médecins du mondecrisis response in KhYBer paKhtunKhWa paKistan

:medecins du monde /

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heaLthcare pLusmédecins du monde is an international humanitarian organisation providing medical care to vulnerable populations affected by war, natural disasters, disease, famine, poverty or exclusion. originally established in France in 1980, the médecins du monde international network now extends to 16 countries in europe, Asia and the Americas. médecins du monde’s work depends on the efforts of nearly 3,000 medical and logistics professionals who volunteer their time. Thanks to their dedication and expertise, we are able to run emergency and development programmes in more than 60 countries while minimising costs.

BeYond medicaL careAlthough médecins du monde’s primary aim is to provide medical care, our work goes further to ensure long-lasting effectiveness. We draw on our experience on the ground to bear witness to obstacles to health- care and to advocate for change.

at home and aBroadour projects take place in both developing and developed countries. Across the countries where the médecins du monde network is present, our medical teams provide healthcare to the most vulnerable groups in their society.

médecins du monde : a medicaL ngo

w What are our actions in KpK?

:medecins du monde /

:PAKisTAn /

Ensuring accEss to hEalth sErvicEs for thE conflict & post conflict affEctEd populationin paKistan The mdm project in KPK ensures access to standardized and comprehensive PHc services and offers capacity to prevent and respond to outbreaks for the conflict affected population in districts of KPK. mdm has deployed mobile medical teams to static and mobile clinics and especially focuses on the most vulnerable, espe-cially children and women, as the services include nutritional screening and treatment of malnourished children, vaccination and reproductive health care.

in June 2009 mdm first started primary health activities in swabi and Buner districts. As the conflict spread across FATA (esp. orakzai, Kurram, south Waziristan) causing further civilian displacements, mdm responded by expanding primary health services to Kohat (march 2010), Hangu (April 2011) and dera ismail Khan (July 2011). mdm briefly responded to the effects of severe flooding that hit Pakistan in July/August 2010, by deploying mobile health teams to charsada and nowshera districts.

mdm conducted a rapid health assessment in Tank district in January 2012. mdm aims at addressing the needs of idPs from FATA where they are and building links with communities across regional borders to gradually increase acceptance of population to further work in FATA.

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DERA ISMAIL KHAN

TANK

HANGU KOHAT

paKistan

KhYBer paKhtunKhWa

KhYBer paKhtunKhWa

mdm areas of work Jun 2009 - mar 2011

Flood response (2010)

mdm current areas of work since march 2010

01 / comPReHensiVe PRimARY HeAlTH cARe seRVices w General health situation is the main issue to address in the area in terms of public health. The general pattern of reported diseases shows a health status clearly related to precarious conditions of living. The noticed pathologies are: Acute res-piratory infections (28 % of the consultations in our 5 clinics), skin diseases (15 %), diarrhoeas (8 %), malaria (2 %) and Anaemia (3 %).

mdm offers comprehensive primary healthcare services that include curative consultations, Reproductive health, immunization, Health education and free drug provision ser-vices. in this regard, mdm recruits and trains qualified health staff with special focus to increase staffing of female doctors in the health facilities to grant women better access to repro-ductive health care services (Ante and Post natal consulta-tions, referral of high risk pregnancies, family planning, and provision of delivery kits…).

in 2011w mdm has conducted total of 84,930 curative consultations | w 11,400 immunizations | w 3,300 reproductive health consultations, including antenatal care, postnatal care and family planning. | w consultations for children under 5  contributed to 30% of the total consultations and women to 63%. | w idPs made 70% of all consultations.

02 / nuTRiTionw nutritional screening and nutritional support (cmAm) are implemented for all eligible children between 6 and 59 months coming to mdm static or mobile clinics. severely malnou-rished children without complication are treated with Plumpy nut, while the mothers are sensitized and offered free educa-tion on proper feeding practices and prevention.

in 2011w mdm has screened 13,600 children for malnutrition, while 362 children were treated for severe malnourishment.

03 /emeRGencY PRePARedness & ResPonsew emergency preparedness & adequate responses are per-formed in case of any outbreaks, natural disasters or new massive displacements of population in selected districts. This is done in conjunction with community capacity building activities, addressing topics like hygiene promotion, disease prevention, immunization awareness campaign, etc.

w during the monsoon seasons of 2011, mdm responded to potential cholera outbreak by establishing diarrhea treatment center (dTc) in Kohat district, when 62 patients were treated during 2 weeks response period.

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w Long term approach to crisis response in KpK

:medecins du monde /

:PAKisTAn /

Women’s reproductive Health care Programme in Khanpur, south Punjab.

infectious disease children Hospital in Peshawar.

exploratory mission in Punjab Pakistan to assess possible support to women victims of violence.

Pilot project in sargodha shelter Home.

Agreeement signed with the social Welfare department, Women development and Bait-ul-maal of Punjab

operation smile/Reconstructive surgery camps for women burnt by acid and fire in islamabad.

earthquake relief Programme in Khagan Valey.

Healing the wounds of domestic Violence in Punjab.

extension of the program to 34 shelter homes and support to mumKin eVAW Alliance.

comprehensive primary heal-thcare program via mobile clinic for both displaced per-sons and residents in Kyber-Pakhtunkhwa-KPK

2012-2013 – Primary Healthcare program to be continued in Kohat, Hangu, dera ismail Khan and Tank districts of KPK, while FATA intervention may be consi-dered. Handover of the project to sWd and strengthening the mumKin network.

mdm decided to intervene in KPK to respond to the massive civilian displacement caused by Pakistan military operations in swat Valley first (2009) and then in the Federally Administered Tribal Areas (2010) aiming at eradicating the militancy movements and insurgencies, by providing access to healthcare services to both displaced and hosting populations in KPK.The health system in KPK, and in particular in the areas where a large number of idPs have settled, appears to be over-burdened and unable to respond to the increased demand. indeed qualified human resources are insufficient; most of the health facilities are partially damaged; drugs and equipment are often not available and the referral system is not functional. Building on its extensive knowledge of KPK, experience in providing pri-mary health care (PHc) services in crisis context, and well established acceptance by local communities, mdm plans to continue relying on its ability to be mobile and reactive, in order to be where the highest needs are. mdm may also consider a new program in FATA to support the moH in restoring the highly damaged health system, while at the same time maintaining a low level emergency presence in the area in order to respond to the natural disasters and disease outbreaks.

HisToRY oF mdm in PAKisTAn

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Médecins du Monde H 25, street 3b, Block F10/2, islamabadPAKisTAn /

Tel+ 92 (0) 4236 65 50 98 9

emAilgenco.pakistan@medecinsdumonde.net

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ouest France solidarité