US embassy cable - 05ISLAMABAD16480

C O N F I D E N T I A L SECTION 01 OF 03 ISLAMABAD 016480 
 
SIPDIS 
 
DEPARTMENT PASS TO USAID 
 
E.O. 12958: DECL: 11/04/2015 
TAGS: EAID, MARR, MASS, PNAT, PREL, PK, Earthquake 
SUBJECT: PAKISTAN EARTHQUAKE RESPONSE: WHERE WE ARE AND 
WHERE WE'RE GOING 
 
1.  (U) Summary.  As we approach the one-month anniversary of 
the earthquake, post offers this overview of relief efforts 
to date and an assessment of key priorities for the future. 
The earthquake itself caused much more damage and loss of 
life than initially estimated, but the Pakistani and 
international response has generally been strong -- with the 
United States leading in most categories of assistance.  The 
humanitarian relief phase of the assistance effort began with 
clearing operations and the delivery of search and rescue 
teams, medical aid, food and shelter.  This phase is 
continuing with a heavy focus on preparation for harsh winter 
conditions and it will last at least until winter begins to 
subside at the end of March.  (We expect the November 19 
donors conference will set the agenda for the reconstruction 
phase of the donor response.)  In the immediate aftermath of 
the earthquake, the U.S. and international donors have 
focused on airlifting urgently needed supplies and equipment 
into the theater and onward by helicopter into the affected 
areas.  The need for air shipments into Pakistan will 
continue as we prepare for the onset of winter, but the need 
will diminish over time as NGOs and international 
organizations find more sustainable sources locally and in 
the region. The need for helicopter lift into quake-hit 
regions will continue at least through the winter.  End 
Summary. 
 
Earthquake Response to Date 
--------------------------- 
 
2.  (U) As more reliable numbers begin to emerge, the full 
impact of the 7.6 magnitude earthquake and the level of 
international response are becoming clear.  The GOP is now 
reporting 73,000 dead and 69,000 injured.  Press reports 
suggest that in some areas men are virtually the only 
survivors, as women and children were predominantly in homes 
or schools that collapsed. An estimated 2.8 million 
Pakistanis require shelter assistance.  The humanitarian 
response to the earthquake is a work in progress, but has for 
the most part been timely and effective.  The Pakistani 
military response has been especially impressive, and the GOP 
response structures have begun to coalesce.  Personnel on the 
ground are learning fast. 
 
3.  (U) The United States has been quick to respond and has 
played a very significant and visible role in earthquake 
recovery.  Six Navy ships have delivered 115 pieces of heavy 
equipment and 158 tons of humanitarian relief supplies from 
US, Egyptian, and Gulf State donations.  The USAF has run 
well over a hundred airlifts into Pakistan.  The US Army, 
Navy, and NAS have flown over 1,500 helicopter sorties into 
the north delivering more than 4.3 million pounds of goods. 
Thirty one U.S., and US funded, helicopters are flying relief 
missions.   Of the roughly 8,900 tons of relief supplies 
received by Pakistan by November 3, the U.S. accounts for 
some 4,100 tons (46 percent), dwarfing any other single 
donor.  US helicopters have delivered over 2,100 tons of 
relief supplies; the closest runner up among donors is the 
UK, with 182 tons (8 percent of the US total).  Even Pakistan 
(at 496 tons) has delivered less than a quarter of the U.S. 
total. 
 
4. (U) USAID has committed $41.8 million, with the focus on 
shelter, water and sanitation and other relief supplies. 
Military humanitarian assistance is at least $60 million thus 
far.  DoD has 933 deployed personnel to provide relief and 
reconstruction assistance and has established a Mobile Army 
Surgical Hospital (MASH) in Muzaffarabad.  To date, almost 
600 patients have been served, including 46 surgeries.  By 7 
November a U.S. Marine field hospital will be open in 
Mansehra.  The Embassy has established and staffed Forward 
Operating Bases in Muzaffarabad and Mansehra to help 
coordinate USG aid and assist Pakistani Authorities. 
 
Get Them Through The Winter 
--------------------------- 
 
5.  (U) The strategic objective of the current relief phase 
is to get the population of the affected area through the 
winter, until the end of March.  The key needs include 
shelter, blankets, food and medical supplies. 
 
6.  (U) Shelter: We estimate that 400,000 households will 
require some form of shelter assistance and at least 10,000 
large tents will be needed to house clinics, schoolrooms, 
offices and the like.  The GOP maintains that a combination 
of donor contributions, existing supplies and intensive 
domestic production will generate 500,000 tents by the end of 
November.  Assuming the GOP is correct and that the 
domestically manufactured tents are adequate, the unmet need 
will be for the larger tents, plus plastic sheeting to 
upgrade family tents as necessary.  However, we also expect 
that at least 60 percent of families will choose to stay at 
or near their existing (destroyed) homes, so the tents will 
need to be augmented by selected building materials to enable 
families to self-engineer a "warm dry room" during the 
winter.  These materials include plastic sheeting, corrugated 
metal roofs and stoves, fuel and household goods. 
 
7.  (U) Blankets: The GOP hopes to provide two blankets per 
person for an affected population numbering an estimated 3.3 
million (i.e., 6.6 million blankets).  Some 3.8 million 
blankets have been provided to date, leaving a gap of 2.8 
million. 
 
8.  (U) Food:  While there is not an immediate acute need for 
food, orders must be placed soon in order to ensure adequate 
supplies for the winter, particularly if a large population 
of refugees moves into the camps being established by the 
GOP.  The World Food Program estimates the food need at 
720,000 metric tons, enough to feed 2.8 million people for 6 
months.  As a net food importer, Pakistan will not be able to 
meet this incremental food need via domestic production; much 
of it will have to be shipped in. 
 
9.  (U) Other Supplies: Roughly 65 percent of the health 
infrastructure in the affected area has been destroyed.  Over 
the longer term, this infrastructure will have to be 
reconstructed, but there is an immediate need to replenish 
stocks of antibiotics and other drugs.  We will be ordering 
up to ten health kits (that can serve up to 10,000 people 
each for three months).  Other needed supplies include family 
hygiene kits, tool kits and cooking kits. 
 
An Evolving Relief Effort 
------------------------- 
 
10.  (U) The initial emergency phase of this humanitarian 
relief effort has required rapid delivery of supplies and, in 
many cases, direct execution of relief operations by U.S. and 
Pakistani military elements.  This emergency phase will last 
for at least another two weeks as we prepare for the onset of 
winter.  During this period, U.S. military airlift capacity 
will be urgently required for delivery to Pakistan of shelter 
materials, blankets, food and other supplies identified in 
paras 5-9. Over time, however, there will be a natural 
transition toward more cost effective and efficient sea-lift 
transport and delivery mechanisms as partner NGOs develop 
local sources for these goods.  Despite daily improvement in 
some road networks, medium helicopter lift will remain 
essential through the winter to deliver supplies from depots 
in Islamabad and elsewhere to remote areas in the north 
isolated by massive land-slides. 
 
Comment 
------- 
 
11.  (C) The quantity and timeliness of U.S. assistance is 
beginning to pay measurable dividends in terms of local 
perceptions of the United States in general and the U.S. 
military in particular.  English and Urdu press regularly 
carry pictures of U.S. helicopters and relief supplies as 
well as articles that credit the U.S. for its response.  In 
our judgment, U.S. actions have already had a measurable 
impact on perceptions among Pakistani Kashmiris and within 
the Pakistani military (most of whom have never had sustained 
contact with the U.S. military).  In view of what we have 
already invested, and the positive impact it has had, we will 
need to be careful as we approach the transition toward a 
more sustainable USG relief effort. It is essential that 
Pakistanis not see this transition as a lessening of U.S. 
commitment and we should seek to preserve the positive 
visibility our military has received. 
 
12.  (C) U.S. military assets -- including helicopter lift 
and medical units -- will continue to be needed in some 
amount through the winter for essential humanitarian reasons. 
We should also begin to consider whether there are aspects of 
the reconstruction phase the U.S. military could usefully 
participate in. The positive and benign aspect of the US 
military on display in Pakistan and throughout the region may 
offer a strategic opportunity for continued humanitarian 
activity as a major premise of military engagement over the 
next two years. 
CROCKER