Children in Pakistan 20 September 2010

8/8/2019 Children in Pakistan 20 September 2010

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Children in PakistanEvery Childs Right - Responding to the Floods in PakistanSeptember 2010


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3/22Every Childs Rights - Responding to the Floods in Pakistan - 1

OVERVIEWThe Pakistan oods began in July 2010 ollowingheavy monsoon rains in the Khyber Pakhtunkhwa,Sindh, Punjab, Gilgit-Baltistan, Balochistan and Pak-istan-Administered Kashmir regions o Pakistan. Thedisaster has inexorably worsened or fve straightweeks, with oodwaters engulfng the country romnorth to south. Over two thousand people have diedand over a million homes have been destroyed sincethe ooding began.

More than 20 million people have been a ected,exceeding the combined total o people a ected bythe 2004 Indian Ocean Tsunami, the 2005 Kashmirearthquake and the 2010 Haiti earthquake. In undingterms, the revised interagency appeal disaster (US$2 billion) issued on 17 September was the largestever, surpassing even that or the Haiti earthquakeearlier this year. With over 10 million children hit bythe ooding, the humanitarian crisis in Pakistan is so

massive that the actual scale continues to elude theimagination o the public across the world.

Approximately one-f th o Pakistans total land areahas been underwater due to the ooding. Floodinghas also destroyed large tracts o agricultural landand crops within an already ood-insecure country.Given the widespread crisis, the risk o child malnu-trition looms large, with the very young extremelyvulnerable. Malnutrition is compounded by thevicious circle o contaminated water, bad sanitationand poor hygiene practices, which is also likely tolead to illness and urther malnutrition, and malnutri-tion in turn increasing the risk o sickness.

Some areas o Pakistan, notably Sindh Province,continue to be ooded and hundreds o thousandso people are still being evacuated. The emergencyis by no means over. In other areas, as ood watersrecede, people are moving back to homes. Liveli-hoods have been destroyed in areas where peoplewere already struggling to meet their daily survivalrequirements be ore the oods.

The impact o the oods will continue to be elt oryears, even decades, to come. Initial estimates romthe Government o Pakistan and the InternationalFinancial Institutions suggest that tens o billions odollars in damage has been dealt to the economyand in rastructure. The cost in human terms is incal-culable. Continued e orts need to be made immedi-ately to ensure there is su fcient support or re-sponding to the immediate crisis as well as the earlyrecovery components that need to be addressedsimultaneously. Recovery and ulflling everychilds right will take a long time. We need to onlylook back at the Tsunami and Haiti to recognise thatlarge-scale emergencies involve saving lives in theimmediate response but also rebuilding the abric osocieties - some o which was already rayed - in aresilient manner.

Fast Facts One- i th o Pakistans total land area

is looded - with the lood waters stillmoving Pakistan is experiencing severaldisasters simultaneously.

Twenty million people are a ected,including over 10 million children o which2.8 are under ive.

The WASH Cluster led by UNICEF iscollectively reaching over 6 million peoplewith a combination o sa e water suppliesand water treatment or amilies. As parto this e ort some 2.5 million people arereceiving sa e water through UNICEF.

The Health Cluster with majorsupport rom UNICEF reached hal amillion children under- ive with polioimmunisation and more than 420,000children have been immunised againstmeasles.

Key nutrition supplies reaching over375,000 children under- ive and 50,400pregnant and lactating women.

35,000 children have access toeducational and recreational services and26,000 children and women have receivedpsycho-social support.

Some 16,400 schools are a ected and 1.8million children are at risk o being unableto attend school.

UNICEFs revised unding requirement isUS$ 252.3 million, with a remaining unding

gap o US$ 160.8 million as o 17 September.


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HUMANITARIAN NEEDS

The consequences o the ooding or Pakistanspoorest and most vulnerable people are serious. Othe 20 million people who have been a ected, ap-proximately ten million children and three millionwomen are severely a ected. The United Nations andits partners have launched an appeal to provide aid

or up to 14 million people over a 12-month period.

Initial fndings o the Multi-Cluster Rapid AssessmentMechanism (McRAM) assessments show key priori-ties are shelter and ood.

However there is also a high risk o a second waveemergency related to disease outbreaks given con-taminated water sources, access to potable waterand sanitation acilities, poor living conditions, pooraccess to ood and nutrition or children. For UNICEF,increased provision o sa e water, sanitation, hy-giene interventions, nutrition and health services andthe expansion o learning opportunities and scale-upo protection mechanisms remain critical.

1. Water Sanitation and Hygiene The results o therecently completed McRAM assessments showthat a worrying amount o the water that is avail-able is not potable. E orts continue to improvethe quality o water provided both at the sourceand at the household levels. Only 42 per cent ohouseholds surveyed had closed water contain-ers, though 53 per cent were practicing some

orm o household water treatment. Sanitationand hygiene are rapidly becoming the prior-ity problem with just 20 per cent o householdssurveyed having a clean toilet and 26 per centwashing their hands with soap.

2. Communicable Disease - Reports rom healthauthorities show continuously increasing caseso malaria, acute respiratory in ections, skindiseases and acute diarrhoea in ood-a ecteddistricts. Since 29 July, over 4.7 million patients(with estimated 600,000 children under 5) havesought health services, o which 19 per cent weresu ering rom skin in ections, 15 per cent each

rom acute respiratory in ections, 13 per centrom acute diarrhoea and 3 per cent rom sus-

pected malaria.

3. Nutrition The oods have had a negative im-pact on in ant eeding practices. Approximately50 per cent o nursing mothers have reducedbreast eeding and around 15 per cent havestopped breast eeding since the oods began.

Women report that they do not have su fcientprivacy or breast eeding. Around 10 per cent omothers with young children report having to re-duce complementary ood given to their children.

Across all provinces there are reports o distri-bution o breast milk substitute products. Thesereports were the most prevalent in Sindh (morethan 25 per cent o households reporting). TheVulnerability Assessment report led by WFP alsorevealed 7.4 million extremely vulnerable peoplein a ected areas with the number in Sindhexpected to increase. NGO screening reportsindicate pockets o severe acute malnutritionemerging in these areas. It is estimated that thereare approximately 126,000 children at risk o be-ing severely malnourished and 420,000 childrenat risk o being moderately malnourished.

4. Protective Environment for Children - An estimat-ed 1.8 million children are at risk o being unableto attend school at the start o the school year inSeptember, as over 8600 schools were damagedand over 5600 schools are occupied by ood vic-tims and need repair and rehabilitation. Directlyand indirectly more than 16,400 schools havebeen a ected. The oods have also created newprotection risks or children and exacerbated pre-existing threats: children have been or are at risko being separated rom their amilies, they areat risk o abuse, they lack or have limited accessto assistance, and they have witnessed death anddestruction.

An Inter-Cluster Survival Strategy is being developedin conjunction with the Health, Nutrition, WASH andFood Clusters to prevent a second wave emergencyo disease outbreaks. Teams have moved into thefeld to establish strong coordination between Clus-ters in the most at risk districts in order to be in aposition to conduct prevention and response inter-ventions.

PRIORITIES FOR CHILDRENLarge scale mobilisation e orts and an unprecedent-ed pulling together o all partners are required. TheProvincial Governments and the Federal Governmento Pakistan, through national and provincial disas-ter management authorities, through Federal andProvincial Ministries, departments and parastatals,are directing the response, and the Pakistani Armyis also playing a key role. All Humanitarian Clustershave been activated, and there are also numerouslocal and international actors outside the Cluster sys-tem whose e orts must be taken into account.


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Severely Affected Areas

Moderately Affected

Pakistan-AdministeredKashmir

Punjab

Sindh

Balochistan

FederallyAdministeredTribal Areas

KhyberPakhtunkhwa

SIMULTANEOUS HUMANITARIAN ANDEARLY RECOVERY INTERVENTIONS

Strategic priorities and timelines, as well as the typeo approach, will vary between and within provinces.In Khyber Pakhtunkhwa, more than two thirds o thea ected population have already returned to theirhomes. In the south in Sindh oodwaters are stillrising, nearly hal o the a ected population is resid-ing in organised camps, and the majority o othersare living in spontaneous encampments or collectivecentres. Flexibility will be needed to respond e ec-tively to these varying contexts.

The crisis has hit the poorest, the weakest and themost vulnerable, a ecting people di erently acrosswealth quintiles, ethnicities and gender. The long-term impact will be elt or years to come and willhave a pro ound impact on meeting the MillenniumDevelopment Goals (MDGs) or Pakistan. The cen-tral challenge o meeting the MDGs with equity isclear in this respect we will need to re ocus on thepoorest and most marginalised children, women and

amilies that have been a ected.

UNICEF is currently developing a 12-month early re-covery strategy that leverages the linkages betweenclusters to maximise results. UNICEF will work todevelop capacity at the community, district, province

and policy levels to provide sustainable solutionsand ensure national ownership. The strategy will beclosely linked to the 12-month Cluster strategies thatare being prepared or the revision o the PakistanFloods Emergency Response Plan (FERP).

UNICEF, as a member o the UN-Disaster Need As-sessment (DNA) Task Team, has agreed to contributeto strengthening o sectoral analyses o the damageand loss assessment that had been initiated by theWorld Bank, with emphasis on the human dimen-sions o the impact o the disaster. Supplementingthis e ort, the Task Force also agreed to conductthe study o the ood impact on the achievement oMDGs, independent rom the World Banks DNA withtechnical support rom UNICEF.

Source: OCHA. The boundaries and names shownand the designations used on this map do not implyo icial endorsement by the United Nations.

Pakistan FloodsMap of Affected Areas



Core Commitments or Childrenin Humanitarian Action

WATERSANITATION AND

HYGIENESTRATEGIC RESULT

Girls, boys and women have

protected and reliable access

to su fcient, sa e water and

sanitation and acilities

The ood had a devastating impact across a ected areas.Sanitation is now virtually non-existent, water sources havebeen damaged and contaminated and people have lost es-sential household items to etch and store water, resultingin an acute shortage o sa e drinking water. People have losttheir sanitation acilities and are orced to rely on open de e-cation women are particularly a ected, lacking privacy andsa ety, particularly in spontaneous camps where displaced

people have concentrated, where acilities are inadequateor completely lacking. Hygiene is also rapidly emerging as apriority issue with acute watery diarrhoea, respiratory in ec-tions, and skin and eye diseases on the rise, with severalconfrmed cases o cholera already reported.

Responding to Immediate Needs

Water Supply

More than 6 million people have been reached with interven-tions through joint e orts o the WASH Cluster led by UNI-CEF. UNICEFs overall contribution to these e orts is reach-ing over 2.5 million people with sa e water supplies reachingthe targets set or this phase o the intervention. Over onethousand water supply schemes have been restored or reha-bilitated. UNICEF is providing sa e water through over 680water tankers in daily service.

Lady Health Workers (LHWs) and NGO partners have distrib-uted more than 2.5 million water puri ying tablets and sa-chets (each tablet purifes up to 5 litres o water). UNICEF isalso collaborating with the Pakistan Council or Research onWater Resources (PCRWR) to test and chlorinate all unction-ing water sources in ood-a ected areas o the provinces.

Sanitation

Scaling up sanitation in the immediate phase has been di -fcult due to the general lack o capacity among partners. So

ar over 3,000 latrines (separate or men and women) havebeen set-up serving over 20,000 persons.

Where space permits, private washing areas or womenhave been set up near latrines. The plan is to reach the targetpopulation o 2.5 million with combined sanitation and hy-giene interventions.

Province Population reached withclean drinking water

Punjab 380,540Sindh 119,316Khyber Pakhtunkhwa 1,683,411Balochistan 240,000Gilgit Balistan 26.030Azad Jammu & Kashmir 100,420TOTAL 2,549,717Source: UNICEF WASH Section, Islamabad


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HEALTH

STRATEGIC RESULT

Excess mortality among

girls, boys and women in

humanitarian crisis is

prevented

Women and children are acing major li e-threatening chal-lenges due to low access to basic health care, damages tohealth acilities, socio-cultural barriers preventing women

rom accessing care and the cost o care or amilies whohave lost their livelihoods. Initial estimates as o 1 Septem-ber 2010 reported that some 236 health acilities had beendamaged and 200 were destroyed in our ood-a ectedprovinces.

With the ood advancing downstream, an additional 80acilities were reported damaged in Sindh. Community

based providers, including Pakistans network o Lady HealthWorkers (LHW) and Community Midwives have been a ect-ed themselves and community level health care networksare severely disrupted. Out o the 20 million a ected by the

oods 820,000 (4.1 per cent) are pregnant women, 2,800,000(14 per cent) are under 5 and 700,000 (3.5 per cent) are un-der 1 year.


ImmunisationsUNICEF is ocused on reaching all children in 57 worst-a ected districts living in camps, schools and other tempo-rary shelters with total vaccination coverage o polio (0-59months) as well as measles and vitamin A distribution orchildren 6-59 months. In August, in severely a ected districtsin Khyber Pakhtunkhwa, 92 per cent o children (260,100 outo 284,852) were reached with polio vaccinations, 91 per cent(232,622 out o 253,217) were reached with measles vaccina-tions and 82 per cent (234,616) were reached with vitamin Asupplementation. Gaps remain in other ood-a ected areasand campaigns are planned and underway or September

and October. The table below illustrates e orts o the Gov-ernment and the Health Cluster including UNICEF as a keypartner.

Emergency Health

Medical services are being provided in all provinces throughmedical camps, mobile medical teams and static acilities.So ar over 200,000 people (about 75 per cent o which arewomen and children) have beneftted rom these services in

Province Polio Measles Vitamin A

Punjab 118,613 61,992 49,842Sindh 71,746 63,302 52,098Khyber Pakhtunkhwa* 273,425 252,367 235,065Balochistan 29,328 28,574 24,388Azad Jammu & Kashmir 6,843 14,506 14,506TOTAL 499,955 420,741 375,899Source: Provincial Health Departments.

* Khyber Pakhtunkhwa fgures include routine and campaign results.


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Khyber Pakhtunkhwa. The Government is also pro-viding services to more than 1.7 million patients incamps and health acilities in Sindh and Punjab.Some 81,800 clean delivery kits and 110,000 new-born care kits soon to arrive in a ected areas willhelp mothers give birth sa ely and ensure propercare can be given or their babies. UNICEF also im-mediately started distributions and pre-positioning

o Oral Rehydration Salt and zinc to treat up to 2.1million episodes o diarrhoea with 3 months wortho supplies to be given to LHWs in all ood-a ecteddistricts. UNICEF is also supporting an e ort to ront-load antibiotics or treating pneumonia and re erralshave been made or acute cases o acute respiratoryillness (ARI).

UNICEF will also engage and support LHWs whoare now caring or ood a ected people as well asLHWs who are among those a ected by the oods.LHWs are essential or multiplying and scaling upinterventions. Plans are underway to support 10,500

displaced LHWs with shelter. Some 20,000 displacedLHWs and Community Midwives (CMW) who haveto cover an increased number o patients will be sup-ported with additional supplies, basic equipment andoperational costs.

To avert the outbreak o Malaria, UNICEF is sup-porting the Departments o Health or umigation ostanding oodwaters in the 4 provinces o Punjab,Sindh, Khyber Pakhtunkhwa and Balochistan. So arover 7,100 umigation operations have taken place,while 25,000 bed nets have been distributed in Balo-chistan, and an additional 912,500 nets are on order

or distribution.

Health and hygiene promotion messages are con-tinuously being provided through Lady Health Work-ers, the national Maternal Neonatal and Child Healthprogramme as well as NGO partners and institutionsin the temporary camps or displaced populations.The Mother and Child Health Week and Days are tobe launched on 19 September with the Ministry oHealth.

Messages have been developed in collaborationwith Government counterparts. Tools are beingdeveloped or LHWs to conduct health sessions onpneumonia, diarrhoea, clean water, sanitation andin ectious disease.

Challenges and Looking Forward

The main challenge is a shortage o emale serviceproviders. The way orward includes intensi yingvaccination campaigns and concurrent vitamin A dis-

tribution, conducting Mother and Child Weeks (MCW)to deliver a defned package o maternal, newbornand child health care services.

UNICEF will also expand e orts to provide medicine,equipment, other supplies and operational supportto Lady Health Workers and Community Midwivesand health acilities to resume and to restore com-

munity-based basic maternal, neonatal and childhealth services.

Funding

Requirements: US$ 50,826,101Funded: US$ 16,333,236.92Gap: US$ 34,492,864

Note: All fgures are in US dollars. Funds required are aso the revised inter-agency appeal launched 17 September2010. Amounts reported are on an interim basis as o 15September 2010. Funded amounts re ect actual contribu-tion amounts.

Funded: 32.1 %US$ 16.3 million

Gap: 67.9%US$ 34.5 million




NUTRITION

STRATEGIC RESULT

The nutritional status o

girls, boys, and women is

protected rom the e ects o

humanitarian crisis

Loss o property, ood stocks and the damage to standingcrops will urther increase ood insecurity at householdlevel or millions o Pakistanis. Keeping in view the hygieneand sanitation situation, there is a high risk o water bornediseases which will urther aggravate the already compro-mised nutritional status o children, and pregnant and lactat-ing women, resulting in increased morbidity and mortality.Based on the estimation that 20 million people are a ected,

there are an estimated 2.8 million children that need support.There are approximately 126,000 children at risk o beingseverely malnourished and 420,000 children are at risk o be-ing moderately malnourished.


Surveys and Monitoring

Surveys shows that 40 per cent o households have lost alltheir ood stocks. Fi ty per cent o breast eeding mothers re-ported that they have reduced breast eeding and 15 per centhave stopped breast eeding since the oods. These fndingsprovide qualitative in ormation or urther assessments inthe specifc areas such as in ant eeding in emergencies.However, nutritional surveys are still required to providequantitative data or strengthening planning and implemen-tation o nutrition interventions in ood-a ected areas.

Acute Nutritional Needs

Distribution o key nutrition supplies like High Energy Bis-cuits, Ready-to-use-supplementary oods (RUSFs), Unimix,micronutrient sachets and tablets is ongoing. A one-timesupplementary ood distribution in coordination with WFPto fll the gaps is underway or 376,065 children under 5 and50,400 pregnant and lactating women. A ected communitiesare also being provided with ORS sachets, Zinc, Amoxicilinand de-worming tablets. In Khyber Pakhtunkhwa re erralsare being strengthened to treat acutely malnourished chil-dren without complications through outpatient therapeutic

eeding programmes (OTPs) already established in ooda ected areas and to provide management o severe acutemalnutrition (SAM) according to national technical guide-lines.

Specialised emergency nutrition supplies, such as thera-peutic paste (Plumpynut), therapeutic milk, medicines and

anthropometric equipment are also being distributed toimplementing partners to scale up treatment o acute malnu-trition. UNICEF is collaborating with WFP on supplementary

eeding centres, and with WHO on stabilisationor thera-peutic eeding centres. A stabilisation centre or severelymalnourished children with complications is being estab-lished at Larkana Civil Hospital in Sindh, while another isalready unctional in Rajanpur in Punjab.

UNICEFs targets rom mid September are: 75,600 (60 percent o annual caseload) severely acute malnourished chil-dren treated through acility and community based manage-



ment o acute malnutrition; 180,000 (43 per cent oannual caseload) moderately acute malnourishedchildren. At the same time 126,000 pregnant and lac-tating women at risk o malnutrition will be providedwith supplementary ood rations in collaborationwith WFP, and micronutrient defciencies will be ad-dressed and prevented through provision o multiplemicronutrient supplementations to 376,065 children

aged 6-36 months and 123,200 pregnant and lactat-ing women.

Nutrition Cluster Coordination

Through Cluster partners, 17,762 children and 29,462pregnant and lactating women have received orti-fed blended ood and BP5 biscuits. With the arrivalo new stocks o ready-to-use therapeutic oods,UNICEF as Cluster-lead in Nutrition is launchingscale-up e orts or treatment o severely malnour-ished children under 5 and micronutrient supplemen-tation or children under 5 and pregnant and lactat-

ing women.

To control micronutrient defciencies and preventunder-nutrition, 18,179 children and 18,722 pregnantand lactating women have received micro-nutrientsupplementation. The Cluster has reached more than8,000 community members with key messages onbreast eeding, appropriate complementary eed-ing, hand washing and hygiene in camps in Punjabthrough Lady Health Workers. More than 30 Supple-mentary Feeding Programmes and 30 out-patienttherapeutic programmes are unctional in ood a -

ected districts o Khyber Pakhtunkhwa.

The Cluster is also actively pursuing promotion,protection and support to breast eeding. Followingthe Ministry o Healths guidelines against breastmilk substitute donations, UNICEF, WHO and WFPissued a Joint Statement calling or support orappropriate in ant and young child eeding in the cur-rent emergency, and caution about unnecessary andpotentially harm ul donations and use o breast-milksubstitutes.

The Cluster is strongly urging all who are involved inunding, planning and implementing the emergency

response in Pakistan to avoid unnecessary illnessand death by promoting, protecting and supportingbreast eeding and appropriate complementary eed-ing and by preventing uncontrolled distribution anduse o breast-milk substitutes.

Cluster partners have agreed to establish three sub-working groups: Nutrition Assessment and Surveil-lance, Community Management o Acute Malnutri-tion and In ant and Young Child Feeding.


The main challenge remains lack o partners toimplement emergency nutritional interventions andthe need or training o regular development part-ners on humanitarian nutritional response program-ming. Increased unding is needed or communityand acility-based management o acute malnutrition

in all a ected provinces. Due to the ongoing criticalneeds, scale and requirements o this emergency,UNICEF is compelled to bring supplies by air at veryhigh costs. At the same time, planning is ongoingwith a ocus on community-based management oseverely malnourished children to cover all the needsand prevent a deterioration o the nutritional statuso young children and pregnant and lactating wom-en, including protection and promotion o optimalin ant and young child eeding practices.

FundingRequirements: US$ 27,555,748Funded: US$ 17,925,733.21Gap: US$ 9,630,015



Gap: 34.9%

US$ 9.6million




EDUCATION

STRATEGIC RESULT

Girls and boys access sa e

and secure education and

critical in ormation or their

own well-being

Initial assessments reveal that 1.8 million children in schoolshave been a ected by the oods and that more than 16,400schools have been directly and indirectly a ected, with

oods compromising also the availability o trained teach-ers. Many other school buildings are being used as tempo-rary shelters by displaced amilies. Subsequent assessmentswill be required to determine the psychosocial impact o thedisaster on students and teachers, and the needs o local

education authorities and managers.


Restoring Access to Quality Education

The oods a ected over 16,400 schoolsincluding 8,618schools that have been damaged while another 5,689schools are being used as temporally shelter. There wereapproximately 1.8 million children in schools a ected by the

oods, including 680,000 girls. Today they are all at risk omissing the start o the academic sessiona risk that weighsmore on girls given previous social and cultural barriers toaccess.

To restore access to quality education, the total numbero Temporary Learning Centres has increased rom 98 to373 across 3 provinces and Pakistan-Administered Kash-mir, benefting 35,106 children. Provision o school suppliesincluding tents, school-in-a-box kits, and recreation kits, arebeing procured through UNICEF o fces in Nepal, Sri Lanka,A ghanistan, and Bangladesh.

Out o the 130,000 school retention kits in stock, 15,000 havebeen distributed and another 35,000 will be distributed thismonth, while other essential teaching and learning materialhave been provided to Temporary Learning Centres.

The National Rural Support Programme in Pakistan-Admin-istered Kashmir has provided 77 tents to UNICEF or settingup urther centres, while UNICEF and other cluster partnerswill support the Government in setting up 250 Tempo-rary Learning Centres in the area beneftting nearly 10,000students. Plans are also underway to set-up 650 centres inPunjab.

Capacity Building

UNICEF brought in special technical expertise to build theEducation Clusters capacity in emergency response andplanning. UNICEF is also providing technical assistance insupport o rapid assessments in all provinces and in Paki-stan-Administered Kashmir, with a frst assessment complet-ed in Punjab to be released in early September.

At the same time partners in Sindh were trained on Mini-mum Standards o Education in Emergency and Early Recov-ery, and on use o the School-in-a-Box kit.



The nutritional status o

girls, boys and women is

protected rom the e ects o

humanitarian crisis

Education Cluster Coordination

UNICEF and Save the Children UK coordinate theCluster with the Ministry o Education in Islamabadand in 5 districts across 4 provinces. The Cluster isworking with the Government and partners to ensurethat education interventions are appropriately priori-tised, but in the frst month o the emergency imme-

diate li e-saving interventions were the ocus o moststakeholders.

By the end o August however the Education Clusteridentifed the need to ocus immediately on provi-sion o school supplies (including tents, school inbox kits and recreation kits) ahead o the next schoolyear. The Education Clusters in Islamabad and sub-national Clusters in provinces are ocusing on plansto construct temporary school structures to com-pensate or the schools that were damaged and thatare not sa e or children. The aim is to ensure con-tinuation o education during the transition period

rom tents to permanent buildings. At the same timecommunication materials have been developed anddistributed or IDP shelter schools across the a ectedareas in all the provinces.

The Cluster is also advocating or a more integratedapproach to school improvement during early recov-ery so that all key actors in uencing the quality oeducation or both boys and girls are properly ad-dressed such as:

Provision o psychosocial support or childrenand teachers a ected by the ood;

School eeding and other ood incentives or allchildren;

Installation and proper use o missing acilitiesin schools or better health, hygiene and schoolsa ety.

Due to limited resources and access, comprehensiveneeds assessment or the educational sector hasonly begun. The rapid assessments or Sindh, Pun-jab, Balochistan and Pakistan-Administered Kashmirhave been completed while the rapid assessments

or Khyber Pakhtunkwa and Gilgit Balistan are nearcompletion.


For the frst month o the emergency, activities werelimited as health and sanitation concerns were priori-tised. However, early recovery planning initiated dur-ing the immediate response phase has started andeducation needs have been included in the revisedhumanitarian appeal which also includes an EarlyChildhood Development component.

The crisis has also prompted actors in the educationsector to reach out to all children including out-o -school (OOS) children in ood-a ected areas. Educa-tion Learning Centers established or a ected popu-lations are flled with children o both sexes whohave never been to schools be orethere is no data

or those out o school be ore or a ter the oods.Special advocacy campaigns will be designed during

the early recovery phase to increase enrolments oOOS children with special ocus on primary and mid-dle level. Special emphasis will be paid to enrollingadolescent girls into adolescent girls learning cen-tres, which are in the process o being established.

Funding



Funded: 31.4%US$ 11.4 million

Gap: 68.6%US$ 25 million




CHILD

PROTECTIONSTRATEGIC RESULT

Girls and boys rights to pro-

tection rom violence, abuse

and exploitation are

sustained and promoted.

The oods have created new protection risks or childrenand exacerbated existing ones: children have been or are atrisk o being separated rom their amilies, they are at risk oviolence, abuse, exploitation and discrimination, they lack orhave limited access to assistance, and they have witnesseddeath and destruction. In addition, there is a high risk thatcertain orms o gender-based violence (GBV) against bothwomen and children (girls especially) will escalate post-

ooding at both the community level and within temporarysettlements.

Other protection risks will be created or exacerbated by thedeepening vulnerability o amilies ollowing the oods.For instance, traditional harm ul practices such as earlyand orced marriage could be used as coping mechanismsby amilies whose livelihoods and ood security have beencompromised. The increased burden on women to eed andcare or their amilies and amily separation leading to anincrease in women and girl-headed households is likely toproduce a surge in domestic violence. Where possible, sa eor respite spaces or women should also be established to

promote psychosocial well-being.


Child Friendly Spaces and psychosocial support

By 15 September, UNICEF had partnered with NGOs toensure 146 static Child Friendly Spaces (CFS) and 15 mo-bile CFSs were established in Khyber Pakhtunkhwa, Punjab,Balochistan, and Pakistan-Administered Kashmir, providingeducational and recreational services to 35,000 children.

By mid September, UNICEF and its partners had also pro-vided 2,141 women and 25,629 children with psychosocialsupport to cope with the stress created by the oods anddisplacement. Although disaggregated monitoring systemsare not in place in Punjab, the ratio o children receiving psy-chosocial support is 53 per cent boys and 47 per cent girls.Women are mostly receiving psychosocial support throughUN and other partners through the Protection Cluster.

Children without Family Care

UNICEF and partners are identi ying and registering unac-companied, separated and missing children and tracing

and reuni ying them with their amilies. By mid September,out o 12 unaccompanied children, 2 children have beenreunifed with amily and out o 288 separated children, 235children have been reunifed with amily with the support byChild Protection Help lines and other re erral mechanisms.

Referral Services

Existing hotlines or child protection are now being utilisedto attend to the queries o a ected amilies and re er themto appropriate services. UNICEF and partners are identi yingand registering children who are in need o services through



Child Rights Monitors working at the communitylevel and who re er vulnerable children to appropri-ate services.

Child Protection Sub-Cluster Coordination

UNICEF and the Pakistani Ministry o Social Wel arehave activated the Child Protection Sub Cluster at

the national level as well as in the our provinces andPakistan-Administered Kashmir. Child Protection SubClusters at the provincial level are currently conduct-ing rapid assessments to better map child protectionneeds and assess vulnerability.

Key messages are under development or dis-semination through radio and other communicationchannels. The Child Protection Sub Clusters Termso Re erence and Code o Conduct were reviewedand will be integrating a wide range o Governmentdepartments with a mandate or children, includingthe Ministry o Interior, the National Database and

Registration Authority (NADRA) in charge o popula-tion registration, and Bait-al-Mal in addition to theMinistry o Social Wel are.

At the same time, the Gender-Based Violence Sub-Cluster was activated on 15 September, and is beingled jointly by UNICEF and UNFPA at national level.Both UNICEF and UNFPA are fnalising a GBV re-sponse plan which includes operationalisation oGBV Sub-Clusters at the provincial level. GBV ac-tion sheets or each o the Clusters have also beenadapted to the context o Pakistan and are beingdisseminated at Inter-Cluster level to ensure genderconcerns are properly taken into account across allhumanitarian interventions.


Rapid and ongoing assessments have shown thatchildren and women are generally excluded romaccess to non- ood items (NFIs) during distributions.There is an urgent need to distribute NFIs specifcally

or women and children including clothes, shoes,torches etc. So ar, only 14,834 women and childrenhave beneftted rom NFI distributions including5,375 in Punjab and in Khyber Pakhtunkhwa 5,369boys, 3,781 girls and 309 women.

At the same time, there is a critical shortage o und-ing to cover a ected areas which continue to in-crease as ood waters move. This is especially true inSouth Sindh and a lack o partners with strong childprotection and GBV expertise is impeding the re-sponse. There is also a need to train organisations onchild protection and GBV to strengthen their capacityto ollow-up on and address and deliver appropriateservices in response to GBV-related issues that havebeen reported as a result o increased vulnerability

- including reports o trading ood or sex amongthe most vulnerable who have lost ood stocks andlivelihoods. Lastly, more dedicated human resourcesare needed or GBV. Programme o fcers are in placein Sukkur and Hyderabad and Child Protection SubCluster coordinators working at the provincial levelare covering GBV until provincial level GBV SubCluster coordinators are recruited.

Funding




Gap: 52.2%US$ 6.8million




Gender

UNICEF is addressing gender concerns in the humanitariancrisis in Pakistan through a multi pronged approach. Data isbeing collated rom the feld and analysed and then advo-cated at di erent orums including the Clusters or policyinterventions. UNICEF is also collating sex-disaggregateddata rom the feld when it comes to damaged schools and

occupied schools in the provinces that have been a ected bythe ood. In addition: Gender checklists have been shared to mainstream

gender into Flood Emergency Relie and Early RecoveryResponse activities.

Gender Focal Persons have been appointed rom di er-ent agencies or the Clusters and UNICEF is supportingClusters by providing gender ocal persons in the Educa-tion and Nutrition Clusters.

Situation analysis o gender disparities is underwayparticularly regarding the situation o damaged schools.

Analysis in Punjab has been completed with Khyber Pak-htunkhwa, Balochistan and Sindh in the pipeline.

Gender checklists have been dra ted or teachers inTemporary Learning Centres to ensure the acilities aregender sensitive and meet the needs o students. Girlsare also encouraged to enroll in the UNICEF providedtemporary schools where School-in-a-Box and recre-ational kits with games and sports equipment are pro-vided to acilitate the re-opening o classes.

Plans or Focus group discussions are in the pipelinewith adolescent girls to discuss their problems and o ersolutions when it comes to issues like menstruation,harassment and tra fcking and other orms o GBV.

UNICEF has meanwhile supported the establishment o aGender and Child Unit at the National Disaster ManagementAuthority by seconding an experienced sta . This is ex-pected to increase policy leverage on mainstreaming genderand child sensitive policy interventions, including through aworkshop held at the end o August at the NDMA on sepa-rated and unaccompanied children.

CROSS-CUTTING

PRIORITIES



In Pakistans food-devastated Sindh province,emale health workers play key role

Ms. Jatoi was teaching a session on health promotion to the local village when shereceived warning o the impending oodwaters. She and the other villagers quicklytook what belongings they could carry and ed to higher ground, where theycamped on a roadside or the next our weeks. From there they watched in horroras the waters rose rapidly, washing away the lives they once knew.

Three weeks later, the village residents returned and began to rebuild their lives.Ms. Jatoi and her team o lady health workers started conducting sessions withchildren in the impoverished, ood-a ected villages they serve areas that are themost vulnerable to outbreaks o disease and diarrhea, especially among children.

UNICEF has supported the LHW programme in Sindh province since its inception,providing the health workers with blood pressure monitors, thermometres and

health treatments such as ORS and zinc supplements.

It also supplies lady health workers with in ormation, communication and educa-tion materials in order to support their training and outreach activities.

Vital community link

Although she hasnt been paid ortwo months, Ms. Jatoi is dedicat-ed to her job. Be ore the oods,she had even started to expandher regular repertoire o immuni-sation and health promotion to in-clude reproductive health advice.

With 10 expectant mothers due tobring new li e into the village oAgha Ali Jatoi and some 28 oth-er women currently breast eed-ing these sessions have becomecritical or the local women.

Ms. Jatoi explained that, at frst,

many women were hesitant to discuss reproductive matters. However, now, theyknow me well and we have more open discussions, she said. They ask manyquestions they were a raid to ask be ore.

In the di fcult post- ood environment, Ms. Jatoi and her team are a vital link to thecommunity. They are essential to ensuring that the millions o children a ected bythe disaster in Pakistan are protected rom a urther deadly spread o illness anddisease there.

Community health worker Kalsum Jatoi demonstrates the useof Oral Rehydration Salts for treating diarrhoea in PakistansSindh province.



CHILDRENSNEEDS

Scaling Up

The scale o the emergency in Pakistan has evolved overseveral weeks, starting in the north o the country on the23rd July with new areas being inundated every day.

This has required a constantly growing response, includingbolstering UNICEFs presence in established o fces ( rom

the existing Country O fce and its 5 feld o fces UNICEFmoved to open three new feld hubs in little over a month),the shi ting o sta , supplies and unds, and the establish-ment o two operational hubs in Sindh and Punjab (with athird underway in Hyderabad) and a requent upward adjust-ment o needs as the number o people a ected has grown

rom a ew thousand on day oneto over 20 million as o 15September.

Dan Toole, our Regional Director or South Asia has beenappointed UNICEFs Special Representative or the Flood Re-sponse or 3 months to lead on overall strategic planning oUNICEFs work; coordination o direct UNICEF support to thee ort as well as our Humanitarian Cluster role and resourcemobilisation. The current UNICEF Representative MartinMogwanja will continue in his current role as HumanitarianCoordinator to support the overall humanitarian e ort.

A UNICEF 11-person Management Support Team that willprovide strategic advice and guidance or implementationand man agement strategies is also deployed.

As part o our regular operations in Pakistan UNICEF have298 sta on the ground who have been re-deployed torespond to the ood emergency. In addition 138 additionalsta have been surged to assist with UNICEF programmesand Cluster responsibilities.

A large amount o supplies are needed or this response.The pipeline reight is 4,059MT (11,293 m3) or the next 2-3months. Logistics and warehouse specialists have been de-ployed to Multan, Sukkur, Karachi and Islamabad.

The overriding security situation in Pakistan remains tense.Despite a brie reduction in the overall number o securityrelated incidents ollowing the ooding, they are againon the rise. There remains potential or security incidentsagainst the humanitarian community. Appropriate security

measuresthat balance sta sa ety with the need to deliverprogrammesare imperative but require additional unding

Scaling Up UNICEFsEmergency ResponseCapacity to meet



Inter-Agency Collaborationand Coordination

The revised Pakistan Floods Emergency Response

Plan (FERP) appealing or over US$ 2 billion waslaunched on 17th September. This is considered tobe the biggest ever humanitarian appeal or relieand early recovery or the ood a ected populationsacross the country, over a period o 12 months.

UNICEF is taking the lead in Cluster Coordinationin WASH, Nutrition and Education (with Save theChildren) Clusters; Child Protection Sub-Cluster andGender Based Violence (GBV) Sub-Cluster, led jointlyby UNFPA. UNICEF has activated all humanitarianClusters at the national level, with dedicated Clus-ters coordinator deployed in the our most a ected

province.

An Inter-cluster Survival Strategy is being developedin conjunction with the Health, Nutrition, WASH andFood Clusters to prevent a second wave emergencyo health outbreaks. Teams have moved into the feldto establish strong coordination between clusters inthe most at risk districts in order to be in a positionto conduct prevention and response interventions.

5

0

5

0

5

25 July 2010 Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7

A ected population

6 August 2010UNICEF Immediate NeedsDocument released orUS$ 47.3 million

11 August 2010PIFERP released or

US$ 459 million

26 August 2010UNICEF Immediate NeedsDocument revised orUS$ 141 million

17 September 2010Revised FERP released orUS$ 2 billion

UNICEF revisedrequirements in FERP

or US$ 252.3 million



RESOURCEMOBILISATION

To kick-start the emergency UNICEF has released US$ 12million rom its Emergency Response Funds as a loan tothe Pakistan response at the onset o the crisis to fll criticalgaps. In August, both Anthony Lake, UNICEF Executive Di-rector o UNICEF, and Dan Toole, Regional Director or SouthAsia, visited the ood-a ected areas to survey the damagethemselves and to rein orce an urgent plea or support to thePakistani people.

UNICEF had initially issued an Immediate Needs Document(IND) on 5 August, which was revised on 26 August with a re-quirement at US$ 141 million. The IND is very closely linkedto the inter-agency Pakistan Interim Floods Emergency Re-sponse Plan (PIFERP) issued on 10 August. Most o UNICEFsrequirements (apart rom child protection and education) arere ected in the inter-agency PIFERP.

As the oodwaters recede, the humanitarian communityhas re-assessed the needs o the response and early recov-ery programme. Likewise, a ter revising its requirements tomeet childrens needs in Pakistan, UNICEF is now appeal-

ing or US$ 252.3 million under the inter-agency PakistanFloods Emergency Response Plan (FERP) launched on 17September 2010.

As o 15 September 2010, UNICEF had received US$ 92.2million (income to date) and has US$ 23.6 million in pledg-es, which totals to US$ 115.8 million. Out o the undingreceived so ar (excluding pledges), 51 per cent has beenreceived rom government donors while UNICEFs NationalCommittees have provided 44 per cent o the unding. Theremaining 5 per cent has been received rom other undingsources including the United Nations Central EmergencyResponse Fund (CERF).

O the unds received, 60 per cent had been contributedas unearmarked unding to any specifc project or sector.This allows UNICEF to be exible and swi t in responding tochanging realities on the ground and in ensuring li e-savingsupplies and interventions beneft the target populationswho are most in need.

The top fve government donors and the top fve NationalCommittees or unding received so ar are as ollows:

Governments o Australia, Japan, Norway, United King-dom, and the United States;

UNICEF National Committees o Australia, Germany,Italy, United Kingdom and the United States.

UNICEF would like to thank all the private and public sectordonors or the contributions and the pledges that have beenreceived so ar.

What I saw today has convinced

me that we must step up our

humanitarian operations to stave

o a potential second wave odisease and misery or millions

o amilies, especially the most

vulnerable, children and women,

says Anthony Lake, UNICEF

Executive Director. We are here

today and or the long-term, aswe plan or the early recovery

phase o the operation.

On 30 August, UNICEF Executive Director An-thony Lake (right) administers an oral poliovaccine to a baby at the Prang GovernmentPrimary School in Charsadda District, Khyber-Pakhtunkhwa Province.

UNICEF Requirements:

US$ 252.3 million

Funding against requirements


21/22

The table below illustrates the sectoral breakdown o unding received (excluding pledges) as o 15 September.Requirements have been updated to re ect the most recent needs presented in the recently launched PakistanFloods Emergency Response Plan.

Funds Received To Date and Gaps (in US$ millions)Health Nutrition Water, S anitation

and HygieneEducation Child

ProtectionCoordination Grand

TotalFunds Required 50.8 27.6 123.8 36.4 13.0 0.7 252.3Funds Received 16.3 17.9 38.9 11.4 6.2 1.5 92.2Funding Gap 34.5 9.6 84.9 25.0 6.8 (0.8) 160.8

Requirements40

Health

50.8

Nutrition WASH Education ChildProtection

Coordination

0

0

80

60

40

20

34.5

16.3

27.6

17.99.6

123.8

84.9

38.9 36.4

11.4

25.0

6.2 6.813.0

1.5 0.7

Gap

Received

WASHUS$ 84.9 million

WASHUS$ 90.4 million

EducationUS$ 25 million

Child ProtectionUS$ 6.8 million

NutritionUS$ 9.6 million

HealthUS$ 34.5 million

Sectoral Funding GapsAgainst Funding Received

Note: All igures in US Dollars. Sectoral requirements based upon the Pakistan Floods Emergency Response Plan. Funds required are as o therevised inter-agency appeal launched 17 September 2010. Amounts reported are on an interim basis as o 15 September 2010. Funded amountsre lect actual contribution amounts o unds received by UNICEF. Pledges are not included.Totals in the table may not be exact due to rounding.

Total funding gap: US$ 160.8 million


22/22

For more information please contact

Karen Allen, Deputy Representative, kallen@unice .orgDeepak Bajracharya, Chie Field Operations, dbjracharya@unice .orgOscar Butragueno, Emergency Coordinator, ebutragueno@unice .orgKristen Elsby, Chie o Advocacy and Communication, kelsby@unice .org

United Nations Childrens FundPakistan Country O fce

Website: www.unice .org/pakistan

All Photo Credits: UNICEF/NYHQ2010/ Ramoneda

Documents

Children in Pakistan 20 September 2010