Dawn response to my speech at Agha Khan University, Karachi

KARACHI: As civilians flee from Pakistan’s new war zone in South Waziristan and settle in nearby districts of Dera Ismail Khan and Tank, health specialists and social workers have warned of a widespread outbreak of diarrheal diseases at camps for internally displaced people (IDPs) where people have no access to clean drinking water and sanitation.

Shah Jahan Bhatti, Chairperson Southern Districts Area Water Partnership (SDAWP), is one such activist working in Dera Ismail Khan who is concerned about the massive displacement of humans in a region that is already water-stressed.

Bhatti was in Karachi last week to attend the two-day 13th National Health Sciences Research Symposium: 'Impact of Water and Sanitation on Health, Our problem, our solutions' at Aga Khan University Hospital, where he shared the challenges his regions is faced with.

‘The sewerage system in DI Khan is obsolete. It is based on open drains and the underground water that is consumed by over 90 per cent of the population is also contaminated,’ he said.

Although the local government laid pipes with the financial assistance of World Bank in 2004, the water in these pipes often gets contaminated due to poor insulation.

The out-of-order tube wells in the area and electricity load shedding has further compounded the problem, making it difficult for authorities to meet the increasing demand for clean drinking water with the rise in the number of IDPs.

A normal displaced person needs 15 to 20 litres of water in a camp every day, but in areas where mass displacement has occurred, that is not possible.

Bhatti, who considers his organisation SDAWP as a serious stakeholder in water supply and sanitation initiatives, elaborated that since the entire region faces an acute shortage of water his work is presently focused in seven administrative centres of the NWFP, including Hangu, Kohat, Lakki Marwat, Bannu, Kulachi, Tank and Dera Ismail Khan.

Lack of funds, he added, is another reason that prevents SDWAP from pursuing their efforts in the entire region. ‘Therefore we are focusing on Dera Ismail Khan and Tank at present.’

According to the July 2009 Assessment Mission Report of National Disaster Management Authority on DI Khan, over 50, 000 IDPs from South Waziristan have arrived in the area. The unofficial estimates, however, put the number closer to 0.3 million.

‘The problem with authorities and other aid agencies is they set up health camps to treat the diseases, but do nothing for prevention,’ laments Bhatti.

Masood Akhtar from the National Disaster Management Authority echoes Bhatti's views. ‘The displaced in camps need proper pit toilets and temporary washrooms for bathing. These are their immediate and basic needs, which are often ignored by humanitarian agencies that focus on food and medical supplies only,’ says Akhtar.

In such a scenario, the need for a proper drainage system is often ignored as a result of which open defecation becomes inevitable, especially in the case of children. ‘This contaminates the environment and communicable diseases such as diarrhea and cholera become widespread in camps,’ adds Akhtar.

Speakers at the convention also highlighted that Pakistan spends 55 to 80 billion rupees on public health just due to diarrhea, a disease that has a strong nexus with water and sanitation.

Presently, however, humanitarian agencies have limited access to DI Khan and Tank, which poses a greater challenge to the district administration.

‘Since DI Khan and Tank are sensitive areas in terms of UN access to aid and monitoring, technology intervention can help,’ suggests Bhatti. ‘If agencies are skeptical about whether or not their aid is reaching the people, satellite cameras can be used to monitor the relief work.’ Satellites, he said, would be also helpful since most of the region is inaccessible owing to a poor infrastructure and is neglected by the local town authorities.

Bhatti predicts that the humanitarian crisis would worsen if international aid agencies are not allowed to intervene since local authorities are mostly corrupt and pay little attention to the deteriorating situation in the city.

‘Most of the funds allocated for water has disappeared into the pockets of the corrupt bureaucracy,’ said the social worker, who added that he does not see any positive changes coming in the near future.

‘Things will only change when our doctors and scientists stop bowing before our politicians and work for the well-being of the people of their country.’ He added that the media should also focus on other pressing issues of the region instead of focusing on reports of violence from the region.

‘You need to respect and respond to people’s actual needs if you really want to help them,’ said Omar El Hattab, the UNICEF Pakistan Chief Water, Environment and Sanitation, by way of summarizing the problem.
published on 4th of November 2009