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Nutrition Information in Crisis Situations - Pakistan
NICS 16, March 2008
Heavy monsoon rains, exacerbated by Cyclone Yemyin in late June, led to
extensive flooding in Balochistan and Sindh provinces in July 2007. While
flooding in Balochistan was mostly caused by direct rainfall, the situation in
Sindh was more a result of intense pressure put on its irrigation system. Sindh
province's already poorly maintained system of canals and drains was overwhelmed
by the excess water run-off, leading to no fewer than 20 breaches. The rise of
water was relatively gradual and, as such, those living in flood areas were able
to evacuate to safer ground (AAH-US, 09/07).
AAH-US conducted a food security assessment in September 2007 and two
nutrition surveys in November 2007 to evaluate the effect of the flooding on the
populations of Kamber-Shahdadkot and Dadu districts, from where an estimated
100,000 persons (approximately 10% of the population) were forced to leave their
homes.
The food security assessment found that 71% of those displaced had either
already returned to their homes or anticipated returning home by the end of
October 2007. 89% of respondents identified agriculture as their primary source
of revenue. The majority of farmers lost most, if not all, of their rice crop to
the flooding and are anticipated to have inadequate food stores to last until
next year's harvest. A further 70% of people stated that they had already
reduced their daily food consumption as a direct result of the floods.
Most (86%) of the displaced benefited from some sort of initial food aid.
However, most common coping mechanisms identified were casual labor, the sale of
livestock and borrowing money, all of which will help in the short-term,
although the assessment recommends continued external support to flood victims
until at least the next harvest.
In November 2007, AAH-US carried out two surveys to assess the nutritional
status of children affected by the floods (AAH-US, 11/07). The prevalence of
malnutrition was found to be just above the emergency threshold in both surveys
(figure 10), while retrospective mortality rates were under control.
Figure 10 Prevalence of acute malnutrition and mortality rates, Sindh
province, Pakistan, October 2007 (AAH-US, 11/07)
NICS 10, August 2006
Three nutrition surveys were conducted in Battagram sub-district, Battagram
district and Balakot and Manshera sub-districts in Manshera district in May 2006
(AAH-US, 05/06). The results showed an average nutrition situation (figure 9),
comparable to the results of the survey conducted in December 2005 in Manshera
district (see NICS 9). Mortality rates were under control (figure 9). AAH-US has
closed its feeding centres due to low attendance.
Figure 9 Prevalence of acute malnutrition and mortality rates, Pakistan (AAH/US,
05/06)
NICS 9, May 2006
The October 2005 earthquake causes a tremendous number of deaths and major
destruction in eight districts of the North-West Frontier (NWFP) and Azad Jamud
and Kashmir (AJK) provinces (see NICS 8). Two months later, four nutrition
surveys were conducted. These were among non-displaced families in Mansehra
district; NWFP, displaced camps in NWFP; non-displaced families in Muzaffarabad
district, AJK; and IDP camps in AJK (UNICEF/WFP/WHO, 07/02/06). The surveys
showed average nutrition situations in IDP camps and in Muzaffarabad, while it
was more precarious in Manshera district (figure 13). Crude mortality rates
within the period between the earthquake and the survey were under control
(figure 13). About 70% of the families in Muzaffarabad received some of the food
basket commodities, while less than 40% of the families received them in
Manshera. This is in accordance with the targeting of food aid to the most
affected families, as the level of destruction in Muzaffarabad was greater than
in Manshera. However, the levels of acute malnutrition appeared higher in
Manshera than in Muzaffarabad. When the full food basket was taken into account,
only 50% in Muzaffarabad, and 26% in Manshera, respectively had received it. The
percentage was slightly higher in IDP camps, where 61.8% of the families in NWFP,
and 55.6% in AJK respectively, had received it. The winter was milder than
expected and there was no major medical emergency (MSF, 24/04/06). With the
spring, many displaced people returned home, either spontaneously or with
facilitation. As of mid-May, it was estimated that about 76% of the displaced
families had returned home (OCHA, 19/05/06), however, thousands of households
remained displaced. Aid efforts in Pakistan has recently shifted from relief to
recovery programmes (IRIN, 24/05/06).
Figure 13 Prevalence of acute malnutrition and crude mortality rate,
Pakistan, Decmber 2005 (UNICEF/WFP/WHO, 07/02/06)
NICS 8, January 2006
An earthquake occurred in Pakistan on 8 October 2005, causing major
destruction, about 73,000 deaths and 69,000 severely wounded (OCHA, 31/12/05).
Eight districts (Batagram, Manshera, Shanla, Muzzafarabad, Neelam Abbotabad,
Poonch and Kohistan) have been affected in North West Frontier province (NWFP)
and in Azad Jammu and Kashmir province (AJK) (see map) (UNICEF/WFP, 11/05).
Pakistan earthquake—affected areas and food insecure populations
Of the 5.5 m population, it is estimated that 3.2 to 3.5 m people were
affected, including 2.5 m homeless now living in tents or in transitional
shelters. About 187,000 people live in either the 470 spontaneous camps or the
30 planned ones. It is estimated that 2.5 m people are in need of food
assistance, which is provided by the government of Pakistan to 1.5 m people, by
WFP to 1 m people and by ICRC to 150,000. The area is highly mountainous, which
renders the delivery of aid difficult, especially for inhabitants residing at
higher elevations. Helicopters are often required. Winter and snow further
affects the population and hampers delivery of humanitarian assistance.
Contributions to the UN flash appeal are 56% of the US$ 550 m requested.
The priorities are to provide heating, to winterize tents and to improve
sanitation in camps (OCHA, 27/01/06). It seems that distribution of non-food
items, such as shelter materials has improved lately. The hundreds of
spontaneous camps of less than 50 tents seem to have received the least
attention so far.
An assessment conducted in late November showed that the food security of the
affected population is highly compromised, and will continue to be until at
least the end of 2006 (UNICEF/WFP, 11/05). About 30% of the rice crop and 75% of
the maize crop has been lost due to the earthquake. Moreover, many households
have missed the planting of winter wheat which is normally harvested in
June-August. They will have to wait until the next harvest of maize-rice in
October 2006. Livestock, which was also an important component of the
livelihood, has also been lost with 60% of the households having lost part of it
and 20% having lost all of it. The earthquake also resulted in a dramatic loss
of employment and income opportunities, which, in addition to higher food and
non-food prices, hampers access to food.
It seems that the nutrition situation was precarious before the crisis. To
our knowledge, no comprehensive data on the nutrition situation after the
earthquake was available.
NICS 3, August 2004
Chaghi district in Baloshistan province is a drought-prone area. The district
suffered an especially acute drought between 1999 and 2002, which led to a loss
of livestock and to poor crop production. Food distributions were carried out
during the period. Rains were better in 2003. About 60% of the population is
from the agro-pastoral group; 20% are tenant farmers; the others are landowners
(5-10%), or are involved in government work or in urban business.
A random-sampled nutrition survey was carried out in the district in March
2004 (Oxfam-GB, 03/04). The results showed a poor nutrition situation: the
prevalence of acute malnutrition was 8.3% (6.1-10.4), including 1.3% (0.8-2.0)
severe acute malnutrition. Crude and under-five mortality rates were below alert
thresholds and stood at 0.4/10,000/day and 0.8/10,000/day, respectively. Measles
vaccination and vitamin A distribution coverage were average: 70.4% and 84.6%,
respectively.
The nutrition situation seemed to have improved compared to August 2002, when
the rate of acute malnutrition was 15.9% (12.4-17.0), reflecting an improvement
in the availability of food and of peoples' access to it, although the
population is still vulnerable.
NICS 2, May 2004
Worrying situation in Badin District, Sindh province
After eight years of drought, Badin district experienced heavy rains and
floods during summer 2003. Hundred of deaths were reported, as well as a massive
loss of crops and livestock, and destruction of housing. About 75% of the
villages were estimated to have been affected. Most of the households have
increased their debts to rebuild their houses, re-stock and buy agricultural
inputs and food. Some families who have not been able to rebuild their houses
have been living in public buildings. Families have reduced their food intake
from two to three meals before the crisis to one meal at the time of the survey;
the quality of the meals has also deteriorated.
A random sampled nutrition survey was carried out in the six most affected
union councils of Badin district in February 2004 (ACF/F, 02/04). The survey
showed a worrying nutrition situation: 17.3 % (14.0-21.3) of the 6-59 month olds
were acutely malnourished, including 1.4% (0.6-3.2) who were severely
malnourished. This survey confirmed findings of previous assessments. The food
security situation is not likely to improve in the coming months as some fields
are still flooded and the population has estimated that less than 40% of the
fields will produce a crop in March 2004 (ACF-F, 11/03/04).
Recommendations
From the ACF-F survey:
- Investigate food security concerns of the population and possible
responses
- Address drinking water needs
- Treat acute malnutrition
- Improve hygiene practices
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