Category: International

Pakistan floods: measuring the misery of survivors

Pakistan-old-man queuing for relief goods

How do you measure misery? It’s a question that makes me uncomfortable although the fact is my job involves portraying the suffering of survivors of disasters. The more successful I am at this the more I help raise money to alleviate some of their pain. But with Pakistan I feel I have failed.

Last month, I got a chance to ditch my day job as a writer and actually go to Pakistan to help with the distribution of food and other relief goods. I also managed to post a few blogs and photos while I was out there. But since I got back I’ve been slightly dismayed by the general perception of the situation, as time and again people have said to me: ‘How was Pakistan? It doesn’t seem as bad as Haiti.’

Ambroise outside his home in Haiti

Don’t get me wrong, I know the people in Haiti are suffering, especially with this latest cholera outbreak. Earlier this year I met many survivors, including 19-year-old Ambroise whose mother died in the earthquake. He now lives alone in a house made of scraps of wood and metal. I can’t even begin to imagine how I would cope if I were in his situation.

Through our Haiti Earthquake Appeal we raised more than £10 million, money which is much needed and will help with the overwhelming recovery and reconstruction process which will take years.

But with Pakistan we have only raised around £4 million. Now that’s not an amount to be sniffed at and of course we are so grateful to everyone who has donated, but the problem is, it’s not enough. The needs are huge. To put it in perspective the number of people displaced by Haiti’s quake was around 1.3 million, whereas the number of people affected by the Pakistan floods is more than 20 million.

Of course a shocking number of people died in Haiti (200,000) and the images of the capital city reduced to rubble made it easy for us to comprehend the utter devastation and desperate needs of survivors. But in Pakistan, the floods which killed around 2,000 people, are so vast and spread across the country it’s difficult to get a clear picture of the true extent of the disaster.


As winter approaches, the emergency in Pakistan is far from over. Malnutrition rates have risen to 14 per cent and an estimated 30-50 per cent of children arriving at health facilities have shown symptoms of acute malnutrition.

Because of the destruction, people simply have no way to feed themselves – it will be almost a year before many farmers can bring in another harvest. That means people are going to go hungry unless we continue to help them.

I’d like you to put yourself in one person’s shoes. Please read Manthar’s story and, if it moves you, perhaps you would consider making a donation to our Pakistan Floods Appeal.

Photo © Sarah Oughton/BRC

Haiti: saving lives amidst the cholera outbreak

Mandy-with-kids in Haiti

Mandy George, a Red Cross delegate in Haiti, gives a first-hand report on the developing cholera situation:

Tears roll down a young mother’s face as she rocks her child in her arms outside the Red Cross cholera observation centre in La Piste camp, Port-au-Prince. “My baby, my baby, my baby is sick,” she cries. A Red Cross volunteer asks her when the child fell ill and what his symptoms are. She decides that he is sick enough to be admitted and tells the mother to bring her baby into the observation centre to receive treatment.

The British Red Cross, along with other health care partners, set up the centre as soon as cholera became a threat in Haiti. “We were hoping for the best – not to see cholera in Port-au-Prince – but we were preparing for the worst,” says Borry Jatta, BRC hygiene promotion manager. “This camp is home to at least 50,000 people and is one of the largest in Port-au-Prince. We knew that if cholera came to the city, it would most likely come to La Piste.”

Kids-in-Haiti-cholera observation centre

The preparation has paid off: at least 45 people with cholera-like symptoms have been admitted to the centre in the past three days and the centre is well staffed and able to cope with the volume of patients. It is divided into two parts; one is for those needing oral rehydration that they can simply drink, with most people sleeping off the worst of their sickness. The other area is for the more serious cases where patients have already become so dehydrated that they need IV treatment. Red Cross volunteers regularly patrol the centre spraying chlorine to disinfect the floor, beds, buckets and walls.

Widdine, 9, has lived with her family in La Piste since the earthquake. She was brought into the centre by her father in the middle of the night. “It was so fortunate that we could come here,” he explains. “Widdine had been vomiting and loosing fluids through diarrhoea for a couple of hours. I had already heard about cholera from the Red Cross and thought she might have it. So I brought her here and they helped her to rehydrate and looked after her. Slowly she has improved.” Widdine even manages a smile as she gets ready to go home to her shelter on the other side of the camp.

“Making sure people are aware of the symptoms is critical,” explains Borry. “People do not have to die from cholera, but they need to get treatment fast. That is why the British Red Cross has been working since the first cholera case in Haiti to drill these messages into the heads of camp residents, and let them know that they can come to us for help if they need it. Fortunately we have been able to catch quite a few cases early and save their lives.”

Others are not so fortunate. A two year old baby boy lies limp in his mothers arm. Nurses insert an IV drip. His eyes roll back, white and red, without even enough energy to keep his eyes closed. These most severe cases are sent to a nearby cholera treatment centre where they can receive more acute medical help. The parents are helped by Red Cross volunteers to load their two sick children into a waiting ambulance.

“We are afraid,” says Widinne’s father. “We are afraid to sleep in a house since the earthquake. We are afraid because we try to make a living any way we can to take care of our families, but it is hard. We are afraid because of cholera. But we are also lucky because we have somewhere we can get help. I thank God that my little girl is going to be OK.”

Find out more about how we are helping people in Haiti

Photo 1 credit: Severine Vanel/IFRC

Photo 2 credit: Mandy George/BRC

Haiti: fighting cholera in the capital

Mandy-with-kids in Haiti

Mandy George, our communications delegate in Haiti, reports back on the developing cholera situation in the aftermath of Hurricane Tomas:

Tomas was kind to us. The potentially crippling hurricane passed us by without unleashing its full fury on this already devastated nation. The mood that followed was a relieved anti-climax of the finest variety. The streets were deserted, an eerie calm prevailed over the city. There was some damage, and a handful of people lost their lives, proof of the vulnerability of so many to a tropical storm. Many of the camps in Port-au-Prince spent a couple of days very muddy, and minor repairs were needed to some shelters. The disaster preparedness measures that the British Red Cross had put in place seem to have been very effective – canals drained excess water away, sandbags prevented them from flooding, people were able to protect their most valuable documents from the water. So lucky. “God decided to be kind to us,” one lady told me.

And so yesterday, my heart was heavy, a great sadness descended on me, to find out that we are facing an extremely serious situation that we were desperately hoping to avoid, though realistically it was unlikely. Cholera has come to La Piste camp, home to at least 50,000, where the British Red Cross has been working since the earthquake. Yesterday alone, we saw 20 cases of people showing cholera-like symptoms, although results from the laboratory will take some time to come back. But we all know what it is. Fortunately, we have been expecting the worst, while hoping for the best, so we were, and are prepared to deal with this.

The British Red Cross cholera observation centre kicked into action, referring the most serious cases to a cholera treatment centre, and treating less severe patients with IV drips and oral rehydration treatment. All ten beds quickly filled up, and today we have seen another 15 cases. Not all come from the camp: the word has travelled and we have seen people from outside coming to the centre to seek assistance. It is going to be a busy time. So far things have been running smoothly and are under control, but this is obviously a very worrying series of events. And so, we have plans to step up our activities in the camp as much as possible, continuing with the critical job of spreading hygiene messages to keep people safe, setting up chlorination points where people can sterilise their buckets to collect treated water in safe containers, and reinforcing our latrine cleaning teams to make sure that we have dedicated people from the community on duty all day long. The cleaner the camp, the safer the camp.

As the children play around La Piste, singing their little songs about hand washing, I feel a sense of relief that at least they have some support here, at least we can do something. Seriously concerning, are those parts of Port-au-Prince where there is no sanitation at all. I recently visited an area with no toilets, just the canal. “Well, we used to have toilets, but they were just a hole over the canal,” one resident told me. Cholera in that area could spread like wild fire.

And so it is one disaster after another, but that is why we are here, so we are all trying to muster up as much strength as we can to keep fighting to keep this new threat at bay, and deeply hoping that many more do not lose their lives in the face of this most recent crisis.

Find out more about our work in Haiti

Photo 1 credit: Severine Vanel/IFRC

Photo 2 credit: Talia Frenkel/American Red Cross

Haiti: waiting for Hurricane Tomas to hit


Mandy-with-kids in Haiti

Mandy George is one of our delegates currently based in Haiti and she has just sent this report:

There is an air of anticipation over Port-au-Prince this morning. Hurricane Tomas is just to the South West of us, currently hitting the Haitian coastline and is predicted to move north and have the worst impact on Port-au-Prince this afternoon. It’s already pouring with rain and the wind is picking up. The rain is so heavy it sounds like hail thumping the roof where the British Red Cross team is sheltering.

It’s just a waiting game now. Red Cross preparedness teams have done all they can over the past two days,  furiously taking advantage of the last few hours of calm yesterday to help people prepare for the storm: lining canals with sandbags to stop flooding, clearing drains, securing tents with ropes, blasting advice from sound trucks going around the camps, emergency first aid training for dealing with the most common injuries.

We all have to been back at our apartments in ‘hibernation’ since 2pm yesterday… waiting until we can get back out there to assess the damage and help people recover from the storm. Even if we only get heavy rain in Port-au-Prince, there are still going to be a lot of people that need our assistance. We have Red Cross response teams ready to go as soon as the weather eases up, and we have enough emergency stock in country for up to 17,000 families.

I have lots of food and water and am fortunate enough to have a solid building to shelter in. But for the people in the camps – I dread to think what they are going to go through. At least we will be here to respond afterwards…

It is a strange feeling to know that a disaster is coming, in stark contrast to the earthquake that had no prior warning. It is also interesting to compare public attitude towards a disaster here in Haiti to the UK or the US. Back at home people would be madly preparing, emptying store shelves of food and water and the media would be whipping the public into even more of a frenzy.

From conversations with residents of La Piste camp yesterday, many of them do not necessarily realise the potential severity of this storm, despite being used to hurricanes. Maybe it’s just that they have already been through so much, maybe it is lack of information. That is why we have drastically stepped up our preparedness information campaign over the last 48 hours, along with practical disaster risk reduction activities. At least for this disaster we have been able to do something to prepare.

As for me, I’m trying to decide what is more scary: the ground shaking on a regular basis or the anticipation of major winds and rain as I tape up my windows with masking tape. And as for the cholera epidemic…

More about the cholera epidemic

The urgent need to stop the spread of cholera in Haiti


Guest post from Alyson Lewis, head of the British Red Cross health advisory team .

Vibrio cholerae (courtesy Wikipedia)

After every major natural disaster that robs communities of their homes and forces people into conditions without clean water or toilets, fears of further deaths through disease are immediate.

Whatever the cause, be it storm, flood, or as in Haiti’s case an earthquake, the combination of having no access to clean water coupled with unsanitary conditions – where human waste can mix with water people have no choice but to drink – creates a fearsome breeding ground for disease.

While there is a vast array of possible health threats, top billing for potential outbreaks amongst those hit by a disaster is almost exclusively reserved for cholera.

But just why is this disease so feared?

A tiny bacteria, cholera causes extreme diarrhoea and vomiting.

Initial symptoms are stomach pains, quickly evolving into diarrhoea that becomes rapidly worse, eventually producing what is colloquially known as ‘rice water’ – pale, watery faeces which literary pours out of the body.

Patients can lose up to 10 litres of fluid in a single day and, untreated, the dehydration brought on by cholera can kill within 24 hours.

It is an unimaginably horrible way to die, and anybody who has witnessed the disease at first hand is unlikely to ever forget it.

On top of this, in places where conditions are ripe, cholera’s transmission can be terrifyingly prolific.

In the last year, an outbreak in Zimbabwe resulted in almost 100,000 cases in a little over six months and more than 4,000 deaths.

Passed on through dirty water, when bacteria from the faeces of a sufferer finds its way into drinking water, or through food, if people don’t thoroughly wash their hands after going to the toilet, the potential for the disease to breakout and claim lives in the wake of a disaster is huge.

Credit: Talia Frenkel/American Red Cross

But paradoxically, for such a formidable disease, treatment is simple.

Rehydration with clean water, salt and sugar should be enough to save someone’s life.

IV fluids can help in more advanced cases, and antibiotics can shorten the length of the disease, but straightforward rehydration is the major tool.

Treatment alone, however, is unsustainable without tackling the root cause of an outbreak.

In virtually every case, this is a lack of access to clean water and clean toilets, and a lack of hygiene.

Since the earthquake in Haiti, agencies have been working continuously to minimize the threat of cholera and other waterborne diseases.

Every day, the Red Cross trucks 2.4 million litres of clean water to more than 300,000 people living in camps in Port-au-Prince, and has built more than 2,500 latrines, serving almost a quarter of a million people.

There have also been mass hygiene promotion programmes reaching tens of thousands of people living in camps.

That cholera has not raised its head before is in no small part to the massive international aid effort.

In response to the current situation, the Red Cross has already sent vital medical supplies to the main hospital in Saint Marc, in the affected area, and is trucking tens-of-thousands of litres of clean water, along with chlorine, to help stop further transmission of the disease.

Red Cross teams have also been reaching people with hygiene information, including through mass SMS messaging.

All of these are effective, common sense emergency steps, just as the nine months of water distributions and latrine construction and servicing, have been sensible, effective measures to prevent an outbreak.

Longer term, are the issues of development and reconstruction.

Pre-earthquake, sanitation in Haiti was already some of the worst in the world – last year, the UN reported that less than half of people in Port-au-Prince had access to clean water and only around a third had access to adequate sanitation. The earthquake has only made things worse.

To prevent cholera and other diseases being a constant threat, permanent infrastructure needs to be put in place, but this is long-term recovery which will take years.

Right now, the Red Cross will continue its work, delivering lifesaving help to those in need and desperately working to protect communities from outbreaks of disease.

Read more: Red Cross responds as health concerns grow

This week's headlines


Some of the headlines that have caught our attention this week.

As usual, these links may contain views and opinions with which the British Red Cross might not necessarily agree with nor endorse.

138 dead after cholera outbreak in Haiti – CNN

Haitian Health Ministry officials have informed the World Health Organization that 138 deaths are a part of a fast-moving cholera outbreak north of Port-au-Prince, a U.N. official said.

Asylum seekers may have to pay towards cost of appeals – The Scotsman

Asylum seekers and migrants who want to appeal against decisions made against them will be charged under new plans.


David Cameron was last night forced to defend the Government’s massive hike in overseas aid while slashing public spending in Britain.

Typhoon Megi heads for China after striking Philippines – BBC

Typhoon Megi was the strongest to hit the Philippines for several years and caused significant damage, tearing the roofs off houses and cutting power. It has now passed over the main island, Luzon, and is heading towards the southern coast of China.

Big increase in drunken 10-year-olds who need an ambulance – Evening Standard

London Ambulance Service figures today reveal that the number of 10- and 11-year-olds requiring medical treatment for alcohol abuse has more than doubled in the past two years.

In the news this week


Starting today, we’ll be doing a weekly roundup of some of the headlines that have caught our attention over the past 7 days. They all relate to our core areas of work – emergency response, first aid, refugee services, volunteering, and resilience – but they don’t necessarily reflect our own views on the subjects covered.

Feel free to leave your own thoughts on these topics in the comments.

Pakistan flood damage at $9.5 bln

“Pakistan’s recent floods inflicted $9.5 billion in damage to property, crops and infrastructure, according to an Asian Development Bank and World Bank assessment, Finance Ministry officials said on Wednesday.”

Senegal takes in Haitian student refugees

“It is one of Africa’s poorest countries, with simmering discontent over power cuts and unemployment with nearly half the population living in poverty. But Senegal has made good on a promise to give free homes and education to a group of Haitian students who lost everything in January’s devastating earthquake.”

Global hunger index: see how the world compares

“Is global hunger getting worse? According to the 2010 Global Hunger Index (GHI), published by the International Food Policy Research Institute (IFPRI), in many countries nothing has changed over the last decade.”

7/7 bombs acts of ‘merciless savagery’, inquests told

“The 52 victims of the 7 July 2005 bombings were “murdered” in acts of “merciless savagery”, the inquests into their deaths has heard.”

Child asylum-seekers targeted in Home Office budget cuts

“Thousands of child asylum-seekers are to be removed from Britain under savage budget cuts being drawn up by the Home Office ahead of this week’s comprehensive spending review.”

We will need ‘2 Earths’ to sustain our lifestyle

“Our take up of food, land, natural minerals and animals has doubled in under 50 years, says new research.”

International Day for Disaster Reduction 2010

“This year a number of major disasters have captivated the attention of the public and media: the January earthquake in Haiti, the massive earthquake in Chile one month later, the summer heatwave and wildfires in Russia and months of continued flooding in Pakistan.”

The British Red Cross is neither responsible for, nor endorses, the content of external websites.

Pakistan floods: from writer to relief worker


Last week I was writing about our Pakistan Floods Appeal from my desk in London and this week I find myself deployed to help with the distribution of emergency relief in Sindh province – this job is never dull!

A young man in Pakistan carries a box of relief itemsWhen the floods began in the north of the country in July the International Federation of Red Cross and Red Crescent Societies responded quickly, co-ordinating the emergency response with Red Cross National Societies around the world. A number of emergency response units (ERU) were deployed immediately to help with the distribution of food, tarpaulins, blankets and other items as well as to provide medical attention and clean water.

Over the last couple of months as the floods continued south and the disaster has grown (now affecting huge swathes of the country and one in eight people), more emergency response units have been deployed, including the British Red Cross logistics ERU.

Early on, the Finnish and Danish Red Cross set up a warehouse in Mardan, Khyber Pukhtoonkhwa province from which they continue to distribute emergency relief items to people affected in the mountainous north.

Last month, the British Red Cross set up two warehouses in the south of the country – one in Multan, Punjab province and one even further south in Sukkur, Sindh province. After working flat out to get the warehouses up and running the four member team has been reaching up to 14,000 households a week with food parcels and other emergency items. Each household has approximately seven people.

The first team has now returned and a second team is now in place – which is where I come in. I am replacing Kate Thomas – who has been blogging about her role in responding to the floods over the past month on Posterous.

Like Kate, my role will be to keep on top of what emergency relief items we are expecting to be delivered. This means tracking every movement of every aid item from the moment it arrives in the country by sea or air, it’s transport to our warehouse and finally delivery to the people who so desperately need it.

Hundreds of boxes of relief itemsTracking the goods is vital so that the rest of my team can keep the flow of aid smooth. The challenges when dealing with such huge quanities of stock include making sure there’s enough room in the warehouse when it needs to be delivered and stored and enough trucks, time and people to load the aid when it needs be distributed.

It may sound strange that the Red Cross has sent me – as someone who works in communications – to help with the delivery of relief, but it’s not quite as random as it sounds!

I also have a background in the operational side of the Red Cross’ work and I have undergone the training necessary to join our logistics emergency response unit. In 2006, I was deployed to Indonesia after an earthquake in Yogyakarta and in 2007 I worked in the Maldives on the tsunami recovery programme.

So, today, I’m in Islamabad being briefed about the operation and tomorrow I will go to Sukkur. I am here for three weeks and I know it’s going to be busy as already the plans are to ramp up our distributions to double the amount. But after sitting in London writing about the floods for the last couple of months it feels good to be here and to get stuck into the emergency operation.

Although the floodwaters are beginning to recede in most areas, the emergency is far from over. Millions of people have lost everything and desperately need ongoing support with food, clean water and healthcare.

So much land has been damaged and it’s unlikely it will be fit for the next planting season, which is fast approaching.

Although the Pakistan Red Crescent, with support from the Red Cross/Red Crescent Movement, has already reached more than one million people with emergency food and other aid, this support will be needed for months to come.

If you want to keep up to date with the work we’re doing in Pakistan, I’ll be uploading photos and blogging on our emergencies blog.

Images © Olav Saltbones/IFRC