Pakistan has had a troubled history since it was officially founded in 1947. Regional confrontations, chronic insecurity as well as domestic political upheavals have all contributed to a weakened health system that is nearing collapse in some areas.
Health indicators in Pakistan are some of the lowest in the world, and around one in ten children dies before the age of five. The border areas are among the worst-affected and recent regional conflicts and natural disasters have further heightened the population’s need for health care.
Merlin arrived in Pakistan following the Kashmir earthquake in October 2005 which killed 73,000 people, left thousands homeless and destroyed the health infrastructure. We responded within 24 hours of the earthquake, providing primary health care through mobile and static clinics, field hospitals and a referral service for emergency cases. Our emergency response has now drawn to a close and we have handed over the health facilities we supported in Muzaffarabad district to local authorities.
Our programme now focuses on two areas in Pakistan: Balochistan, the poorest, most sparsely-populated south-western province, and the conflict-affected North-West Frontier Province (NWFP) and the Federally Administered Tribal Areas (FATA).
HUMANITARIAN UPDATE
In May 2009, continued fighting in the NWFP and FATA regions of Pakistan forced 2.3 million people from their homes in the largest internal displacement since the Rwandan genocide. Merlin was already taking action, having started to provide health and nutrition services to the first wave of displaced people at the end of 2008.
Since then, our medical teams in Pakistan continue working around the clock – in summer temperatures of over 50°C – to deliver vital health care to people displaced by the conflict and to the families that have taken them in. We increased our staff seven-fold in two weeks, from 50 to 350 to achieve this and by July we were serving some 300,000 people with lifesaving health services and treating as many as 2,000 patients a day.
We have eight static health clinics set up in the camps, as well as eight mobile clinics travelling throughout the region bringing health care to those sheltering displaced families.
Fighting has decreased in some areas and the government has established a Return Task Force to help displaced families return to their homes. Merlin is still working in the remaining camps for displaced people, but we have also adapted our response to address the changing situation. Our mobile health teams are supporting returnees on their way home, and we are going into areas that were recently affected by fighting to provide health care and nutrition services and help the authorities to rebuild the health system.
Merlin is one of the first NGOs allowed into conflict-affected Buner district in NWFP, and is currently providing health care there to returnees from the camps.
HOW MERLIN IS HELPING:
Providing health care in remote, neglected areas
We are helping 158,932 people
Balochistan is a remote desert area bordering Afghanistan, with freezing winters and summer temperatures that rise above 50˚C. Following Cyclone Yemyin in June 2007, and an earthquake that struck in October 2008, we are providing primary health care services and emergency nutrition support to 133,932 people through mobile and static clinics in Jhal Magsi district and at least 25,000 people in Ziarat district.
Emergency response and recovery
We are serving 400,000 people
The ongoing conflict and insecurity in NWFP and FATA has caused a steady influx of displaced people into areas around Peshawar. Merlin is supporting the provision of emergency primary health care and nutrition services through mobile and static clinics.
Now that families are beginning to return home, we are going into the conflict-affected areas to help rebuild shattered health systems and provide health care to these returnees.
Targeting malaria
In order to tackle high rates of malaria, Merlin is working with the Global Fund for Malaria in 19 districts of Pakistan, supplying bed nets, rapid diagnostic tests and microscopes to a combined population of over 12 million people. We have also begun a project to reduce malaria, focusing on improving diagnosis and prevention in eight highly-affected districts in Balochistan, NWFP and FATA.
Key achievements
• At the height of the displacement crisis in July 2009, Merlin had eight static health clinics set up in the camps, as well as eight mobile clinics travelling throughout the region bringing health care to displaced families and those sheltering them, and eight community based therapeutic care feeding programmes treating displaced people and host families for malnutrition
• By the end of February 2009, we had provided access to primary health care to 133,932 people in Jhal Magsi district of Balochistan
• In May 2009, Merlin distributed 400,000 mosquito nets, 64 microscopes for new labs, and 6,830 rapid diagnostic test kits to implementing partners in 19 districts in Pakistan as part of the Global Fund for Malaria
• Between October 2005 and July 2008, nearly 1.5 million displaced people in earthquake affected regions received essential primary health care services
• Merlin was one of only two NGOs to receive an award from the Pakistan government’s Earthquake Reconstruction and Rehabilitation Authority for our excellent work in the region. Our Country Director and Country Health Director received personal recognition
Donors supporting Merlin's work
WHO (UN CERF), UNICEF (UN CERF), DFID, ECHO, OFDA, Global Fund for Malaria, independent private donors
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