US embassy cable - 05ISLAMABAD15766

UNCLAS SECTION 01 OF 08 ISLAMABAD 015766 
 
SIPDIS 
 
STATE ALSO PASS TO USAID 
USAID/W FOR A/AID ANDREW NATSIOS, JBRAUSE 
DCHA/OFDA KISAACS, GGOTTLIEB, MMARX, RTHAYER, BDEEMER 
AID/W FOR DCHA/OFDA 
SOUTH ASIA RESPONSE MANAGEMENT TEAM 
SOUTH ASIA EARTHQUAKE TASK FORCE 
DCHA/FFP FOR LAUREN LANDIS 
ANE DEPUTY ASSISTANT ADMINISTRATOR MARK WARD 
BANGKOK FOR OFDA SENIOR REGIONAL ADVISOR TOM DOLAN 
KATHMANDU FOR OFDA REGIONAL ADVISOR WILLIAM BERGER 
ROME PASS FODAG 
GENEVA FOR RMA AND NKYLOH 
NSC FOR JMELINE 
EUCOM FOR POLA/J3/J4/J5 
BRUSSELS FOR USAID PLERNER 
NEW YORK FOR TMALY 
SECDEF FOR SOLIC/PKHA, USDP/J3 
JOINT STAFF WASHINGTON DC FOR J3/J4/J5 
HQ USEUCOM VAIHINGEN GE FOR J3/J5 
 
 
E.O. 12958: N/A 
TAGS: EAID, AEMR, ASEC, MASS, ECON, KMDR, KPAO, OIIP, OPRC, PGOV, PREL, PK, Earthquake, Earthquake: USAID/DART Situation Report 
SUBJECT: PAKISTAN - EARTHQUAKE:  USAID/DART SITUATION REPORT 
3 
 
 
------- 
SUMMARY 
------- 
 
1.  The Government of Pakistan (GOP) estimates that the 
earthquake killed 41,121 people and injured 67,634 others, 
and these numbers are likely to increase.  The 
USAID/Disaster Assistance Response Team (USAID/DART) reports 
that the GOP has made a credible effort to respond to the 
earthquake given the difficult circumstances, and relief 
activities are moving at a much faster pace than the 
USAID/DART has observed during other disasters.  Too many 
non-governmental organizations (NGOs) are operating in easy 
to reach places, and humanitarian agencies involved in the 
response are concerned that too much humanitarian assistance 
will be provided in these areas, while the more remote areas 
will continue to be neglected.  The U.N. World Health 
Organization (WHO) reports that water purification plants, 
chlorine tablets and/or water treatment sachets, tents, 
blankets, and mobile operation theaters are the most urgent 
health needs.  The International Organization for Migration 
(IOM) estimates that between 300,000 and 600,000 winterized 
tents are necessary.  To date, approximately 20,000 tents 
from the international community have been distributed, and 
130,000 tents are in the pipeline.  The GOP reports that 
100,000 tents have been distributed, and 150,000 tents are 
in the GOP pipeline, but this has not been confirmed.  End 
summary. 
 
------------ 
Health 
------------ 
 
2.  On October 16, the USAID/DART Health Officer (HO) 
attended the health cluster meeting.  The USAID/DART HO 
reported that the International Rescue Committee (IRC) is 
setting up a 200-bed hospital and equipment in Abbottabad 
and has excess surgical equipment.  IOM reported that there 
is an urgent need for paramedics, doctors, and volunteers in 
Muzaffarabad.  Meeting participants expressed concern about 
reports from Mansehra indicating that blood is being 
transfused without adequate screening. 
 
3.  The Pakistani military has established a 100 to 200-bed 
triage hospital at Chaklala airbase to admit patients 
directly on arrival.  The Pakistani Ministry of Health (MOH) 
will decide where to send the patients after treatment. 
 
4.  The GOP will be opening up 10,000 hospital beds 
throughout the country within the next few days.  The MOH 
reported that at least 50,000 people are in need of hospital 
care and have not yet received any medical care. The 
Pakistani military plans to send a field hospital to the 
Neelum Valley. 
 
5.  According to WHO, the lack of basic necessities such as 
food, water, blankets, and tents is also affecting health 
workers in the field.  The previously existing health system 
no longer exists as many health facilities have been 
destroyed or damaged, and health staff are either highly 
traumatized, injured, dead or taking care of their own 
family members. 
 
6.  WHO reported that medical and surgical teams are 
treating thousands of patients per day, and patients are now 
arriving with infected open fractures and gangrene.  WHO 
expects that the lack of clean drinking water and sanitation 
facilities for the affected population could soon create a 
major health threat if sufficient quantities of drinking 
water are not provided.  WHO reported that the major risks 
are diarrheal and pulmonary diseases and the non-treatment 
of injuries of earthquake victims. 
 
7.  On October 17, the health cluster reported that urgent 
surgical requirements include both surgical supplies and 
anti-tetanus globulin.  Additional referral sites are being 
established in Sindh and Punjab.  WHO reported that the 
urgent health needs are water purification plants, chlorine 
tablets and/or water treatment sachets, tents, blankets, and 
mobile operation theaters. 
 
--------------------- 
Water and Sanitation 
--------------------- 
 
8.  On October 17, the U.N. Liaison Officer (LO) attended 
the water and sanitation meeting and reported that while the 
situation is reportedly improving, it is still serious.  It 
has been estimated that less than 20 percent of the critical 
water and sanitation needs have been met.  The water and 
sanitation cluster reported that there are more than two 
million people lacking sanitation facilities.  The 
priorities are to obtain adequate and safe drinking water, 
sanitary disposal of excreta, and ensure basic hygiene. 
 
------------- 
Food 
------------- 
 
9.  Food distributions have started in Muzaffarabad.  The 
food cluster reports that 67,400 people in 29 villages in 
the Muzaffarabad area have been supplied with high energy 
biscuits from 19 distribution points.  A second round of 
distributions will start shortly.  The food cluster reports 
that 100 metric tons (MT) have been delivered to the 
Muzaffarabad area as of October 16. 
 
10.  On October 17, a U.S. Embassy/Pakistan representative 
attended the food and nutrition cluster meeting.  The U.N. 
World Food Program (WFP) reported that a revised flash 
appeal will be announced on October 24.  WFP is still 
attempting to assess areas that were affected by the 
earthquake.  WFP will conduct an aerial reconnaissance in 
the next two days to determine which roads were damaged and 
what areas are accessible.  WFP will also try to assess the 
migration patterns of people.  From the current migration 
patterns, there is already an assumption that there will be 
two outcomes regarding food distributions:  large camps for 
people where food will be needed and food will have to be 
transported to inaccessible and remote areas. 
 
11.  WFP is examining transporting food from Muzaffarabad to 
more remote areas for distribution.  WFP is also trying to 
determine the following:  the amount of food in country, 
what additional food is coming into the country, percentage 
of affected areas needing food, and how much food is 
required to assist affected areas.  WFP's goal is to assist 
the one million most vulnerable people.  Currently, the 
ration requirements are: 450 grams of wheat flour, 70 grams 
of vegetable oil, 5 grams of iodized salt, 200 grams of high 
energy biscuits, and 80 grams of dates. 
 
--------------- 
Shelter 
--------------- 
 
12.  The U.N. High Commissioner for Refugees (UNHCR) 
continues to report that tents are the top priority, and IOM 
reported that the immediate need for shelter is becoming 
more critical as survivors continue to live outdoors in the 
rain and the cold nine days after the earthquake.  At the 
October 17 shelter meeting, IOM provided tentative figures 
and estimated that between 300,000 and 600,000 winterized 
tents or non-tent shelters would be required.  To date, 
approximately 20,000 tents from the international community 
have been distributed, and 130,000 tents are in the 
pipeline, including tents on the way and those on order that 
may not arrive until November.  The GOP reports that 100,000 
tents have been distributed, and 150,000 tents are in the 
GOP pipeline, but this has not been confirmed.  Urgent 
shelter needs exist in Bagh, Balakot, Mansehra, and 
Batagram.  All tents must be winterized.  According to the 
GOP, 600,000 tents are needed to support a vulnerable 
population of 3,000,000 affected residents.  The critical 
window for the delivery of tents is the next four weeks, as 
the weather will then worsen. 
 
13.  Although UNHCR would prefer to support spontaneous 
settlements, the GOP is pressuring UNHCR to establish large 
camps.  UNHCR is now working in five different locations, 
and the cluster reported that earthquake victims are now 
coming to UNHCR camps sites to obtain supplies and are then 
returning to their home sites.  This leads UNHCR to believe 
that the problem is one of distribution rather than the need 
for camps. 
 
----------------------- 
Camp Management 
----------------------- 
 
14.  At the camp management cluster meeting on October 17, 
participants agreed that the goals of the camp management 
cluster are to avoid displacement by providing shelter and 
emergency relief items to people near their homes; provide 
assistance to informal settlements as a means of preventing 
the need for larger camps; establish camps only when 
necessary and keep them as small as possible; when 
necessary, provide technical assistance to camps established 
by others; and aim to adhere to Sphere standards.  The 
United Kingdom's Department for International Development 
(DFID) noted that in four weeks, the weather will change and 
there will be heavy snowfall. 
 
------------------- 
Protection 
------------------- 
 
15.  The GOP is enforcing a quote No-Adoption end quote 
policy for the immediate future.  The GOP is also placing 
orphans in camps with relatives.  Children are currently not 
being registered as they are evacuated from hospitals. 
Assessments are being conducted at local hospitals to 
identify the number of children not registered. 
 
-------------- 
Logistics 
-------------- 
 
16.  According to the USAID/DART, the military side of the 
airport is functioning efficiently; however, one of the 
major problems is the logjam at the civilian airport, as 
there are many pallets whose contents and owners are 
unknown.  The logistics cluster group meeting reported that 
a mapping system is needed for the distribution network. 
The USAID/DART Team Leader reported that the USAID/DART 
continues to work with military colleagues to coordinate the 
offloading and distribution of relief commodities.  For 
extremely large amounts of commodities, the USAID/DART has 
recommended that the military link with the U.N. Joint 
Logistics Center (UNJLC) and /or the Pakistani military to 
arrange delivery.  The UNJLC is in the process of setting up 
a presence at the airport. 
 
------------------- 
Relief commodities 
------------------- 
 
17.  On October 15, the USAID/DART Administrative Officer 
and the USAID/DART Public Affairs Officer flew by Chinook 
with the U.S. military to deliver a pallet of 225 blankets 
and water containers to Mercy Corps in the village of Jabori 
in the Sonar Valley.  After delivering the blankets and 
water containers, the team flew to Balakot to transport 
women and children needing additional medical treatment to 
Islamabad. 
 
18.  On October 16, 17, 18, three USAID airlifts of relief 
commodities carrying tents arrived in Pakistan.  A total of 
1,570 tents will be provided to Mercy Corps and transported 
to the Mansehra region to be distributed between the Battal 
and Siran valleys.  The value of this assistance including 
transport is USD 471,436. 
 
19.  On October 18, a USAID airlift of 20 concrete cutting 
saws arrived in Pakistan.  The value of assistance, 
including transport, is USD 64,617. 
 
20.  On October 18, two USAID airlifts of relief commodities 
arrived in Pakistan.  The two airlifts carried a total of 
650 rolls of plastic sheeting, 5,000 blankets, and 5,000 
water containers.  The total value of this assistance, 
including transport, is USD 301,750. 
 
------------- 
Coordination 
------------- 
 
21.  On October 17, the USAID/DART Team Leader met with 
representatives from DFID's Conflict and Humanitarian 
Affairs Department (DFID CHAD) and the European Commission's 
Humanitarian Aid Department's Disaster Preparedness Program 
(DIPECHO) to discuss the coordination of relief efforts and 
develop a comprehensive response strategy between the three 
organizations. 
 
22.   The USAID/DART reports that the GOP has made a 
credible effort to respond to the earthquake given the 
difficult circumstances, and relief activities are moving at 
a much faster pace than has been observed by the USAID/DART 
in other major disasters.  Although there are many problems, 
the USAID/DART expects to see an improvement in coordination 
as the GOP moves from a tactical to a more 
strategic mode. 
 
 
CROCKER