried about those left behind. “People are getting hurt in the aerial bombardment. They have no medicines. Children are sick and frightened and things will only get worse once winter sets in,” said Dilawar Khan, who lives in Peshawar but has family in South Waziristan.

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http://www.irinnews.org/report.aspx?ReportId=86856LAHORE Sunday, November 01, 2009 (IRIN) - Like most blind and low-vision children in Pakistan - as well as many with correctable vision - Kaneez Fatima, 10, does not go to school. “She cannot see the blackboard clearly. We do not know why. So her teacher said she could not learn,” Kaneez’s mother, Bushra Bibi, told IRIN.LAHORE Sunday, November 01, 2009 (IRIN) - Like most blind and low-vision children in Pakistan - as well as many with correctable vision - Kaneez Fatima, 10, does not go to school. “She cannot see the blackboard clearly. We do not know why. So her teacher said she could not learn,” Kaneez’s mother, Bushra Bibi, told IRIN.

Bushra and her husband have never considered the possibility that their daughter’s sight problem could merely be a refractive error, easily corrected with a pair of glasses. The couple, who have little formal education, have two other children.

“We have no money to take Kaneez to a doctor or buy glasses,” said Bushra. The family’s income is Rs 8,000 (US$100) a month.

According to Niazullah Khan, country director in Pakistan of the UK-based charity Sight Savers International, there are 1.4 million blind people in Pakistan. Of these, 45,000-48,000 are children under 15.

“Three times that number of children has low vision,” he told IRIN.

The World Health Organization (WHO) defines low vision "as visual acuity less than 6/18 and equal to or better than 3/60 in the better eye with best correction". It also notes there is, globally, a “high burden” of refractive error - which can be rectified with appropriate optical correction.

“We often see children with eye problems and though we refer them to free eye clinics not all parents take [their] children there. They are not aware poor sight can affect learning and quality of life,” said Dr. Nishat Kausar, a general practitioner. “Often people just try to buy cheap glasses from roadside sellers,” she said.

There are at present only 64 schools for blind and visually impaired children in Pakistan (population 165 million).

“We are trying, under new government policies, to facilitate education in mainstream schools for children with low to moderate vision, because the environment in schools for the disabled is not right for them. They need to live with normal people and learn how to manage,” Khan said.

Cataracts

Aroosa Haroon, 12, was diagnosed with cataracts in both eyes a year ago. Her parents, both librarians, were able to pay for surgery, performed on an outpatient basis at a private hospital, and Aroosa says “I can see perfectly again.”

She is fortunate. There are 9,000-10,000 cataract blind children in Pakistan. Cataracts account for 53 percent of all blindness in the country.

According to Sight Savers, 3000-4,500 paediatric cataract surgeries take place annually.

However, there are also other threats to sight, some of them linked to poverty. This is one reason why Kaneez, from a low income family, struggles with an uncorrected vision error, while Aroosa, from a more privileged background, was treated before poor sight could affect her education.

The link between poverty and blindness has been established by some scientific studies.

Vitamin A deficiency

One of the reasons for this is a widespread Vitamin A deficiency, experts believe. Globally, WHO notes, this is the leading cause of childhood blindness.

“Clinical deficiency of Vitamin A causes night blindness that may ultimately end up with loss of vision,” Azhar Abid Raza, health officer for the UN Children’s Fund (UNICEF) Pakistan, told IRIN. “According to the National Nutrition Survey 2001-2002, 12.5 percent of children showed evidence of being vitamin A deficient,” he said.

Pakistan has, with UNICEF support, run a Vitamin A supplementation programme, linked to National Polio Immunization Days, since 1999.

The battle against blindness is being waged in both the public and private sectors, with organizations such as the charitable Layton Rahmatullah Benevolent Trust running 56 eye clinics and hospitals across the country.

“We treat one in every three eye patients [in the country] and our mission is to offer quality eye-care to anyone who needs it,” said Najmus Saquib Hameed, a trustee of the organization.

But despite these efforts, children like Kaneez Fatima remain out of school. “I wish I could see enough to read, like my sisters can,” she said.

kh/at/cbhttp://www.irinnews.org/report.aspx?ReportId=86829DERA ISMAIL KHAN Thursday, October 29, 2009 (IRIN) - Fear and a growing wariness on the part of potential IDP hosts means some South Waziristan internally displaced persons (IDPs) are finding it hard to get accommodation in the neighbouring districts of Dera Ismail Khan and Tank.DERA ISMAIL KHAN Thursday, October 29, 2009 (IRIN) - Fear and a growing wariness on the part of potential IDP hosts means some South Waziristan internally displaced persons (IDPs) are finding it hard to get accommodation in the neighbouring districts of Dera Ismail Khan and Tank.

"No one is ready to take us, because they think we are sympathetic to the militants battling government forces," said Wazirullah Mehsud, 60.

He also believes that because those fleeing the battle zone are Mehsuds - from the same tribe as the leaders of the Taliban based in South Waziristan - hosts are sometimes reluctant to take them in.

"The thing is that some of the people coming from South Waziristan could be militants. Dera Ismail Khan has seen many bomb attacks and other violent incidents in recent years. We are scared to keep people from South Waziristan in our homes, especially when many of them are men, because they could have links to the militants," said Salim Khan, a local shopkeeper.

Maj-Gen Athar Abbas, a spokesman for the Pakistan military, told the media: "Militants are shaving their beards and mingling with ordinary people to try and flee."

Continuing attacks are adding to people's apprehensions. A car bomb in a crowded market area in Peshawar, the capital of the North West Frontier Province, killed at least 100 people on 28 October.

Fear

"Such news makes us afraid, even though we want to help people in trouble," said Aleem Ahmed, an electrician based in Dera Ismail Khan. He said he was "thinking about" a request from a friend to host an IDP family.

The Mehsud and Wazir tribes make up most of the 500,000 population of South Waziristan, one of seven tribal territories adjacent to Pakistan's border with Afghanistan. The current leader of the Taliban, Hakeemullah Mehsud, like his predecessor, the late Baitullah Mehsud, belongs to the larger Mehsud tribe.

"I have had many problems even finding a room to rent. Because I am on my own, with my two sons, people think we may be militants," said Asad Mehsud, 60. His wife and daughters-in-law have moved to Peshawar, where the family has relatives.

Other IDPs, particularly those who have close relatives in Dera Ismail Khan, face fewer problems. "We have been well looked after by my cousin and his family. Even though they have five children themselves, and it has been hard to add seven more to their household, they have been kind and have taken us in," said Saifullah Mehsud.

"As far as we know the IDPs are still staying with host families," Billi Bierling, public information officer for the UN Office for the Coordination of Humanitarian Affairs (OCHA) in Islamabad, told IRIN. She said the overall registration figure of IDP families from South Waziristan had reached 33,371. In Dera Ismail Khan and Tank 1,689 IDP families were registered on 28 October, as the influx from conflict-hit areas continues. No formal IDP camps have been set up as yet.

Culture shock

For some IDPs, especially women who have in many cases never left their villages, the experience is a bewildering one. "I had never seen water flow from taps inside homes, or used a toilet that flushes," said Waseefa Bibi, 25, a mother of two. She is also delighted with the nappies donated to her for her three-month-old baby, saying, "now I know how to put one on."

However, Waseefa and other displaced women, have problems too: "We live in a house belonging to our hosts, with 13 people in four rooms. Our hosts are not close relatives, and it is hard for me and my sister-in-law to maintain 'purdah' [seclusion from men who are not blood relatives observed by some women on the basis of religious belief]. We also feel very shy going to the toilet when the men are around," Waseefa told IRIN.

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http://www.irinnews.org/report.aspx?ReportId=86799LAHORE Tuesday, October 27, 2009 (IRIN) - Razia, a widow from Lahore, looks after three daughters under 15 on a monthly income of Rs 5,000 (about US$60) earned by washing clothes, and like many others she is finding it increasingly difficult to feed her family.LAHORE Tuesday, October 27, 2009 (IRIN) - Razia, a widow from Lahore, looks after three daughters under 15 on a monthly income of Rs 5,000 (about US$60) earned by washing clothes, and like many others she is finding it increasingly difficult to feed her family.

Last month, during Ramadan, she could buy a subsidized 10kg sack of flour at Rs 175 ($2), but prices have now returned to their pre-Ramadan level of Rs 550 ($6.6) per 20kg bag. Other items sold at subsidized rates for Ramadan are also up, she said.

"I bought sugar at Rs 50 [60 US cents] a kilogram from government utility stores last month. Now I pay Rs 60 or more," Razia told IRIN. Like most families, sugar is an essential item for her household. "We use it for tea, and without sweet tea it is hard to get through the day," she said.

Taking note of the hardship caused by soaring sugar prices, Pakistan’s Supreme Court, has ordered http://www.thenewspk.com/2009/10/sell-sugar-at-rs-40-per-kg-supreme-court/ sugar to be sold at Rs 40 [48 US cents] a kilogram pending a decision on the matter by a special commission.

“This is a good move by the court. It may offer some relief. Already, because flour is so expensive, we eat less,” said Nazeer Ahmed, 60, a rickshaw driver, adding: "All of us, including my three children, sometimes go to bed with just a mouthful of bread and pickles."

“Food items are costlier, so people are buying less. For example, a dozen eggs which cost around Rs 35 last year, cost Rs 60 this year,” Manzoor Abbas, a shopkeeper at a Lahore market, told IRIN.

“Alarming”

According to the Washington-based International Food Policy Research Institute, [http://www.ifpri.org/publication/challenge-hunger-2008-global-hunger-index] levels of hunger in Pakistan are “alarming”.

A recent incident in Karachi is illustrative of people’s desperation: Twenty women and girls, who had gone with hundreds of others to take advantage of free flour being distributed by a shopkeeper, died in a stampede. [http://www.dawn.com/wps/wcm/connect/dawn-content-library/dawn/news/pakistan/metropolitan/04-stampede-kills-18-women-karachi-qs-16]

The government’s Consumer Price Index (CPI) showed prices in July and August were up 10.93 percent on the same period last year. Annual food inflation at the end of August was 10.59 percent, according to the CPI, and perishable items had gone up 17.27 percent.

Corruption?

There is also a debate about how many people benefited from subsidized food schemes during Ramadan. “Hardly 25-30 percent of the targeted population in Sindh Province was able to benefit from the cheap flour scheme, because there was a lot of corruption and mismanagement,” Muhammad Yousuf, chairman of the Pakistan Flour Mills Association in the southern province, told the media in Karachi.

“Measures to provide relief to the poor by supplying food items… free or at concessional rates, are good as responses to unforeseen disasters… [but] they cannot be recommended as a solution to permanent problems such as poverty,” said I. A. Rehman, secretary-general of the autonomous Human Rights Commission of Pakistan. New policies were needed to eradicate poverty, avoid anarchy and offer permanent solutions, he said.

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http://www.irinnews.org/report.aspx?ReportId=86598DERA ISMAIL KHAN Monday, October 26, 2009 (IRIN) - Thousands of displaced children from South Waziristan have received measles vaccinations for the first time.DERA ISMAIL KHAN Monday, October 26, 2009 (IRIN) - Thousands of displaced children from South Waziristan have received measles vaccinations for the first time.

So far, 180,000 children, from both internally displaced persons’ (IDP) and host families in North West Frontier Province (NWFP), have been vaccinated against measles, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA), and further vaccination campaigns are planned.

“These people have often never had any kind of contact with healthcare workers. Access to them has been impossible due to the fighting in Waziristan and the resistance of militants to vaccinators,” said Taufiq Khan, a volunteer doctor who is helping care for the IDPs.

Some 139,000 people have so far fled fierce fighting in South Waziristan and arrived in the neighbouring districts of Tank and Dera Ismail Khan in NWFP, according to OCHA.

“Over 57,600 have been registered in those two districts in the past 10 days. IDPs from South Waziristan are living in host communities, with friends and families, or in rented homes, as has been the pattern with other recent conflict displacement in Pakistan,” OCHA said in a statement on 24 October. [http://wwww.reliefweb.int/rw/rwb.nsf/db900SID/MYAI-7X62YH?OpenDocument]

Low literacy rate

According to government statistics, [http://www.fata.gov.pk/subpages/socioeconomic.php] the literacy rate for Pakistan’s Federally Administered Areas is 17.42 percent, compared with 35 percent for the NWFP. South Waziristan is one of seven tribal agencies located on the Pakistani-Afghan border. Only 3 percent of women are literate and there is only one doctor for every 7,670 people.

“I have never been to a doctor or even seen one. There is no doctor in our village, though I had heard about vaccinations for children,” said Nazeer Mehsud, 70, an IDP. He said his grandchildren had been sick with coughs when the family arrived in Dera Ismail Khan two weeks ago.

“But a doctor has now given us medicine and their fever is down. We have also received all kinds of other items, like biscuits and dried milk, and we are grateful for all this assistance because we had no idea what things would be like for us.”

The UN Children’s Fund (UNICEF) said most of those displaced are women and children.

“Especially vulnerable”

Luc Chauvin, deputy head of UNICEF in Pakistan, said in a statement [http://www.unicef.org/media/media_51520.html?q=printme] the IDPs “have already lived through years of insecurity in one of the remotest and poorest parts of Pakistan which has left them especially vulnerable. Now, we must ensure they are protected from the effects of poor nutrition, sanitation and disease, not to mention the terrible upheaval of displacement and violence.”

He added that less than 60 percent of children in South Waziristan received routine immunizations.

Host families who have opened their doors to the displaced, as their tribal code of hospitality demands, are also benefiting from the assistance being given to the IDPs. “My children were also given warm blankets and some shots they needed by a health team,” said Jahanzeb Khan, who is hosting a family of 10 in his three-room house.

“We do not know these people, but they were in need and despite some security concerns because they could be militants escaping the army, I am happy to do what I can to help,” he said.

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http://www.irinnews.org/report.aspx?ReportId=86751HUA HIN Monday, October 26, 2009 (IRIN) - After only a few days Southeast Asia's inter-governmental human rights body is already being criticized over its terms of reference as well as its ability to have any impact on human rights in Myanmar.HUA HIN Monday, October 26, 2009 (IRIN) - After only a few days Southeast Asia's inter-governmental human rights body is already being criticized over its terms of reference as well as its ability to have any impact on human rights in Myanmar.
 
The Association of Southeast Asian Nations (ASEAN) launched its Intergovernmental Commission on Human Rights (AICHR) on 23 October with the signing of the Cha-am Hua Hin Declaration at  the 15th ASEAN summit held in Hua Hin, Thailand, over the weekend.

Thailand’s Prime Minister and ASEAN chairman Abhisit Vejjajiva said it “showed the commitment of ASEAN member-states to realize the historic quest of the people of Southeast Asia for freedom”.
 
But critics say its mandate is limited and that its undertaking to “promote human rights within the regional context, bearing in mind national and regional particularities and mutual respect for different historical, cultural and religious backgrounds” does not go far enough, given that Myanmar continues to be cited by human rights watchdogs as one of the world's worst violators.

Kraisak Choonhavan, chairman of the ASEAN Inter-parliamentary Myanmar Caucus, said the country’s military government had yet to demonstrate a willingness to adhere to principles of democratic governance under the ASEAN charter.
 
And ASEAN’s long-held assertion that Myanmar’s political and human rights issues were internal affairs was no longer applicable, particularly since such problems had affected other countries in the region, he said.
 
Engaging with the military

According to Charm Tong of the Shan Women’s Action Network in Myanmar, the military has stepped up operations against ethnic groups in the east ahead of next year’s election, resulting in the displacement of thousands to neighbouring Thailand and China.
 
Western sanctions are in place, although the US has reversed its previous policy by saying it would talk to the junta.
 
ASEAN has typically stressed non-interference in the internal affairs of its member states, with a notable exception in August, when a statement issued by the Thai PM in his role as ASEAN chairman expressed "deep disappointment" with the sentencing of Burmese opposition leader Aung San Suu Kyi to an additional 18 months house arrest.
 
Additional challenges
 
Other critics cite the composition of the AICHR.
 
According to Debbie Stothard, speaking on behalf of the ASEAN People's Forum, a network of NGOs, eight of the 10 commissioners are government appointees, with only Indonesia and Thailand allowing human rights experts and lawyers to select their commissioners.
 
Of the 10 ASEAN member states, only Indonesia is regarded by US-based watchdog Freedom House as a fully-fledged democracy, with other states ranging from flawed partial democracies to states with little freedom of speech or assembly.
 
In his closing remarks at the summit, ASEAN Secretary-General Surin Pitsuwan attributed the divergent attitudes towards NGOs among ASEAN member-states to “different rules and regulations, which led to a differing view on how to appoint the civil society representatives”.
 
Last year, ASEAN launched a charter that pledges to reform the bloc into a European Union-style entity by 2015.The human rights body was created as part of this initiative.
 
However, according to Bridget Welsh, a professor of Southeast Asian studies at Singapore Management University, the birth pangs of the AICHR do not bode well for ASEAN development in general.
 
“The handling of the ASEAN human rights body seriously undermines the credibility of the organization and simultaneously raises questions about the transformation of the regional architecture of the organization,” she told IRIN.
 
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http://www.irinnews.org/report.aspx?ReportId=86745PESHAWAR Thursday, October 22, 2009 (IRIN) - Many internally displaced persons (IDPs) who have fled South Waziristan tell harrowing tales of rockets hitting roads or houses as they tried to leave areas where Taliban militants are fighting government forces.PESHAWAR Thursday, October 22, 2009 (IRIN) - Many internally displaced persons (IDPs) who have fled South Waziristan tell harrowing tales of rockets hitting roads or houses as they tried to leave areas where Taliban militants are fighting government forces.

“I watched my cousin’s home burst into flames after being hit by a bomb. Fortunately he had taken his family away last week,” said Miran Gul, an IDP from a village near Makine in South Waziristan.

Miran Gul said he had to “walk for over 12 hours” to reach the town of Razmak in North Waziristan, from where he got transport to Peshawar.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) in its latest situation report [http://www.reliefweb.int/rw/rwb.nsf/db900SID/MUMA-7WZ8C3?OpenDocument&rc=3&emid=AMMF-7HUDG8] said: “The IDPs report hardships on their way out of the conflict area as all main roads are blocked and tightly controlled… there is a curfew imposed in all conflict-affected parts of South Waziristan.”

Dawn newspaper reported [http://www.dawn.com/wps/wcm/connect/dawn-content-library/dawn/news/pakistan/provinces/16-displaced-family-hit-by-bomb-12-dead-hs-06] that 12 members of a family were killed after being hit by a bomb while trying to flee South Waziristan.

Access to the IDPs is a continuing problem, but help is being provided.

Billi Bierling, a spokesperson for OCHA in Pakistan, told IRIN: “Even though access is a problem due to the difficult security situation in the area, the UN agencies and their implementing partners are providing much-needed help to the IDPs. So far the IDPs are staying mainly with host families or in rented accommodation. However, the IDPs who are registered are receiving food and non-food items, such as bedding, kitchen utensils, towels, soap, etc.”

No IDP camps - yet

Citing the North West Frontier Province (NWFP) government’s Social Welfare Department, OCHA’s situation report said 106,800 IDPs were now registered in neighbouring Tank and Dera Ismail Khan districts in NWFP, with 85,000 in Dera Ismail Khan.

Some 26,300 IDPs have arrived in the two districts since 13 October, whilst 80,500 came to the area between May and August 2009, it said.

“At present, the IDPs are accommodated with host families and no camps are set up, neither in Dera Ismail Khan nor Tank districts. However, the authorities might consider camps in the future, as more civilians leave the areas of conflict,” OCHA said.

Bierling said the aid community was expecting the current number of IDPs “to increase to 250,000 if military operations continue”.

Meanwhile, NWFP Relief Commissioner Shakeel Qadar Khan told IRIN: “Provision has been made for the IDPs to get Rs 5,000 [US$60] a month.”

Winter approaching

One of the main concerns of IDPs is how long they may be displaced for. “Winter is approaching fast. It will be hard to move back if roads close due to snow,” said Miran Gul. He is also concerned about what could become of their homes if “no one [is there] to clear away the snow on roofs”.

The fighting is reported by people who have come out of the area as being “fierce”, and people are concerned about relatives still trapped there.

“My brother is still based near Wana [principal town of Waziristan] with our parents, who refused to leave the family home. Contact is difficult, because telephone services are bad, and I worry constantly about them,” said Azam Khan, now in Peshawar.

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http://www.irinnews.org/report.aspx?ReportId=86688ISLAMABAD Wednesday, October 21, 2009 (IRIN) - The UN World Food Programme has been forced to close 20 food hubs supplying food aid to over two million people in North West Frontier Province, owing to rising security fears.ISLAMABAD Wednesday, October 21, 2009 (IRIN) - The UN World Food Programme has been forced to close 20 food hubs supplying food aid to over two million people in North West Frontier Province, owing to rising security fears.

WFP spokesman Amjad Jamal told IRIN “This is a temporary closure, for a few days only, depending on the security situation.” All WFP food distribution centres, in Charsadda, Swabi, Dir, Mardan, Buner, Swat and Bajaur were closed on 21 October. The situation is to be reviewed later this week.

The move comes as the security situation worsens. All educational institutions were closed on government orders following a suicide bombing on 20 October at the Islamic University in Islamabad in which at least six people were killed. Dozens of others have died in a spate of bombings over the past two weeks in other places. Earlier this month, a suicide bomber attacked the WFP office in the capital, killing five employees.

The WFP food hubs had been giving out supplies to the 2.3 million people displaced this year as a result of the conflict between government forces and Taliban militants. Though most of those displaced from Swat, Dir and Buner have returned home since fighting ended in July, a large number remain in need of food aid.

Debt

Stephen Brack of the International Committee of the Red Cross told IRIN: “Offering people in conflict-hit zones food is also important so they don’t build up more debt, since many lost livelihoods and have spent the savings they had during the displacement.”

Around 2.4 million displaced people received aid from the WFP food hubs last month, according to Jamal. News of their closure brought immediate concern from people who continue to struggle to survive.

“I still have no job, though now and again I earn a little doing odd jobs. The monthly food aid given to us helped make sure my family had something to eat, and made us feel a bit more secure,” Abdul Wahab, 35, told IRIN from Mingora in Swat.

WFP is optimistic people such as Wahab will not suffer. “We are distributing monthly food rations, which means people only come once a month to pick up their rations. We also anticipate that from last month’s distribution they still may have some food available, thus it will not affect these IDPs and hopefully the distributions will resume from tomorrow or the day after,” Jamal said.

Interior Minister Rehman Malik said on 20 October Pakistan was “in a state of war”. At least 2,280 people are estimated to have died during the last two years as a result of “terrorist” attacks.

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http://www.irinnews.org/report.aspx?ReportId=86672ISLAMABAD Monday, October 19, 2009 (IRIN) - Thousands of people have fled Pakistan’s South Waziristan territory adjacent to the Afghan border, as a military operation against Taliban militants got under way on 17 October.ISLAMABAD Monday, October 19, 2009 (IRIN) - Thousands of people have fled Pakistan’s South Waziristan territory adjacent to the Afghan border, as a military operation against Taliban militants got under way on 17 October.

A curfew was imposed in parts of Waziristan and troops began moving in, preventing others from fleeing. Action against militants had been anticipated for months.

A similar military campaign against militants in Swat District, North West Frontier Province (NWFP), ended in July, leading to the displacement of some 2.3 million people in the area.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) in its latest humanitarian update on Pakistan [http://www.reliefweb.int/rw/rwb.nsf/db900SID/MUMA-7WW2J6?OpenDocument&rc=3&cc=pak] said about 500 people were fleeing South Waziristan daily.

“For planning purposes, the estimate for a likely displacement from South Waziristan in the event of further military operations has been increased from 160,000 to 220,000 people. This includes the over 77,000 people already displaced, registered and verified in D.I. [Dera Ismail] Khan and Tank Districts,” OCHA said.

“In the last four days, we have estimates of about 120,000 people leaving South Waziristan. They join the 80,000 estimated to have been displaced previously,” Ariane Rummery, spokeswoman for the UN Refugee Agency (UNHCR) in Pakistan, told IRIN. She said the figures were based on estimates, “and there could be others we do not know about”.

As with previous waves of displacement from parts of NWFP, most of the displaced are staying with relatives or in rented accommodation, mainly in NWFP's Dera Ismail Khan and Tank districts, neighbouring South Waziristan.

“I will move from here to my uncle’s home in Peshawar, because I want to avoid spending money. We have not heard about any camps and even if they come up, I do not want my family to live in a tent - possibly for weeks or months because the fighting could go on for some time,” said Haji Asadullah Khan, who came to the town of Tank from Wana, the principal city of South Waziristan, and has been living in a rented room since then.

“Insufficient preparations”

In a 16 October statement Amnesty International said its research teams on the ground had found “insufficient preparations for health facilities, supplies of food and drinkable water, and shelter for the displaced”.

“There has been growing unrest and even bombardment for weeks. I felt I had to take my family away,” said Ehsanullah Wazir, who is now in Dera Ismail Khan staying with his cousin. “We hope we will not have to stay for long. I am already concerned about the livestock I have left behind in our village because they could be stolen or killed with only my elderly parents to look after the animals,” he told IRIN from Dera Ismail Khan.

South Waziristan covers 11,585sqkm and has a population of some 500,000.

Maj-Gen Athar Abbas, the chief of the Inter Services Public Relations for the armed forces, told the media: “The operation was launched early in the morning on Saturday [17 October]. Both air and ground troops are taking part.”

NWFP Information Minister Mian Iftikhar Hussain told IRIN: “The government is providing all possible assistance to the displaced population”. He said “thousands of families” had been displaced, and that this number could increase.

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http://www.irinnews.org/report.aspx?ReportId=86630ISLAMABAD Monday, October 19, 2009 (IRIN) - A drill for rescuing people in coastal areas in the event of a tsunami was carried out in Thatta, Sindh Province, by the National Disaster Management Authority (NDMA) supported by the UN Educational, Scientific and Cultural Organization(UNESCO) on 17 October.ISLAMABAD Monday, October 19, 2009 (IRIN) - A drill for rescuing people in coastal areas in the event of a tsunami was carried out in Thatta, Sindh Province, by the National Disaster Management Authority (NDMA) supported by the UN Educational, Scientific and Cultural Organization(UNESCO) on 17 October.

The effectiveness of the Indian Ocean Tsunami Warning and Mitigation System was also tested.

About 500 people living in coastal areas participated in the drill. In July 2007 Cyclone Yemyin left 245 people dead and affected a further 2.3 million people, according to a report [http://www.reliefweb.int/rw/RWFiles2007.nsf/FilesByRWDocUnidFilename/YSAR-757NW4-full_report.pdf/$File/full_report.pdf] by the International Federation of the Red Cross and Red Crescent Societies.

Senior NDMA official Amir Muhiuddin told the media the exercise was intended to increase preparedness and improve coordination throughout the coastal region.

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http://www.irinnews.org/report.aspx?ReportId=86632DAKAR Wednesday, October 14, 2009 (IRIN) - Designed to be safe havens in times of disaster, health facilities are vulnerable to upheaval when catastrophe strikes, according to the UN, which is focusing on hospital safety for International Day for Disaster Reduction.DAKAR Wednesday, October 14, 2009 (IRIN) - Designed to be safe havens in times of disaster, health facilities are vulnerable to upheaval when catastrophe strikes, according to the UN, which is focusing on hospital safety for International Day for Disaster Reduction.

Only half of UN member countries have set aside money for health facility emergency preparedness, according to World Health Organization (WHO).

The world’s 49 least-developed countries house at least 90,000 health facilities, most of which have not been evaluated for disaster preparedness. Latin American and Caribbean countries have created a Hospital Safety Index that has been used in Bolivia, Ecuador, Peru, Oman, Sudan and Tajikistan.

In Burkina Faso September 2009 flooding forced the largest hospital to shut down. The facility is barely functioning six weeks later.  Health Minister Seydou Bouda told IRIN he believes disaster can effect change. “In Burkina Faso nothing will be like it was before. Each [health] sector activity should integrate crisis management into its operations because catastrophe can arrive at any moment.”

UN Special Representative for Disaster Risk Reduction Margaret Wahlström said much has been done to boost hospital safety worldwide, but more investment is needed to brace hospitals for potential disasters.

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http://www.irinnews.org/report.aspx?ReportId=86581MINGORA Tuesday, October 13, 2009 (IRIN) - Health officials say 13 cases of polio have been confirmed in Pakistan's volatile Swat District over the past four months, mainly because vaccinators have been unable to access children there for over a year.MINGORA Tuesday, October 13, 2009 (IRIN) - Health officials say 13 cases of polio have been confirmed in Pakistan's volatile Swat District over the past four months, mainly because vaccinators have been unable to access children there for over a year.

Fierce fighting between government troops and Taliban militants, which began in May, has displaced hundreds of thousands of people from Swat. Before the army campaign in the area which ended in July, militants had prevented access for anti-polio teams.

"The Swat District currently has a polio outbreak. However, the good news is that we were able to immunize children who had left these areas. Upon their return we were able to immunize a significant proportion of children during a campaign in September," Melissa Corkum, polio programme coordination specialist with the UN Children's Fund (UNICEF) in Islamabad, told IRIN.

She said a three-day anti-polio campaign in Swat had begun on 12 October.

"This time I will get my one-year-old daughter protected against polio. My son, who is five, has had drops several times before. Once I took him to a hospital in Peshawar to get them, because the Taliban in control here at that time said anyone vaccinating children would be punished," Imran Gul, a Swat resident, told IRIN.

Sixty-two cases of polio have been confirmed so far this year in Pakistan, with 35 in North West Frontier Province and the Federally Administered Tribal Areas.

"These include 12 cases in the militancy-hit Bajuar Agency and 13 in Swat District," NWFP Health Director-General Fazal Mahmood said.

"The good thing is that most people are conscious they have missed out on vaccinations and are keen to get them now," said Hassan Khan, a Mingora-based physician.

According to the World Health Organization, Pakistan and Afghanistan are among four countries in the world where polio is still considered endemic.

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http://www.irinnews.org/report.aspx?ReportId=86560DAKAR Thursday, October 08, 2009 (IRIN) - A landmine survivor in Senegal’s Casamance region on 6 October used the recent report, ‘Voices from the Ground’, based on a survey of mine victims worldwide, to remind aid agencies, Senegal’s anti-mine agency and the media of victims’ needs and governments’ responsibilities. DAKAR Thursday, October 08, 2009 (IRIN) - A landmine survivor in Senegal’s Casamance region on 6 October used the recent report, ‘Voices from the Ground’, based on a survey of mine victims worldwide, to remind aid agencies, Senegal’s anti-mine agency and the media of victims’ needs and governments’ responsibilities.

The Handicap International report, which authors say is the first such compilation of mine victims’ views on assistance, says: “[Landmine] survivors are still too often left to do just that – survive – on the margins of society, when they should be helped to rebuild their lives and thrive in the heart of their communities.”

The report includes input from 1,645 mine survivors in 25 affected countries.

Mamady Gassama of the Senegalese Mine Victims Association highlighted the Senegal portion of the report, which says the government needs to boost national funding for victim assistance rather than depend on donors.

“The government must not leave victims’ needs to – often uncertain – external aid,” said Gassama. Senegal is a signatory to the Mine Ban Treaty, which calls on the international community, and individual governments “in a position” to do so, to assist victims.

Mine survivors surveyed said among their greatest needs is assistance in skills training and employment.

np/mad/pthttp://www.irinnews.org/report.aspx?ReportId=86506NAIROBI Thursday, October 08, 2009 (IRIN) - When an earthquake strikes a town, or a building is levelled by an explosion, news footage invariably shows search and rescue teams trawling through the rubble looking for survivors. But what does it take to rescue people trapped under tons of concrete?NAIROBI Thursday, October 08, 2009 (IRIN) - When an earthquake strikes a town, or a building is levelled by an explosion, news footage invariably shows search and rescue teams trawling through the rubble looking for survivors. But what does it take to rescue people trapped under tons of concrete?

Step one - coordination

The first thing is to activate search and rescue teams, often highly trained volunteers.

"Most of our members are doctors, ambulance operators, engineers or fire fighters," said John Holland, operations director of Rapid UK [http://www.rapidsar.org.uk/], a charitable search and rescue group.

They go through a rigorous two-year training process before they are allowed to assist in disasters.

"We try to deploy within 24 hours because the earlier we are on the ground, the better the chances of rescuing survivors," Holland said. "During the Pakistan earthquake [in 2005], we were able to deploy in 21 hours."

The International Search and Rescue Advisory Group (INSARAG) [http://ochaonline.un.org/Coordination/FieldCoordinationSupportSection/INSARAG/tabid/1436/language/en-US/Default.aspx] - a global network of more than 80 countries and disaster response organizations under the UN umbrella - has standardized guidelines for rescue missions.

"Once a government has made that call for international assistance, we alert our members, who begin mobilizing to travel to the area," said INSARAG's Winston Chang, a Singapore Civil Defence Force veteran who coordinated the search and rescue efforts following the recent earthquake in Padang, Indonesia. "We run a portal where once a disaster occurs, we pool information and our various teams can input data on their movements - whether they are on standby, mobilizing or have reached the ground."

INSARAG will usually set up an “on site operations coordination centre” where all search and rescue teams get instructions - depending on their area of specialty - on where to go and how to operate; the desk holds regular meetings to update itself and the teams on the progress being made on the ground.

"These operations can be quite large; just now in Padang, there were a total of 21 teams with 668 personnel and 67 search dogs," Chang said. "They need bases of operation where they will fuel their heavy equipment, coordinate their internal logistics and sleep."

"We also ensure that they follow specific standards of operation and remain culturally sensitive, especially since the teams are from such diverse backgrounds," he added.

Step two - analysis

Once in the disaster area, the first step is to analyze the task at hand, said Julie Ryan, a volunteer with the British NGO, the International Rescue Corps. [http://www.intrescue.co.uk/news/index.php/about-us/home]

In a collapsed building, "you need to analyze the building, assess its history and try to establish where in the building people are most likely to be", she told IRIN. "You also need to determine how badly a building has been damaged and whether it is likely to collapse any further, causing damage to [survivors] and rescue teams."

The assessment also involves checking for hazards such as downed power lines, gas leaks, flooding and hazardous materials. Protective gear includes special suits, gloves, masks, and oxygen and carbon monitoring systems for air quality.

Step three - search mode

At its most basic, this involves trying to spot limbs in the rubble, and calling out to survivors to identify their locations.

Rescuers look for "voids", or pockets where people may be trapped when walls collapse or where survivors may have hidden, such as under desks, in bath tubs or stairwells.

"We feed a camera on the end of a flexible pole into the collapsed building - this shows where people are and how much of the building's structure is left," Ryan said.

"Rescuers also use sound location devices connected to a microphone system; the device bangs on the rubble three times and if people tap back or call out for help, they can be tracked and assisted," she added.

Listening is a crucial part of the operation, and search teams will often stop for several minutes to try to hear any calls, scratches or taps.

Other search tools include a thermal image camera system, which shows areas of body heat, and trained sniffer dogs. "We also use a carbon dioxide analyzer, which helps us detect people who might be unconscious but still breathing," Ryan said.

Buildings that have been searched are marked with INSARAG-recognized signs to avoid duplication of searches.

As survivors are found, rescuers try to get them to keep talking to determine their exact location, and dig towards them - the least dangerous way to do this is by hand.

Step four - the rescue operation

If survivors are trapped under rubble, it may need to be stabilized first; a process called cribbing - the construction of a rectangular wooden framework, a box crib, underneath the debris - may be used.

Survivors who are not able to move usually need to be lifted, dragged or carried out of the rubble using special equipment.

"If people cannot be manually dug out, then we can cut them out - there are specialized tools that can cut through concrete, metal and wood to reach survivors," Ryan said. "There is also a process known as `slabbing’, where heavy slabs of concrete are removed in order to free survivors - this is always a very difficult judgment call, because it risks further collapse, which could injure or kill more people."

Concrete saws, jackhammers, chainsaws, bolt cutters, cranes and bulldozers are all part of the tool kit; chains, cables, anchors and rope-hauling systems are used to remove large pieces of masonry. Other equipment may include flat bags that are inserted under heavy objects and inflated with an air pump, and “shoring” equipment, which ensures passageways are stable and safe.

As survivors are removed, their medical condition is determined; patients are prioritized according to triage - based on the severity of their condition.

Search and rescue teams usually start the most urgent medical procedures on site; the most experienced teams may have defibrillators and endo-tracheal equipment to shock people back to life or perform emergency tracheotomies.

Step five - closure

Deciding when to end a rescue operation is always difficult.

"Obviously, the more time passes the less likely you are to find people alive," said Ryan. "But sometimes - especially if they have water available - people can remain alive for many days. In Pakistan, our team rescued two boys five days after the earthquake; they had survived on trickles of rainwater through the rubble."

According to Ryan, finding bodies - cadaver rescue - after the search for survivors is over is a very important part of any operation.

"Even when people haven't survived the collapse of a building, families find that having a body to bury is an important part of getting closure," she said.

According to INSARAG's Chang, the high octane operations can take their toll on rescuers, especially when they have to pull hundreds of dead people out of buildings.

"Most of them are used to dealing with blood and death in their daily professions, but from time to time it can become very difficult," he said. "Many teams are equipped to deal with trauma - the Swiss government's team, for instance, has a psychologist on hand, while doctors in the Singapore team have been trained to search for signs of trauma in team members."

Once the host government officially calls off the search, INSARAG starts the process of withdrawing the teams. A few remain and become part of the humanitarian relief effort, rebuilding hospitals and schools or shelter for families, but most will head back to their day jobs and await the next call to action

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http://www.irinnews.org/report.aspx?ReportId=86493ISLAMABAD Thursday, October 08, 2009 (IRIN) - Exactly four years after the devastating earthquake of 8 October 2005 in northern Pakistan, almost all the 3.5 million people made homeless have been re-housed, officials say.ISLAMABAD Thursday, October 08, 2009 (IRIN) - Exactly four years after the devastating earthquake of 8 October 2005 in northern Pakistan, almost all the 3.5 million people made homeless have been re-housed, officials say.

About 600,000 houses (90 percent of them in rural areas) were destroyed or badly damaged. Almost all have been repaired except for a few where there are disputes over ownership. In urban areas 90 percent of houses have been repaired, Gen Farooq Ahmed Khan of the government’s National Disaster Management Authority told IRIN.

Many new houses were put up by the government’s Earthquake Relief and Rehabilitation Authority (ERRA). However, some construction work in badly affected cities such as Muzaffarabad, the capital of Pakistan-administered Kashmir, continues.

The quake, which measured 7.6 on the Richter scale, killed more than 75,000 people.

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http://www.irinnews.org/report.aspx?ReportId=86489BANGKOK Monday, October 05, 2009 (IRIN) - Most migrants do not move from developing to developed countries, and when they do, rather than hurting host economies, they benefit them, according to a new report by the UN Development Programme (UNDP).BANGKOK Monday, October 05, 2009 (IRIN) - Most migrants do not move from developing to developed countries, and when they do, rather than hurting host economies, they benefit them, according to a new report by the UN Development Programme (UNDP).

The UNDP's Human Development Report 2009, launched globally on 5 October in Bangkok, dispels several myths about migration, instead underlining the economic and social benefits for countries.

"Mobility can bring large gains in development," Jeni Klugman, director of the report, told IRIN. "It's presently very much constrained by a whole range of barriers, and reform [of] these barriers could allow much greater potential to be released."

The annual report calls for several migration reforms, including for states to ensure basic rights for migrants, and the mainstreaming of migration into national development plans.

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