Following a report on the race to prevent more deaths in the aftermath of the earthquake in Pakistan, two experts discuss the ongoing relief efforts.

Background


Discussion

KATIE RAZZALL: They survived the earthquake, but their plight is desperate. Ten days on, nearly a third of Pakistan's injured still haven't been reached by doctors. And when nightfall comes, with temperatures already close to freezing, they're left with very little shelter. The U.N.'s relief agency, OCHA, and the International Federation of Red Cross and Red Crescent Societies both say they've been given only a fraction of the money they need. It's an unusually slow response to a disaster they say.

More than 40,000 people died in the earthquake; more than that will die through the winter if supplies don't reach them. The most pressing need is for winterized tents.

WOMAN (Translated): I need a good tent. My children are sleeping here on just a carpet. We don't have a tent and we're living in the open.

KATIE RAZZALL: The U.N. says it needs half a million cold weather tents. Thirty-six thousand have already reached Pakistan. Just over half have been distributed so far. Another 220,000 are in the pipeline, of which 100,000 will come from the Pakistan government. Agencies are hoping they'll source more, but they still estimate a massive shortfall.

LIAQAT HUSSAIN, Deputy Commissioner, Muzaffarabad: As the winter is setting in, our top priority and our most basic demand is the tents and the blankets and then the food comes.

KATIE RAZZALL: Part of the problem is that the world simply doesn't have enough winter tents to shelter the three million who've been made homeless on both sides of the Kashmiri line of control. Agencies have been desperately contacting tent suppliers across the globe. Then there's the remoteness of this region -- half a million people still haven't been reached at all.

CHRIS McDONALD, World Vision: Physically getting those tents to people has proven difficult. In some of the areas, there aren't even any roads, you know they're very small tracts. One thing the World Vision has been doing is to get tents and other equipment by donkey to people up in the mountains, and even with some people carrying them on their shoulders.

KATIE RAZZALL: The lucky ones, if you can call them that, are being airlifted to hospitals. So many of the injured are children and far too many, after more than a week of inadequate medical care, will lose limbs.

BOB McKERROW, Head of Delegation, International Federation of the Red Cross: Some of the people -- patients are requiring amputations, they have got advanced gangrene. We have a Red Cross hospital in Islamabad; we have only have got 100 people there but a lot of them are kids who have had feet amputated, legs amputated. One little boy this morning said, "I lost my leg, my mother, my father, I want to go back to the grave and cry on it."

KATIE RAZZALL: The scale of the suffering is immense, but for some reason, perhaps disaster fatigue, perhaps geographical distance, the money pledged isn't matching what's needed. But the people here could be dependent on aid, say the agencies, for the next six months -- a long and difficult operation because of the lack of infrastructure and the rugged terrain. They say money is urgently needed and the international community must find it to save lives.

RAY SUAREZ: For more on the aid effort, we go to: Iqbal Noor Ali, chief executive officer of the Aga Khan Foundation USA. The foundation works with the poor in Asia, Africa and the Middle East. Mr. Noor Ali was born and raised in Pakistan and is now a U.S. citizen. And Nicolas de Torrente is executive director of the U.S. branch of Doctors Without Borders. The organization has 100 staffers working now in Pakistan.

RAY SUAREZ: And, Nicholas de Torrente, maybe we could begin by hearing what your people are telling you from the frontlines. What progress has been made in getting people the help they need?

NICHOLAS DE TORRENTE: Well, as your report outlined, the scale of the devastation is really immense and catastrophic, and we're operating in particular in a very, very difficult terrain, mountainous areas with villages scattered in a large area in very, very harsh conditions, and that is making the relief effort very difficult.

And our teams are focusing -- first they focused on the referral areas in the low-lying areas in referral hospitals and treating a lot of injuries. And they've been trying and struggling to get out into the villages but have only, as your report said, have only reached a fraction of the people in need. And that is a very major concern that -- you know, hundreds of thousands ever people, perhaps, have still not received any assistance, are trapped in the mountains and cannot be reached -- have not been reached by the aid effort so far.

When we are able to reach villages -- and we have gotten by foot and by helicopter to some of them -- what is very striking is the extent of the damage and devastation of the houses and the number of injured people with severe wounds, fractures, spinal injuries on the one hand -- so requiring a lot of care -- and lacerations and infected wounds on the other, so a lot of injured people and our teams have seen hundreds of them.

Again, they've only seen a fraction. That's the major emergency medical need at the moment, and it's very massive indeed. The second big need, also alluded to in your report, is shelter. People are out in the open. It's very cold. It's mountainous. It's windy. It's been raining. They've lost their homes. And they're sleeping out in the open or under corrugated iron - they don't have -- they've retrieved some clothing, you know, clothing from the rubble and are -- and that is, again, they're exposed to the elements, and we've already seen people -- children die of hypothermia, and we're -- there's a very big risk here of further aggravation because of the lack of shelter in these harsh conditions.

RAY SUAREZ: Iqbal Noor Ali, I know that the Aga Khan Foundation is trying to get what help it can to these villages. Let's break it down to its essence. There was a lot of emphasis in our report from the field on the shortage of tents --

IQBAL NOOR ALI: Yes.

RAY SUAREZ: -- and how people are trying to locate tents.

IQBAL NOOR ALI: Right.

RAY SUAREZ: And we saw one family in particular, Zawar Jan, saying that after ten days, she's still sleeping out in the open. How does a tent get from wherever it is in the world to this woman in a hill village in northern Pakistan? Walk us through the process, how you would find her, and how the tent would get there.

IQBAL NOOR ALI: Well, as your report said, and as my friend Nicholas said, it is very difficult to get. We have distributed about 1,000 tents now. The need is enormous. They way it gets there is we have some reserves. Our affiliate in the Aga Khan network that is providing the support is called Focus Humanitarian Assistance. They're a disaster preparedness, mitigation and prevention agency, so they had some stock. They've been trying to procure more. They've been looking as far afield as China and India and even Brazil and Egypt.

And I think it's a major challenge that every agency currently faces. Shelter is the number one need, followed by blankets and medical supplies and medical assistance. The scale of the disaster, as has been described, is enormous. Just reaching these people before winter's completely closed down the roads and any access is a major challenge.

We have four helicopters at our disposal that have been doing their best, despite the weather, running four sorties each a day trying to take relief goods to these people, food, medical assistance. We have 30 doctors in the area. UNHCR has set up now a medical facility in Muzaffarabad as a triage center, so they do triage there and bring the rest to Islamabad. It simply isn't enough. The remoteness of the area, the ruggedness of the area, for those of us who travel there, know under normal circumstances just how difficult it is.

So the need is enormous, and I hope what we are hearing about the lack of response is not long lasting because the need certainly is long lasting.

NICHOLAS DE TORRENTE: Well, I think that in the accessible areas, Muzaffarabad, sort of major towns in the lower lying areas, there is -- medical assistance is being organized, but under very harsh, difficult conditions. We have to also understand that many of the health facilities themselves have been destroyed. Two out of the three hospitals in Muzaffarabad have been destroyed, for instance, and that is posing a major problem.

So, you know, in these areas, yes, things are getting better. In the villages, I think still we have a major problem. Again, a lot of the villages have not been reached, and there there is very little help, if any, that has been made available to the population. So it's still very tough. And the transport issue is a big one because of course we -- even with our doctors, we can treat people and we can do dressings and we can do immediate first aid, but if they need an amputation, if they need more surgical care, they need to be brought to a referral facility, and there, the lack of helicopters, the lack of transport is posing a major problem because we cannot do surgery at a village level in a tent. That's just not possible.

RAY SUAREZ: Mr. Noor Ali, when the tsunami occurred around the Indian Ocean rim, the world seemed to open its pocketbooks.

IQBAL NOOR ALI: Yes.

RAY SUAREZ: Is something different happening this time? And if it is, why?

IQBAL NOOR ALI: I think perhaps it's just too many disasters, one following the other, but, you know, one doesn't control nature. These things happen. And unless we are prepared to step up to the plate now and help these people, as the report said, we'll lose many more lives in the aftermath of the earthquake than the earthquake itself has taken, which is big enough right now.

But even beyond that I think we also need to think about the multigenerational effect this is going to have on those poor families. So beyond the immediate relief we have to think about reconstruction and make a commitment to that because when a poor family loses its breadwinner, they've fallen back into poverty by several generations.

So this is going to be a long-term effect on that area which is important strategically, and in the part of the world that has been unstable. So bringing stability over the longer term is also going to be part of the challenge, as is the immediate challenge of saving lives and saving people who might otherwise die.

RAY SUAREZ: Very quickly before we close, Mr. de Torrente, Doctors Without Borders made worldwide headlines by asking people to slow down the contributions after the tsunami. Is it different this time?

NICHOLAS DE TORRENTE: Well, I think that the immediate emergency needs in the aftermath of this earthquake are bigger than they were in the aftermath of the tsunami -- the number of injured and fractured that we're seeing, injuries that we're seeing, the fact that the health facilities have been devastated -- the fact of the difficult terrain and inaccessibility. You know, we feel that the emergency needs here are greater.

So, you know, the key thing is to be able to give resources and efforts based on need. And that is what the -- in a way, the current system of funding international humanitarian aid is not providing. We've tried to take a step in that direction by asking people in the aftermath of the tsunami to stop giving and we've asked people to support our efforts overall so that we can respond to emergencies, even the ones who don't make media headlines, like the nutritional crisis in Niger or the ongoing situation in Darfur, you know, and to respond where the needs are, when they occur, and to not have to depend on the fluctuations of media interest or political attention and that's what's really needed. We need to fund emergencies on an ongoing basis, because they occur; they can strike at any time and occur wherever around the world.

RAY SUAREZ: Nicholas de Torrente, Iqbal Noor Ali, thank you, gentlemen both.