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Photo: Tariq Saeed/IRIN

An estimated two million people have so far been displaced

ISLAMABAD, 10 June 2009 (IRIN) - Aid agencies are concerned that a further surge in the number of internally displaced persons (IDPs) in northwestern Pakistan could place an intolerable strain on health services at a time when, as the monsoon approaches, health risks are particularly high.

The monsoon season usually leads to a sharp increase in the number of cases of diarrhoea and other diseases.

"The possibility of an additional outflow of a large number of IDPs will certainly add to the pressure on health services," Khalef Bile, a representative of the World Health Organization (WHO) in Pakistan, told IRIN in Islamabad.

“From mid-July we will be having problems with essential drugs. Our stocks will be reduced substantially. So we are worried, and the monsoon is also coming, which is always associated with a surge in disease outbreaks," Bile said.

An estimated two million people have so far been displaced by recent fighting between government forces and militants in the northwest. They are dotted around some 20 official IDP camps and up to 2,000 makeshift camps, or staying - often in very cramped conditions - with relatives in various places.

According to WHO's Health Action in Crises Highlights No. 260 for 1-7 June 2009, the number of reported acute watery diarrhoea cases is rising. Scarce drinking water and inadequate hygiene and sanitation facilities remain a problem.

“The most recent morbidity data show that last week acute water diarrhoea cases were 16 percent of all the medical consultations, while a week earlier they were 13 percent… If more displaced people are living in cramped conditions and there is a bigger strain on the water and sanitation sector, then things might become problematic,” Bile said.

“All these issues together certainly imply that we need to be more alert, more cautious.”

Photo: Tariq Saeed/IRIN

There are some 20 official IDP camps and up to 2,000 makeshift camps

Save the Children report

The UK-based Save the Children NGO said in a recent report based on the rapid assessment of IDPs in host communities in Mardan and Swabi districts in the North West Frontier Province (NWFP) - that 79.2 percent of the surveyed 314 households reported facing some health problems after displacement, with over 50 percent of families reporting diarrhoea as the most common illness.

“The assessment reports an alarming rate of diarrhoeal and other illnesses suffered by IDP families. It also concludes that more than 20 percent of IDP households are not accessing health care even though they perceive a need for it,” the Save the Children report said.

Meanwhile, the Emergency Response Unit of NWFP's Provincial Relief Commissionerate has highlighted on its website the need for several medicines in IDP camps, including oral re-hydration salts, intravenous fluids, Septran, Amoxil, Paracetamol, Flagyl, mosquito repellents and anti-scabies creams. Iron, folic acid and multi-vitamin supplements were also needed for pregnant women.

According to William Spindler, a UN Refugee Agency spokesperson, Pakistan's National Database Authority has so far confirmed registration of almost 1.9 million IDPs (268,674 families) in an ongoing verification exercise to cross-check all people who had earlier registered under an initial fast-track process.

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