UNICEF's emergency response in Pakistan
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UNICEF is working with UN agencies and other international and local humanitarian organizations to support the North-West Frontier Province (NWFP) government in providing basic services to families in IDP (Internally Displaced Person) camps and host communities. UNICEF leads clusters/sectors in nutrition, water and sanitation and education, as well as the child protection sub-cluster while providing significant operational support to health sector interventions such as measles and polio vaccinations.
With the total number of displaced estimated to be two million—Pakistan now hosts the greatest number of displaced persons since its formation.
What is the current situation in Pakistan?
What are the key issues in providing assistance?
What is UNICEF doing to help children who still remain in areas affected by conflict?
What are the future needs of IDPs?
Q: What is the current situation in Pakistan?
Since August 2008,conflict between militants and government troops in Pakistan's Federally Administered Tribal Areas (FATA) and Swat District of the North-West Frontier Province (NWFP), as well as sectarian conflict in some areas, has led to the displacement of thousands of families. This displacement increased dramatically over the last three weeks, with an additional one and a half million people being displaced as a result of increased fighting between the Pakistan Army and militants in the Malakand division of NWFP.
Of the current estimated total of two million displaced people—about 220,000 live in 22 camps, including several newly established sites, and the remaining with host families and in rented accommodation.
Of these, over 556,000 people were displaced by the end of April 2009—before the recent crisis broke out—and were accommodated in 11 IDP (Internally Displaced Person) camps and host communities. However the new phase of military operations which followed has displaced over one and a half million people from Swat, Buner, Lower Dir and Shangla Districts.
Q: What are the key issues in providing assistance?
The new military operations have substantially increased displacement to nearly twice the expected caseload by May 2009. As government forces temporarily lifted curfews in affected areas of Swat, Lower Dir, Buner and Shangla, thousands of civilians fled in the course of a few hours. Since existing camps are already at full capacity, it is essential to ensure that the new camps can accommodate and provide all essential services to the IDPs.
In many cases, families are divided as some members—often adult men—stay to protect their property. Many women and children from a conservative tribal society have to learn to access information and services for the first time, and thus need culturally appropriate support. Literacy rates are very low, at only seven percent amongst women and girls above ten years of age in FATA, and those children who are enrolled have had their schooling interrupted by conflict. Only 16 percent of girls were attending primary school in Bajaur before the conflict. This suggests that IDP camps also provide an opportunity to enrol thousands of children, especially girls, in school for the first time, and provide information to once unreached women.
It is also important that humanitarian assistance be extended as soon as the security situation allows to populations still trapped in the conflict areas of Malakand division. UNICEF's humanitarian action is framed by recently adopted inter–agency 'Basic Operating Rules' (BOR) that provide guidance to humanitarian organisations to enhance their ability to access and assist persons affected by armed conflict, in accordance with well-established and recognised humanitarian principles and in a manner respectful of local culture and traditions
UNICEF has now almost exhausted its contingency stocks of supplies and funding for activities. We urgently require additional resources from donors to expand our support to IDP children and women.
Q: What has UNICEF done so far?
UNICEF's mandate includes Education, Heath and Nutrition, Water, Environment and Sanitation (WES), and Child Protection. Under the cluster approach, UNICEF, the government and other partners collaborate to plan and target initiatives most effectively. UNICEF leads the Education, Nutrition and WES clusters, as well as the Child Protection sub–cluster.
Health:
UNICEF supports actions to improve child and maternal survival and wellbeing and prevent the spread of disease amongst women and children in IDP camps and host communities. Key activities include ensuring that women and children have access to services and routine immunisation (EPI), and appropriate information on good health practices, and health workers are appropriately trained.
- Three fully equipped maternal and child healthcare centres have been established, and have provided comprehensive health services to over 25,000 people. They also provide antenatal and postnatal care.
- In an ongoing vaccination campaign, over 37,000 children have been vaccinated against measles and 8,000 have received vitamin A supplements. Polio vaccinations have been provided to 15,000 children.
- Social mobilisers have been deployed to provide health education.
- UNICEF helps train healthcare providers working in IDP camps in behaviour change communication, integrated management of childhood and neonatal diseases and disease early warning.
- One hundred Lady Health Workers have also been trained in health education in camps. The community health workers have been helped to establish health corners and educate pregnant and lactating mothers in the old IDP camps.
Nutrition:
UNICEF leads the nutrition cluster which aims to ensure that all mothers and children in IDP camps and host communities receive appropriate nutrition for their age and needs, and that those suffering from malnutrition receive supplemental food or treatment. Families affected by conflict are especially vulnerable to inadequate nutrition, especially with food prices increasing by 22 percent in the area. Nutrition initiatives listed here are those for IDPs displaced before late April 2009.
- Over 31,000 children aged 6–59 months and 13,000 pregnant or nursing women have been screened for acute malnutrition.
- About 4,200 moderately malnourished children and 1,800 pregnant or nursing women are registered in the supplementary feeding programme and provided with the fortified food (Unimix) and 731 severely malnourished children in the outpatient therapeutic programme where they receive the therapeutic food (PlumpyNut).Over 200 government and NGO staff were trained in Community Management of Acute Malnutrition (CMAM).
Water, Environment and Sanitation:
As cluster lead for water, environment and sanitation, UNICEF works with development partners and Government authorities to ensure that IDPs are protected from disease through the provision of safe and hygienic sanitation and bathing facilities as well as safe drinking water. Hygiene education is regularly provided.
- UNICEF is providing safe drinking water to 112,000 people in 11 camps, including 33,000 people in five new camps and 79,000 in six old camps. Latrines and bathing sites to accommodate these numbers have also been constructed, and hygiene education supplemented with hygiene kits provided.
Education:
UNICEF leads the education cluster to ensure that IDP children can continue their primary education in a safe and supportive environment. Camp schools also provide a unique opportunity to enrol children who have never attended school in their conservative tribal region: FATA, where Bajaur Agency is located, has a literacy rate of only seven per cent for women and girls above the age of ten. Efforts to repair schools in host communities are also essential where the presence of IDPs had damaged school infrastructure.
- In total, UNICEF supports 24 primary schools in 13 camps with a total enrolment of 8,400 including 2,900 girls. This figure includes seven primary schools in four new camps, with an enrolment of 1,700 children.
- UNICEF has successfully advocated for 61 schools in five districts to be opened for second shifts, accommodating 4,400 children.
Child Protection:
Supporting children affected by conflict is one of UNICEF's key tasks. As co–chair of the child protection sub cluster, UNICEF coordinates efforts to identify and register especially vulnerable children, such as those who have been separated from their families, and provide them with services. It reaches out to children and women, through door–to–door visits and child friendly spaces in which to relax, learn, play and receive psychosocial support.
- In total 29 child-friendly spaces are functional in 13 IDP camps, benefiting 12,750 children. Here children have a space to play and learn, and benefit from psychosocial support from trained female psychologists and child participation facilitators. Of these, three are in new camps and benefit 2,400 children.
- Over 1,100 separated children have been identified and assisted, as well as 3,300 vulnerable families including those headed by children or women.
- Field staff visit tents to identify women and children with symptoms of stress, anxiety or other effects of their experience. To date, 2,500 children (half of them girls) and 1,100 women have received counseling in all camps, many in their own tents.
- An effective monitoring system has been established in all IDP camps.
Q: What is UNICEF doing to help children who still remain in areas affected by conflict?
While access is extremely limited or impossible in conflict areas, reports suggest that civilians there are severely affected. There are reports of casualties, restricted movement even for emergency health services, and devastated infrastructure. There are also concerns about a possible failure to protect civilians from hostilities by all parties. Curfews, which are lifted only briefly before major operations begin, have prevented some from leaving. Those who have left have, in some cases, had to pay high transportation costs or walk up to 50 miles. This affects children, especially separated or orphan children, most acutely.
UNICEF and other members of the humanitarian community are presently unable to access conflict affected areas, and are advocating for all parties to facilitate safe passage for civilians to leave unsafe areas.
Q: What are the future needs of IDPs?
Many of those displaced by the latest round of hostilities are arriving with few possessions and reporting high levels of trauma. UNICEF and its partners are thus prioritising immediate emergency services including shelter, safe water and sanitation, nutrition and health support. Most IDPs are moving into host communities whose own, often meagre, resources are strained especially in schools and hospitals. Security and access issues have also increased with the new round of hostilities, creating a difficult operating environment.
In the coming months, UNICEF's priority actions are to:
- Continue to provide and expand humanitarian assistance including health and nutrition, water and sanitation, education and child protection services to IDPs both in camps and in host communities.
- Negotiate humanitarian access into high–conflict areas like Swat, Bajaur and Mohmand which are presently out of bounds, to ensure service delivery for health and nutrition, education, water and sanitation and child protection services are restored in these areas.
After violence ceases and families are able to return, reconstruction and rehabilitation efforts will begin to rebuild communities, livelihoods, agriculture, and the hundreds of schools and medical facilities destroyed, as well as to ensure that children continue to take advantage of education and health facilities and use information on protection, hygiene and nutrition when they return home.
