The worst natural disaster in Pakistan’s history has affected 20 million people, equivalent to twice the Belgian population, destroyed 300,000 homes, killed 1,500 people and raised fears of an epidemic. The population is in desperate need of aid.

Handicap International has already supplied aid to 30,000 people since 1 August and is continuing its work on the ground. Three additional expatriate staff will shortly arrive in the region to support our 100-strong emergency response team. This team is currently working in the province of Khyber Pashtoun Khan (KPK), and particularly in the cities of Kohat and Mingora (Swat) and in rural areas.

Handicap International’s Emergency Response team is distributing drinking water in the northwest of the country, a key factor in preventing the spread of epidemics, in particular cholera. Handicap International is also repairing water supply systems - pumps and water reservoirs - destroyed by the flooding. The distribution of emergency packs enable families to process and store water, to wash and to cook. A clear-up project has also begun in the districts of Hangu, Swat and Kohat. Handicap International is involving local people in clearing away the waste and debris swept along by the floods, and removing stagnant water from towns, enabling the population to return to the area and limiting the spread of disease.

The organisation is planning to open an additional base in the district of Tank.
 

“Handicap International, like many other NGOs, has not received enough funding for its relief effort in Pakistan, and, without sufficient support, is not in a position to take all necessary action,” says Stéphane Lobjois, Handicap International’s head of mission in Pakistan.

Support Handicap International’s emergency projects in Pakistan with an online donation.

Handicap International is part of the Belgian consortium for emergency relief. See also www.1212.be. 

Handicap International in Pakistan
Handicap International has built up extensive expertise in crisis situations following its work in El Salvador and India (2001), Iran (2004), China (2008), Indonesia (2005 and 2009) and Haiti (2010), as well as Pakistan (2005 and 2009). The association therefore provides direct aid to the most severely affected victims. To ensure the most vulnerable, the elderly, pregnant women and people with disabilities are able to access responsive and sustainable aid, Handicap International is setting up local facilities - Disability and Vulnerability Focal Points - located close to population centres. These focal points help identify the most vulnerable and offer care, walking aids and emergency packs according to identified needs.

The situation in Pakistan has seriously deteriorated over the last week, with heavy rainfall worsening the flooding in the north-west and south of the country. The Pakistani government has recognised that it is facing a natural disaster on a far greater scale than the 2005 earthquake. The UN Office for the Coordination of Humanitarian Affairs (OCHA) estimates the number of victims at around 14 million in the provinces of Baluchistan, Khyber Paktunkhwa, Sind and Punjab. The disaster has so far claimed more than 1,500 lives and destroyed over 290,000 homes. “During a natural disaster like the one currently affecting Pakistan, you’re faced with an ongoing emergency”, explains Stéphane Lobjois, head of mission for Handicap International in Pakistan. “For the last 13 days we have experienced a highly critical situation in which the population’s suffering has shown no signs of abating and the situation is not improving.”

On 2 August, Handicap International decided to release €100,000 in general funds to ensure a swift response to the natural disaster.

Handicap International’s Emergency Response Department acted very quickly to organise the distribution of clean drinking water, a key factor in preventing the spread of epidemics, in particular cholera. Drinking water is still being distributed in the area. Handicap International is also helping people access water by repairing water supply systems (pumps) destroyed by the flooding.
The organisation has also begun distributing 7,000 kits*, enabling families to purify and store water, and to wash and cook.

A clean-up project has also begun in the districts of Hangu, Swat and Kohat. Handicap International is involving local people in clearing away the waste and debris swept along by the floods and removing stagnant water from towns, enabling the population to return to the area and limiting the spread of disease. This project should soon be extended to other areas.

Present in the country since the 2005 earthquake, Handicap International runs several projects in Pakistan and has launched two large-scale emergency operations in the past, most recently in 2009 when three million people fled fighting in the Swat Valley. The organisation was therefore already present in the regions affected by the flooding. Handicap International currently has a team of around 150 people on the ground.

* 3,000 hygiene packs (soap, towels, toothpaste, cotton wool, mosquito repellent, etc.); 3,000 water treatment and storage packs (bucket, jerrycan, glasses, etc.); 1,000 cooking packs (saucepans, plates, etc.)

A central role in the effective coordination of humanitarian aid

As part of the management of a logistics platform of 70 lorries, under the auspices of the World Food Programme (WFP), Handicap International has transported humanitarian aid for some one hundred organisations, including some fifteen Haitian structures.

On 26 January 2010, the UN and the WHO entrusted Handicap International and the German organisation Christoffel-Blindenmission (CBM) with jointly coordinating all rehabilitation actions for injured persons in Haiti, the fitting of orthopaedic devices and the provision of assistance to people with disabilities.   To achieve this, these two associations are working with the Haitian Ministry for Public Health and Population (MSPP) and the Secretariat of State for the Inclusion of People with Disabilities (SEIPH) and all other  stakeholders operating in these fields.

10,000 people already cared for by Handicap International

To date, more than 10,000 people have benefited from Handicap International’s health actions; over 55,000 rehabilitation sessions have been performed; 4,000 technical aids have been distributed (mobility aids and orthopaedic devices); almost 300 people have been or are in the process of being fitted with a prosthesis and almost 200 with an orthosis. Handicap International has also implemented psychosocial support actions concerning 13,000 people.

Over 13,000 tonnes of humanitarian aid transported since 14 January

Out of the total transported tonnage, 9,000 tonnes concerned food. More than 4,600 tents were distributed, providing shelter for 25,000 people. Lastly, more than 2,000 people took part in “cash for work” projects set up by Handicap International.

Three to five years needed to rise to the humanitarian challenge in Haiti

The association will gradually focus its actions on more long-term activities. The provision of liveable, hurricane- and earthquake-resistant temporary accommodation for isolated and vulnerable victims of the earthquake will constitute an important area of action.  We will continue to support and rehabilitate the injured while gradually focusing our attention on the most serious cases and people with disabilities. Next, Handicap International intends to develop its infrastructure rehabilitation and accessibility projects, disaster preparation and prevention activities, and diploma-based training for Haitian rehabilitation and orthopaedic-fitting staff. The underlying aim of these actions is to build the capacity of Haitians and to transfer the management of these projects to them over the long-term.

Dear Editor,
 
Through this letter we would like to draw attention to the challenge of road safety in modern Cambodia and on ways to reduce the tremendous burden caused by road crashes each year, which are often preventable.
 
Three main factors have contributed to the rapid increase of road crashes and fatalities in the last six years. Firstly, the improved quality of the road infrastructure has allowed for significantly higher travel speeds. Despite the modernization of Cambodia’s highway systems, families still living in very close proximity to these roads. As a result, children, cattle and other livestock are commonly seen crossing these roads without fear or concern for oncoming traffic.
 
Secondly, there has been and continues to be a tremendous growth of vehicles on the roads. The Ministry of Public Works and Transport estimates that the rate of increase of road users is over 20% per year. People are traveling more often, they are traveling for longer distances, they take more time to commute from home to work, and they conduct more inter-provincial trade and leisure activities.
 
A simple rule of road safety says that when more vehicles are interacting at a higher speed, the likelihood of a crash and the severity of the injury will be higher. Especially, when certain risk factors are involved!
 
Risk factors are the third main ingredient in Cambodia’s growing road safety problem. In Cambodia, the most problematic risk factors are speeding, drunk-driving, lack of protection in traffic, and disobedience of the traffic rules. Here are a few interesting, yet alarming facts concerning these risk factors in 2009:
 
Speeding: Along the Cambodian National Road network, speed-related fatalities are 50 % of all total crash fatalities.
 
Drunk driving: 87% of drunk-driving casualties are males
 
Lack of protection in traffic – 76% of all motorcycle fatalities are from head injuries, only 8% were wearing helmets at the time of the crash. Only 30% of four-wheel crash fatalities were wearing seatbelts. Pedestrian fatalities are an increasing trend throughout Cambodia.
 
Poor understanding or disobedience of the traffic rules: running red lights, going the wrong way down a street, using the left hand lane to make left turns, and not yielding to incoming traffic are dangerous behaviors, yet are daily occurrences.
 
One of Handicap International’s core aims in Cambodia is to work towards prevention of the 1717 yearly fatalities and 12538 crashes experienced in Cambodia last year.
 
This road safety problem can not be solved independently. Government, civil society, private sector and the general public all play a crucial role in addressing this very real human disaster. Every day 5 persons die on the roads in Cambodia. This is the highest figure in the ASEAN region. It is also calculated that road accidents cost Cambodian Society annually around 248 million USD. This figure includes the costs of hospitalization, damage on vehicles, and loss of earning capacity due to injury, permanent disability or death.
 
Unfortunately only an estimated 1 million USD per annum has been invested in promoting road safety and preventing road casualties and fatalities. This amount is definitely not enough to address the full scope of the road safety problem.
 
In order to significantly reduce the number of road crashes we will need to change the behavior of road users, traffic rules will need to be improved, laws will need to be strictly enforced and infrastructure will need to be adapted and improved. Through awareness campaigns, support to government, distribution of helmets and other interventions, Handicap International is a leader in the road safety sector in Cambodia. Another important tool for monitoring the situation of Road Safety in Cambodia is our Road Crash Victim Information System (RCVIS). Data analysis using the RCVIS System clearly shows us that as a sector we need to increase our efforts in order to make a lasting impact!
 
Socheata Sann
Program manager Road Safety Handicap International Belgium
 
Jeroen Stol
Country Director Handicap International Belgium

Ban Advocates from Afghanistan, Croatia, Ethiopia, Laos (PDR), Serbia and the USA, call on the non-signatory states present at the conference, including Argentina, Finland, Georgia, Nepal, Sudan, Tajikistan, Thailand, Turkey and Vietnam, to announce their clear intentions of joining the convention.  

They deplore in particular the absence of Brazil, Cambodia, Ethiopia and Serbia. Brazil has produced and stockpiled cluster munitions and is crucial to making Latin America free of cluster munitions. As a highly affected country, Cambodia knows the devastating effects of cluster munition use on families and on the development of the affected regions. Serbia hosted the Belgrade Conference of States Affected by Cluster Munitions from 3-4 October 2007 and followed the Oslo Process all along. These countries have not signed as yet.

“No reason can be found for not joining the Convention on Cluster Munitions, since civilians are the first victims of those unacceptable and illegal weapons”, says Aynelem Zenebe, who got injured during a cluster munitions strike on the Ayder School in Mekele, Ethiopia, when she was only six. She calls on her country as well as Brazil, Cambodia and Serbia to sign the treaty.
 
The Ban Advocates and Handicap International Belgium urge countries to ratify the Convention as soon as possible and to invest more in clearance and victim assistance activities in affected countries.  “The already poor communities affected by mines and cluster munitions very often just struggle to survive in an extremely difficult context”, says Bruno Leclercq, Head of the Policy Unit of Handicap International Belgium and former director of the Handicap International program in Cambodia. “The survivors as well as all persons with disabilities should have timely access to the services they need. They not only need urgent medical care but continuous medical follow up and rehabilitation. It is a lifelong investment the families, communities and governments have to take responsibility for and for which the international community has to provide the appropriate funding. I call on the donor states, present at the Santiago Conference, to continue investing in victim assistance programs and to coordinate more effectively with affected states to support the communities still suffering from the impact of cluster munitions.”   

At the Santiago Conference, states and civil society will start a dialogue on the implementation of the Convention on Cluster Munitions and on the Action Plan that will be adopted at the conference in Vientiane, Laos, to be held from 8-12 November 2010. “Only a clear Vientiane Action Plan will bring the most needed support to survivors”, says Mina Zunac, Ban Advocate from Croatia. “Affected communities and individuals should be involved in the planning of national victim assistance plans. For the benefit of all stakeholders, they should be the first ones to be consulted and kept involved in the implementation of victim assistance programs, before any decisions have been taken. Support has to be based on their needs. Therefore each country should undertake a comprehensive needs assessment. Without delay, the national governments should designate an actively functioning focal point with a clear mandate and authority for the coordination of victim assistance efforts. In coordination and even in monitoring, survivors have a particular role to play.”  

A group of 13 people who were injured and disabled following the Sichuan earthquake 2 years ago visited the Shanghai World Expo on the 12th of May (exactly 2 years after the earthquake). They have been receiving rehabilitation services through a project that Handicap International set up in Mian Zhu County, one of the most affected areas of the Sichuan earthquake. Their visit to Shanghai was financially supported by Sanofi Aventis. They are seen here in front of the French and Belgian/EU pavilion.

My name is Tsésan Djo. My hair is grey because I’ve lived through 80 long, hard winters.
 
7.50 a.m. The walls begin to tremble. At first, I don’t understand what’s happening. I look at my cup of tea, which has begun to dance and spill over; then Pema, at the doorway, begins to cry that we must get out of the house. Then I run as quickly as my old legs permit, but already the walls are cracking. As I am passing through the doorway, the wall caves in, breaking my arm, then a leg. I am blocked under a pile of bricks.
 
The quaking stops. It’s calm. I try in vain to extricate myself from beneath the bricks, but with the least movement there are horrible, shooting pains in my arm.
 
Pema, where are you …? I search for her with my eyes, but nothing is moving.
Pema …
 
There, finally, she gets up and approaches me. The blood running down the side of her face and on her hands worries me, but she says that it’s nothing, two scratches at the most … And, once again, she astonishes me with the strength that she harbours in the depth of her body when, with a single movement, she frees me and lifts me up.
 
We make our way, as best we can, towards the centre of the village when the first help arrives. Young men carry me towards what used to be the clinic. There is no longer not a single stone upon a stone; there is smoke; there is dust. And then there are cries coming out of the ruins. So I say to those helping me to leave me there, on the side, and go to help others … I’m hurting, but I’m intact!
 
The next day, they take me to the airport. I’m taken on the airplane to Xining (a town I know only by name) and the provincial hospital of Qignhai. Pema stays behind …. She was right, just “scratches”…
 
And so here I am in Xining. They’ve put metal pieces in my arm, then they told me to rest, that everything would be alright. There are young volunteers who take care of me day and night, nurses who check my wounds and a tchiké who nags me to do my exercises … Pema is fine. And so am I!

Recorded by Didier Demy, his Belgian physiotherapist

Having been a supporter of the organisation since the mid Nineties, Daithi Rua’s song “Vanna’s Blue laces” from his album Black Fox was written in direct tribute to the work of Handicap International and the blue shoe laces that they use as their emblem. Handicap International has been at the forefront of landmine clearance and victim rehabilitation on a global scale for many years. The organisation managed to get many countries to sign agreements to stop the manufacture of landmines they most recently have managed to ban cluster bombs also.

In particular it is a tribute to a Cambodian landmine victim called Vanna inspired by a movie he saw on the topic made by Eric Vander Borght.
 
www.daithirua.com

Handicap International, which estimates that more than 1,000 victims will need long-term rehabilitation, will help by providing active rehabilitation treatment, training and equipment to two main hospitals in Xining, for two months.
 
Some of the most serious casualties were also transferred to provincial hospitals in the neighboring provinces and regions of Sichuan, Gansu and Tibet, where they will remain for a month before being transferred back to Yushu. The organization will also ensure that adequate follow-up care is provided to victims of the earthquake when they return to their homes. This will include training doctors, nurses and township and village doctors. An estimated 12,000 total casualties resulted from the earthquake. The victims who remained in Yushu were less seriously injured.
 
Handicap International’s support will not be needed in terms of emergency relief items, such as tents, food and water, sanitation and basic infrastructure, since the Chinese government has already deployed financial and humanitarian resources in Yushu.
 
However, given Handicap International’s experience with the January 12 earthquake in Haiti and the 2008 earthquake in Sichuan, it is obvious that Handicap International’s support will be needed for physical rehabilitation following emergency medical intervention. Providing appropriate rehabilitation immediately after surgery minimizes complications and the chances of developing permanent disability are reduced. There are currently no rehabilitation experts in Yushu and Xining has a large emphasis on Chinese Traditional Medicine and active rehabilitation is in the early stages of development.
 
In the meantime, Handicap International will use its existing projects in Tibet and Sichuan to provide necessary support and referral. Handicap International works primarily in Chambo, Tibet, more than 149 miles (240 km) from the epicenter of the earthquake, and the organization has been present in China since 1997. It operates many projects in the field of rehabilitation, maternal health, care for orphans with disabilities and it supports associations of persons with disabilities. Handicap International also mobilized major efforts and resources when an earthquake struck the Sichuan region in 2008.