Complex Emergencies

Bokhari, A. et al. (2013). Care-Plus Delivery of MNH Services in Conflict Areas of KP, Balochistan and FATA.SoSec Consulting.
This qualitative research study was undertaken both at the demand and supply sides of the governance equation. On the demand side, the research assesses the influence of patriarchal power dynamics operating at the household level on decision making with regard to accessing MNH services in conflict areas and identifying factors, which can be mitigated to bring about a change. On the supply side, the study explored the availability and utilisation of MNH services at various levels in the supply chain system, the quality of services, the attitude and behaviour of the providers and responsiveness to consumer needs. Interviews and focus groups were carried out in the conflict districts of Balochistan, KP and FATA. Terrorism and militancy have adversely affected the MNH services in these areas. During the attacks, the roads get blocked, public transport disappears and both the health providers and patients find it difficult to reach the health facilities. Thus, the study recommends organising local health committees to keep a bridge between the users and providers; institutionalising local transport system for timely evacuating emergency patients; expansion of community level MNH services providers and paying more for work in the security compromised areas.
http://www.rafpakistan.org/userfiles/FINALReportBook2.pdf

Warraich, H., Zaidi, A. K., & Patel, K. (2011). Floods in Pakistan: a public health crisis. Bulletin of the World Health Organization, 89(3), 236-237.
According to this note by the WHO, the impact of floods in terms of health deserves immediate attention. Resources and rescue efforts have been spread thin due to the war in the tribal areas. Furthermore, widespread mistrust of governmental agencies, primarily stemming from perceived corruption and mismanagement, has hindered donors and citizens from cooperating with governmental initiatives. Thus, there has been a dire need for a coordinated public response, particularly to control the outbreak of infectious diseases. Meanwhile,despite the availability and recommendation of an oral cholera vaccine for use in humanitarian emergencies by WHO,it has not been used in flood-affected areas due to perceived logistic difficulties in delivery. Thus, the note recommends the use of early disease outbreak through geographic information systems software such as Google Earth. It advocates preventing infectious disease transmission as the main focus of relief efforts. This means providing adequate hygiene and sanitation particularly in diarrhoeal disease prevention. It also emphasizes on the flood victims’ need for safe water and information about the benefits of maintaining hygienic practices.Mass vaccination for children against measles and cholera has also been emphasized.
http://www.scielosp.org/scielo.php?pid=S0042-96862011000300016&script=sci_arttext&tlng=pt