Pakistan: ‘not enough food, not enough water’

SINDH PROVINCE, PAKISTAN – She protests weakly when her father holds her up to show me the infection, a boil the size of an egg, on the side of her head. She is perhaps one-and-a-half, maybe two years old, writes aid worker Anna Bertmar Khan, who is in Pakistan with Médecins Sans Frontières (MSF).

I ask her father how long she has had it. “Since the rains came, and our houses disappeared in the hungry river,” he explains. For the past week, this little girl has been living with her siblings and parents on a barren stretch of land, about two miles away from where the river Indus has eaten up their village.

It feels like the end of the world out here: to the west, the barren desert of Sindh stretching out towards the Balochistan mountains. To the east: the river which took the little girl’s home and water as far as my eyes can see.

The people living along the swelling Indus, across the rural landscape of Sindh, are waiting in the open for the river to recede. Many are living in scattered, makeshift camps – 10 to 20 families in each settlement. The homeless now sit under hand-stitched colourful blankets called rilli, stretched across shrubbery or sticks. Sometimes they’ve salvaged a wooden bed or they sleep directly on the ground.

They haven’t received much aid and rely on the charity of passers-by and locals who take from their meagre resources to feed their neighbours. In all the settlements we visit, the children are the worst affected, with many suffering from skin infections due to the dirt, heat and lack of any sanitation. The discomfort shows in their eyes and breaks through when they speak of their lost homes.

Away from the river’s swollen banks, in the urban areas which haven’t been inundated with water, there are large, crowded camps. In Larkana town, the main bus terminal houses more than 7,000 people. There is some food being distributed, and there are water pumps in the bus terminal but people live in the worst possible conditions.

Three latrines are meant to be shared by 7,000 people. Those who managed to save their livestock refuse to be separated from them for fear of theft. So the children eat and sleep next to their tired parents in the open, surrounded by buffaloes, cows and goats, without any privacy or protection against the rain or the sun.

There are four government doctors on call in the camp, but they are exasperated, as the extremely unhygienic conditions are sending more patients than they can handle into their small, yellow tent. The youngest children, who quickly become dehydrated if they contract diarrhoea, are referred to the district hospital. The wards are filling up, and the already frail healthcare system is buckling under the weight of the influx of thousands of people seeking help.

In Sukkur, a sleepy town in northern Sindh, 500,000 people fleeing their homes have entered the district and there are now some 1,500 camps of varying size. In the camps, latrines are being built and food and potable water are being distributed. Medical staff in mobile clinics have been working around the clock to stabilise cases of severe diarrhoea and acute respiratory infections and assist women giving birth.

However, wherever we go there isn’t enough food and there isn’t enough water for either drinking or personal hygiene. The sanitary conditions are extremely worrying, and the lack of shelter, privacy or an extra pair of clothes are chipping away at people’s dignity. Eid-ul-Fitr is only two weeks away, which marks the end of Ramadan, the Muslim fast.

Even the poorest usually manage to get their children a new set of clothes for Eid, and the children’s eyes sparkle with pride at the shining buttons and crisp creases in their shalwar kameezes. “I lost my Eid clothes. The river swept everything away, even my new clothes”, a 10-year-old girl whispers, her eyes brimming with tears.

And there are the tales of tragedy and bravery. Gul Khatoon is a widow, from Dera Allah Yar, a district in Balochistan. When they heard the water was coming, they began gathering their belongings onto a truck. Suddenly, the water came rushing. Gul Khatoon screamed to her four children to find higher ground. They did, but as the water swept past, the children were separated from the truck.

The people on the truck faced the impossible choice of either staying and being swept away, or leaving the children. The truck left. I met her seven days later. Her children, aged three, five, 12 and 14 years old, are alone. When I visit her camp again a few days later, she has set off alone, on a three-day journey from the dry fields of southern Sindh back to her flooded district, to find her children.

In another district, when the waters came rushing in the middle of the night, the mother of a two-day-old baby ran with her husband to a sandy bank next to the river to escape the deadly floods. They didn’t have time to bring anything, and the baby was naked. All their clothes were wet, and the rain continued to fall on them for the three days while they waited for help.

To save her baby from dying from exposure, the mother kept her warm by digging a small hole in the sandy bank where she placed the little body and covered it with dry sand. Her baby survived.

– Anna Bertmar Khan has been working with Médecins Sans Frontières (MSF) in Sindh province, Pakistan. 152 international staff are working alongside 1,279 Pakistani staff in MSF’s existing and flood response programmes in Pakistan. To find out more, please visit MSF.