After nearly three weeks the UN has just raised half the $459m needed for initial relief following Pakistan’s worst ever floods. A US senior defence adviser explains to Channel 4 News there has been a "real issue" in coordinating international aid.
For the past three weeks donors have been lobbied amid warnings that Pakistan is facing a spiralling humanitarian catastrophe, after at least 1,600 people were killed and at least two million left homeless by the floods.
Despite the funds collected, only a fraction of the six million Pakistanis desperate for food, water and medicine have received help.
UN spokesman Maurizio Giuliano said: "There has been an improvement in funding. Donors are realising the scale of the disaster.
"But the challenges are absolutely massive and the floods are not over. The size of (the area affected by) this disaster is equivalent to Austria, Switzerland and Belgium combined. That’s pretty scary."
Defending the reaction time of the international community in donated aid, the US Senior Defence Adviser to the Special Representative for Afghanistan and Pakistan, Vikram Singh told Channel 4 News that it was difficult to know what the impact would be of a slow moving flood.
He said: "It’s hard to see with a slow moving flood, what the impact is going to be, so I think when the floods started on July 29, no-one really had a grasp of the scale this disaster would be. No-one expected that 20 million people would be affected by this flood.
DEC: Pakistan floods set new boundaries
As the Disasters Emergency Committee (DEC) raises £19m for Pakistan following the country’s worst ever floods, the committee’s deputy chief executive tells Channel 4 News the floods have rewritten the boundaries of catastrophes. Read more here.
DEC Member Agency efforts to treat and prevent waterborne diseases include:
• Oxfam has provided clean water for over 150,000 people by fixing water systems and trucking clean water supplies. As well as purchasing aid in-country, they have sent 19,000 water purification tablets, 455 latrine slabs/squatting plates and six de-watering kits (pumps for cleaning contaminated wells).
• Merlin has delivered 4,000 packets of water purification tablets – enough to make 400,000 litres of safe drinking water – 48,000 packs of oral rehydration salts and 20,000 doses of antibiotics to help fight the rising number of diarrhoeal disease and other infections. They are also setting up three Diarrhoea Treatment Units in three districts, capable of treating 300 patients at any one time.
• Save the Children has established a diarrhoea treatment center in Swat for children and adults, and is distributing hygiene kits, and conducting hygiene promotion to prevent rise in water-borne diseases like acute watery diarrhoea.
• Concern have given clean drinking water to 12,400 in Swat and Charsadda.
"But the United States was very quick to respond immediately with assistance in the first days of the flooding and I think we really led the way, where at $90m of US assistance. We have something like 18 or 19 helicopters supporting Pakistani efforts to get relief supplies to where they need to go and to evacuate people. Some 7,000 people or so have been evacuated on US helicopters."
"I think we have a real issue with all of us coming together to let everyone know what the scale of this disaster really is. In the aftermath of an earthquake you know that tens of thousands are dead right away and you see the devastation very clearly.
"But with a flood where the death toll is only around 2,000, it’s much harder to get people and nations to realise the scope of the disaster.
"I would say that over the last several days that’s become much more clear to everyone involved. We are now realising that a fifth of the country is directly impacted and 20 million people are affected so I think people are realising it and I think the fact that the UN are hosting a special session of the general assembly on Thursday will really help drive attention and get the resources that are needed and will be needed to help Pakistan for a long time to recover."
How to donate
To make a donation to the DEC Pakistan appeal call the 24 hour hotline on 0370 60 60 900, visit http://www.dec.org.uk or donate over the counter at any post office or high street bank, or send a cheque.
You can also donate £5 by texting the word GIVE to 70707.
The Deputy Chief Executive of the DEC Kath Hindley told Channel 4 News that some governments were slow off the mark, but said it is the UN’s responsibility to coordinate the international relief effort.
She said: "I can’t speak for lots of governments, because we don’t interact with all of them on the ground, but the UK government led the way in many cases and has been lobbying other governments to give as much as they can possibly give.
"There is a shortfall in international aid and we need to make sure governments give as much as they can.
"Some governments have been slower than others in responding to the crisis. Perhaps that’s because it’s August and many governments are on holiday (recess), but I expect, after Thursday’s UN meeting over the next few weeks thinks will start to happen.
"UN coordination is key – their role in identifying where people are and making sure all humanitarian players cover these places. It’s through these UN coordination meetings and discussions where we find the answer to that and this changes on a daily basis because of the nature of the situation.
"It’s always difficult to coordinate relief efforts in situations where so many people are affected. The UN themselves always find lessons to learn in a short period of time from disasters like this and I’m sure lessons will be learned again from this current tragedy that we will learn together and will be shared widely."
Read more from Jonathan Miller on the floods in Pakistan:
– Emergency aid ‘not reaching’ flood-hit Pakistan
– ‘Four million’ at risk from Pakistan floods
– ’12 million’ directly hit by Pakistan floods
– Pakistan floods: desperation as rain continues
– Pakistan floods: military steps up rescue effort
– Pakistan floods: victim number exceeds tsunami
– More rain as Pakistan floods sweep south
DEC raises £19m
The DEC, which raises funds independently of the UN, today announced that its appeal has raised £19m for the initial relief programme in Pakistan, with member agency relief efforts so far reaching over 700,000 people.
DEC Chief Executive Brendan Gormley said: "The generosity of public’s response to this disaster has continued to build, despite the mood of financial uncertainty and strain currently gripping the country. "But the fact is, more than two weeks after the floods began, conditions are still worsening in Pakistan. Flood waters are continuing to swell and spread to more villages, more rain is expected and the threat of deadly disease outbreaks looms large. We are still very much dealing with an emergency situation." Just a couple of days ago, only a quarter of the aid pledged had been received, prompting the UN Secretary-General Ban Ki-moon to visit the country and urge foreign donors to speed up funding to avert more deaths.
Food rations and access to clean water have only been provided to around 700,000 survivors, according to the UN. Satellite image of the Indus River taken 14 August 2009 (NASA) Satellite image of Indus River 14 Aug 2009 (NASA) Satellite image of the Indus River taken 15 August 2010 (NASA) Satellite image of Indus River 15 Aug 2010 (NASA) Threat of cholera in Swat
Meanwhile, the UN has warned up to 3.5m children could be in danger of contracting deadly diseases carried through contaminated water and insects in a crisis which has affected the lives of at least a tenth of Pakistan’s 170m population.
The DEC today expressed grave concern over the threat of cholera in Pakistan’s Swat valley, warning that millions of people are at risk of potentially deadly water borne diseases. DEC Chief Executive Brendan Gormley said: "We are extremely concerned by reports of cholera in the Swat valley. The numbers reportedly affected so far appear to be small but cholera causes acute watery diarrhoea which allows it to spread very quickly in cramped, unhygienic conditions.
"Aid workers greatly fear cholera after a disaster because, without treatment, more than half those infected are likely to die. Cholera can be prevented by providing clean drinking water, good sanitation and rapid treatment of those affected.
"Our member agencies will be redoubling their efforts to improve the provision of clean water and sanitation to the huge number of people affected by the flooding. Any outbreaks of highly infectious diarrhoeal diseases need to be contained as quickly as possible in order to prevent further deaths."
What causes cholera and why is it so dangerous?
• Cholera is a bacterium that spreads through infected water or food.
• The disease causes acute watery diarrhoea, which can lead to life-threatening dehydration within hours.
• Patients can lose up to 10 litres of fluid a day.
• Where people are living in cramped, unsanitary conditions without proper toilets or clean drinking water, the disease can spread incredibly quickly.
• The incubation period is very short which means people start to become ill very quickly after being infected.
• People with low immunity, such as malnourished children, are at greater risk of contracting the disease and succumbing to it.
• If cholera takes hold in an already vulnerable population it can kill up to 50-60 per cent of those infected if they do not receive prompt treatment.
How can cholera be prevented?
• Adequate sanitation – ensuring toilets don’t leak and are a safe distance from drinking water sources.
• Delivery of safe drinking water.
• Good food and personal hygiene.
• Chlorination of contaminated water sources where possible.
• Public health education and promotion.
• Oral vaccines are also available but are not the best first line of defence against the spread of cholera during an emergency.
How is cholera treated?
• Speed of treatment is the key to survival. If cholera is treated quickly and effectively, the mortality rate is less than 1 per cent, but if left untreated the rate can jump to 50-60 per cent.
• Most cases can be easily treated with Oral Rehydration salts, costing just three pence per sachet.
• Intravenous drips can be used to rehydrate patients in the most extreme case.
• Antibiotics can also be used but are not necessary for most patients so long as they are receiving rehydration treatment.
According to the DEC millions of people are struggling without access to safe water nearly three weeks after the floods struck. Merlin, a member agency of the DEC, has reported a significant rise in cases of acute watery diarrhoea in the worst affected areas, particularly in young children.
In some areas up to 20 per cent of patients are affected.
Linda Doull, director of health and policy at Merlin, said: "If left untreated, the rapid loss of fluids caused by acute watery diarrhoea, such as with cholera, can prove fatal within hours.
"We need to ensure patients have access to medical staff, that enough diarrhoea treatment units are set up swiftly and that the delivery of safe water is made an absolute priority.
"Most cholera cases can be effectively and easily treated with oral rehydration salts, costing just three pence per sachet."
UN officials say there have been 86,000 suspected cases of acute watery diarrhoea reported so far. Acute watery diarrhoea is one of the main symptoms of cholera although it can also be caused by other water borne diseases.
Hundreds of villages are isolated, highways and bridges have been cut in half by floods and hundreds of thousands of cattle, which support the livelyhoods of many villagers, have drowned.
The UN food and agriculture organisation says Pakistan could face further food shortages if its farmers miss the sowing season which is due to start next month.
Public anger has raged in the two weeks of floods, adding more political pressure onto the shoulders of President Asif Ali Zardari and his government – which is a major ally to the US in the war against Islamist militancy.
Highways were blocked by some Pakistani flood victims in a demand for government help and villagers in Sindh have clashed with police with batons as opposition leader Nawaz Sharif tried to distribute aid relief yesterday.