Most people in Punjab have returned to their places of origin three
months after devastating floods started to inundate large parts of
Pakistan. But many flood victims have found their houses destroyed
and now have to rebuild their livelihoods from scratch. Many have
lost all their belongings and savings and are now living in
makeshift shelters in the rubble or in the remains of their damaged
houses.

As winter sets in, the nights are getting cold, even in the
normally hot and humid Punjab. Growing numbers of people living in
damp, flood-damaged houses are contracting respiratory
illnesses.

"The most frequent diseases now are acute respiratory
infections," says IOM physician Dr. Mudassar Ban Abad. "We also
have a lot of patients with gastroenteritis, suspected malaria and
skin diseases," he adds.

 

Dr. Mudassar is working with a team of two doctors, two nurses and
two dispensers, who comprise IOM's mobile medical clinic in the
village of Muslim Chagara in Muzaffargarh district.

The doctors have set up their mobile surgery in a two-room
building provided by a villager. Outside, women with children and
elderly people queue to register.

"We receive around 120 patients per day for our medical mobile
service," says Dr. Mudassar. "We offer primary health care in rural
areas that have no clinic. The villagers often don't have the money
to pay for transport to the nearest doctor," he adds.

Tariq Hussain, a 16-year-old boy from a neighboring village, has
come to seek treatment for fever and body aches he's been suffering
for several days. He appears weakened and his eyes are glowing as
he waits for a doctor to examine him.

"He has had high fever since last week and we don't have a
doctor in our village," says his mother Hameed Mai. She decided to
bring Tariq for treatment here when the local imam announced that
the IOM doctors were coming to Muslim Chagara.

After a brief consultation, the IOM doctor sends the boy to the
adjacent room for a rapid malaria test.

Hameed says she stayed on a nearby hill with her family for
about a month when the water inundated their village. "We only had
our beds as shelter. Nothing else," she says. "The weather was
warm, so we survived. But my children had skin problems and
diarrhea." She says the family has since returned to their house,
which is severely damaged.

The line of patients queuing for treatment outside the surgery
is getting longer. While waiting, the people read health messages
posted on the walls. Colorful posters in Punjabi letters and images
inform women about hygiene and health during pregnancy and about
breast feeding. Other posters inform people about the prevention of
tuberculosis, diarrhea and respiratory infections.

Among the women queuing, many have come to see IOM's female
doctor, because they are suffering from gynecological problems.
Other people have come to get treatment for their chronic
diseases.

"We're happy to get the service on our doorstep," says Sadiq
Hussain, a 48-year-old father of 12, who has been suffering from a
stomach ulcer for the last five years.

The mobile medical service is part of an IOM rural health clinic
based in Muzaffargarh district. It is run by four doctors and
nurses, who provide outreach medical services to remote areas twice
a week, in close coordination with other aid organizations and the
district authorities.

"Our approach is to strengthen the health response of the
government of Pakistan," says Dr. Mudassar. "We don't establish any
parallel systems. We provide our human resources, vehicles and
medicines to complement the existing facilities," he adds.

The IOM health team has rented ambulances to allow
under-resourced local doctors to make hospital referrals.

Pakistan's public health system is very weak in most rural
areas. As in many South Asian developing countries, there is a
significant lack of qualified health personnel.

But Dr. Mudassar says he is hopeful that local health workers
who are now returning after the floods will take over IOM's rural
health clinics in the longer term.

"Our immediate problem is funding, because we only have the
resources to continue our work until the beginning of December. We
need to stay at least until the end of the winter in February. We
don't want to leave flood victims without primary health care
during this difficult time," he observes.

As new patients shuffle in to seek treatment from IOM's mobile
medical team, Tariq is done with the malaria test. The result is
negative. His mother, Hameed, is relieved.

"I'm happy to have these doctors here," she says. "You should
come on a regular basis. It's so helpful you come and give us
medicine for free."