US embassy cable - 05ISLAMABAD16073

UNCLAS SECTION 01 OF 07 ISLAMABAD 016073 
 
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 
 #7 
 
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Summary 
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1.  From October 22 to 23, a team of three Foreign Service 
nationals from USAID/Pakistan conducted an assessment in 
Muzaffarabad and several villages that were affected by the 
earthquake.  The team visited Muzaffarabad city, Shaeed 
Gali, Hasan Gali, Jabbi Haider Shah, Lamian Battian, and 
Gari Habibullah.  The team conducted assessments in the 
health, shelter, livelihoods, and education sectors.  End 
summary. 
 
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Current Situation 
-------------------- 
 
2.  The team met with Government of Pakistan (GOP) 
officials, including the Chief of the Education, Planning, 
and Development Department and the Additional Home Secretary 
for Azad Jammu and Kashmir (AJK) to discuss the current 
situation.  The team learned that the earthquake destroyed 
the majority of GOP buildings in Muzaffarabad, including 
civil secretariat buildings, district government offices, 
and the judicial complex.  The remaining buildings that are 
still standing have not been inspected or cleared and cannot 
be used unless they are assessed or repaired.  The majority 
of school buildings (primary, secondary, high, and 
university) are destroyed or completely damaged. 
 
3.  These GOP officials told the team that the GOP's Annual 
Development Plan (budget) is being reprioritized for 
earthquake relief.  The Asian Development Bank project has 
also been reprioritized for education.  U.N. liaison offices 
have been established in Muzaffarabad, but there is no AJK 
government-led coordination system in place. 
 
4.  The USAID team reported that the GOP sent out teams for 
assessments in areas that are accessible.  The North West 
Frontier Province (NWFP) provincial government is 
establishing teams that are going house to house in affected 
areas giving vouchers to affected residents.  The villagers 
must come to a main office to receive relief supplies that 
are listed on the voucher.  The team reported that planning 
for relief activities must take into account the access 
restrictions of different affected areas: easy access by 
main roads; medium access by main roads/jeep-able tracks, 
short walking tracks; and remote/no access by roads.  For 
local transportation to villages from the city center, 
porters with donkeys and small jeeps are available.  Due to 
the difficulty of access to some villages, the GOP is trying 
to bring people from higher altitude, inaccessible areas to 
lower, accessible areas for the winter. 
 
5.  The team met with residents in rural areas and most 
people are worried about shelter for the upcoming winter. 
Many residents in earthquake-affected areas are afraid to 
use structures that are partially damaged.  People are 
receiving emergency supplies, but not in adequate quantities 
and not in all locations.  People who are the least affected 
are receiving the most assistance as they are located closer 
to distribution points or are able-bodied. 
 
6.  The team reported that buildings constructed using stone 
masonry were the most affected in terms of damage.  Most 
houses in rural areas use stone, wood, and soil (for roofs). 
Those residents who are more affluent use cement blocks for 
walls.  Some residents have already started clearing up 
space and are thinking of temporary shelter for winter.  In 
terms of shelter, tents are not the only option, and the 
team believes that using tin sheets as well as tarpaulin 
sheets on structures is an option.  The team noted that in 
Muzaffarabad, there are between 1,500 and 2,000 masons who 
could be trained to assist with reconstruction. 
 
7.  The onset of winter is a problem as rains and snow in 
higher altitude villages will arrive soon.  However the team 
reports that major infrastructure damage occurred in areas 
that do not receive snow.  Many residents are sleeping 
outside in school spaces as the spaces around their houses 
are full of debris.  The team reported that residents seem 
eager to participate in a cash-for-work program for 
rebuilding damaged houses or rubble removal. 
 
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Shelter 
------------------ 
 
8.  Tents or temporary shelter are the major concern of all 
affected residents.  Most of the rural residents located in 
accessible villages, near roads, and in areas where snowfall 
is not heavy do not want to move away from their land.  Some 
have animals and stored food but no shelter and are sleeping 
outside. 
 
9.  Other residents in rural areas have already started 
clearing space and are thinking about reconstruction but are 
constrained by lack of resources.  These residents have 
requested iron/tin sheets for roofs as they feel that even a 
tent will not be sufficient after snowfall, and they want to 
build a temporary room for the winter. 
 
10.  The USAID/DART is working with USAID/Pakistan to re- 
establish schools using tents from the U.S. Department of 
Defense (DOD).  DOD Seabees are also engaged in large rubble 
removal and the USAID/DART is supporting cash-for-work 
activities for hand rubble removal and site preparation 
removal.  These emergency interventions will lay the 
groundwork for some of USAID/Pakistan's longer-term 
reconstruction initiatives. 
 
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Livelihoods 
----------------- 
 
11.  According to the team, most community members in 
affected areas, especially young men who were day laborers 
in various businesses, are out of jobs and need a source of 
income.  This is an immediate requirement as many adults and 
young people who worked in hotels, garages, transport, and 
daily labor are currently unemployed.  Some options for cash 
for work include debris removal, restoring sanitation 
facilities, and reconstruction activities. 
 
12.  Women in rural areas assist in managing households, 
rearing cattle, collecting firewood, bringing water etc. 
They are dependent on men for the receipt of relief 
supplies.  Women who have lost husbands and have young 
children are now dependent on communities for support.  The 
team believes that creative ways can be used to get them 
involved in some sort of economic or reconstruction 
activity.  The team suggested that widows could be included 
as educators in tent schools as some surviving teachers may 
not be able to return to the schools due to injuries or 
migration.  Educated women may be able to be employed in 
health and education activities. 
 
13.  Cash-for-work or commodities-for-work will be an 
important activity.  Cash alone might be an issue, as the 
cost of commodities rise.  Muzaffarabad has manpower and 
skilled labor for construction, but they will need training 
for quality construction in case new design or materials are 
introduced. In rural areas, immediate reconstruction of 
houses may be possible but not in urban areas. Removal of 
debris is an important issue in urban areas.  The GOP plans 
to build camps in accessible areas, and a center for 
orphaned children and widows is expected to be built in 
Muzaffarabad and Mirpur. 
 
14.  The team also reported that Muzaffarabad has two other 
population groups, in addition to the majority of local 
residents.  There is a population of approximately 25,000 
refugees from border areas of India and a similar number of 
migrant laborers.  These groups are recipients of relief 
assistance and will also provide labor for reconstruction 
and rehabilitation. 
 
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Education 
------------------- 
 
15.  The team reported that both the old and new campuses of 
the University of AJK were completely destroyed in 
Muzaffarabad.  There are some buildings on the new campus 
that are still standing, but they have cracks.  The 
buildings will have to be assessed by experts. It is 
estimated that 250 students died.  Eighty percent of the 
student population was from the neighboring districts of 
AJK. 
 
16.  Almost all the degree and inter-colleges have also been 
severely damaged.  The reconstruction of the University of 
AJK is critical as this is the only university serving the 
region. 
 
17.  Tent schools are an immediate requirement in rural 
areas and in some parts of the city to bring normalcy to the 
lives of children affected by the earthquake.  Almost 80 
percent of schools have been damaged completely and require 
rubble removal for site clearance.  All community members 
agreed that it is important to re-establish schools and 
involve children in some constructive activity that will 
assist them in getting over the trauma of the earthquake. 
 
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Health 
---------------- 
 
18.  According to the team, the buildings of the Combined 
Military Hospital (CMH), the largest tertiary care hospital, 
run by the Pakistani military through an agreement with the 
Government of AJK, have completely collapsed.  According to 
the Commanding Officer (CO) of the CMH, the earthquake 
killed approximately 80 percent of the hospital staff. 
 
19.  The CMH was a 450-bed hospital with a staff of 350. 
Two-thirds of the staff was from the Pakistani military, and 
the rest were from the Government of AJK.  The hospital also 
had a large training institute for paramedics.  The team 
reported that all equipment has been destroyed, and medical 
assistance is being provided in the existing premises by the 
French Military Hospital Camp.  There were no facilities 
nearby to refer complicated cases, until the U.S. Mobile 
army surgical hospital (MASH) opened on October 25. 
 
20.  The Department of Health in Muzaffarabad has 
effectively ceased to function as most staff are direct or 
indirect victims of the disaster and are not reporting for 
duty.  Medical and surgical field teams report 2,000 
patients are being treated daily in Muzaffarabad.  The first 
three days after the earthquake, most patients were treated 
for trauma injuries. Currently, about 40 percent of patients 
are being treated for trauma, and the rest have acute 
respiratory infections. 
 
21.  The team heard that approximately 50 people are being 
operated on each day at Abbas Institute of Medical Sciences 
(AIMS), which is designated as the principal hospital in 
Muzaffarabad.  The infrastructure at the Abbas hospital is 
intact, but it is not fully functional.  Surgical services 
have been re-established with four operation theaters for 
general and orthopedic surgeons.  The Pakistani military 
will transfer people and supplies to this hospital.  Abbas 
hospital has also established a vaccination service.  A 
dialysis unit is being set up in the next few days to 
prevent renal complications from crush injuries.  Three 
vaccination centers and mobile teams have been established 
in Muzaffarabad (in the central camp, stadium camp, and 
Neelum Stadium) to vaccinate people against measles and 
tetanus. 
 
22.  According to statistics provided to the team by the 
Government of AJK, prior to the earthquake, there were 564 
health facilities in AJK and NWFP, and the earthquake 
destroyed 291, partially damaged 74, and 199 health 
facilities are currently operational. 
 
CROCKER