The Internally Displaced Persons (IDPs) pose a serious threat to the economic and social sovereignty of Pakistan. Ironically speaking, neither of the two sovereignties is predominantly existent; for, by and large the economic sovereignty has long been usurped by donors through the instruments of Pakistani politicking. The social sovereignty is gradually being taken away by foreign media, bit by bit.
Whether IDPs relocate in Balochistan and Sindh or elsewhere, one heinous predicament among many others in the looming is the polio epidemic. Some twelve cases have been confirmed so far; however the residents of the Malakand division are extremely vulnerable to this polio outbreak. Despite hurdles, since October 2008 over 3, 77,000 children under five in Swat had been vaccinated while in September 2007 health workers had been desperately impeded in their campaigns. This patriotic notion of disrupting health workers triggered when Swat-based extremist Maulana Fazlullah (Maulana Radio) used an illegal FM transmitter to denounce polio vaccination reckoning it a western conspiracy breeding infertility among Muslims; nevertheless a frightening alarm! Earlier on not a single case had been reported in the valley since 2003. However, the stratagems of Fazlullah worked quite well and in January 2009 some 278 families in Upper Dir, including Dir town denied health workers. Thus between January and May this year, five polio cases have been reported from across the Frontier province.
Rat will play while the cat is away, the Fazlullah’s move has largely been undone and the counter-move is on. During these weeks health workers of the Global Polio Eradication Initiative have set forth nine transit points covering Malakand, Swabi and Mardan immunizing thereby 17,850 children. The Mobile health teams have also stepped to 26 IDP camps, immunizing almost 7,000 children last month. However, since polio affects non-immunized swiftly therefore every child can scarcely be rendered immunized. Therefore, up to 1.3 million children in the Frontier province would remain deprived. In Karachi alone 2, 17,000 children were left immunized during campaigns in April 2009. Sindh being house of polio outspread where there were five cases during 2005 had risen to 18 in 2008. The other part is the ‘undiagnosed’ children already infected with wild polio virus who would effectuate proliferation in IDP camps and elsewhere like as an analogy ‘poverty anywhere is threat everywhere’. The May 28-30 move accessed 33 million children nationwide which must anticipate another move. This calls for greater ‘sensitization’ and moral persuasion.
Coming back to IDPs, historically or histrionically we faced IDPs four times; in 1947, 1965, 1971 and 2005. As yet, the 3.4 million IDPs remain one of the largest displacements ever seen by the world. To Shakespeare, the problems come in battalions; first came drone attacks, then triggered Swat operation. To Shakespeare, Master, I marvel how fishes live in the sea. Why? As men do a-land, the great ones eat up the little ones); the heavenly fact which only time will unearth) and then came the IDPs. Concomitantly; IDPs’ food, health and safety issues are just haunting. As far health issue is concerned, plight is pathetic. Among the 3.4 million IDPs, massive 500,000 are the children under 5 years. According to UNFPA, there are 69,300 pregnant women, out of which 6,000 are expected to deliver within the next month. Some 900 of these women will require emergency obstetric care so as to handle pregnancy-related complications. Given that our mortality rate is 379 per 1, 00,000 which is high in the region and also that one pregnant woman is dying after every 30 minutes in Pakistan, hopes cannot be held high.
The Disease Early Warning System (DEWS) has received 61,174 consultation reports from IDP hosting districts of NWFP during the last week of May.
The data presented in these reports reveal that the leading causes of medical consultations have been acute upper respiratory tract infection which equals 23 % of the total consultations. The other major area of disease is acute diarrhea which gives 12 % on the whole and 22 % in case of children under 5. Yet, overcrowding of IDPs, contaminated water, poor sanitation, banal hygienic conditions, low vaccination coverage, degraded nutritional status and inadequate provision of healthcare unleash a startling risk of outbreak of communicable diseases. Though some 25 outbreaks have so far been registered and contained through the Disease Early Warning Systems, but a resource shortfall can seriously undo preventive measures which may redouble infant and child mortality rate among IDPs. The coming monsoon season is an obvious threat.
The health cluster consisting of WHO, Unicef, UNFPA and 19 NGOs has appealed for immediate funding of $37 million so as to arrange life-saving healthcare to IDP camps.
A request for immediate fueling has also been put forward in the revised Pakistan Humanitarian Response Plan (PHRP). It is supposed to provide and manage medicines, comprehensive Primary Health Care services, monitoring of the disease situation, health and hygiene promotion, testing of drinking water supplies and strengthening the secondary and tertiary level healthcare services; lest a humanitarian disaster spawns. On the other hand, the humanitarian community is not in a sound financial position. The $543 million which was requested through the PHRP on May 22, only 22 % had been funded and the health sector has received only 11% of the requested amount.
To conclude, the nation is reliving the poignancy of October 2005 earthquake. On one hand is the outspread of diseases, disasters, displacements and discomforts. On the other is helping hand, specifically the USA has allocated $ 310 million (which is more than half of the global support) and the government of Pakistan has committed Rs. 50 billion for the IDPs in the coming budget. This adds to our subservience to USA and to substance of fiscal deficit which would rise from 4.6 % to 5 %. In between the subservience and substance lies our national subsistence. ‘But man, proud man, dressed in a little brief authority, most ignorant of what he is most assured, his glassy essence like an angry ape, play such fantastic tricks before high heaven, as makes angels weep.’ (William Shakespeare)