A rescue team works among the debris of Margala Towers after an earthquake in Islamabad October 10, 2005. REUTERS/FAISAL MAHMOOD
LONDON (AlertNet)- As relief agencies scrambled on Monday to respond to Pakistan's massive earthquake, AlertNet asked aid workers and experts for their initial assessments of the extent of the devastation and urgent needs facing survivors.
Following is a rolling snapshot of their early responses, based on telephone interviews.
Isabelle Simpson, head of mission for M??decins Sans Fronti??res in Pakistan:"Since yesterday we've had a team in Muzaffarabad. We hear that they estimate that about 60 per cent of the town is destroyed. People are sitting outside the wreckage of their homes. Most families appear to have had at least one or two deaths. People say they are running out of food, there's no water, no electricity and no fuel or phone lines. There are three to four camps of homeless people starting to form in the centre of town.
"One of our first priorities will be to try to get some capacity back at the hospital and to provide emergency medical care in the camps. From what I know, the majority of the hospital is gone and we will be looking at setting up temporary structures so we have some capacity for in-patients.
"Accessing the more remote areas is probably our biggest challenge because all these areas are only accessible now by helicopter. We hope to have access to helicopters in the next one to two days and get teams out into these areas to provide medical assistance."
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Sigurd Hanson, Pakistan director for World Vision in Islamabad:"It's larger than anyone in this business thought. Our assessment teams are returning now.
"There's a significantly high children mortality rate. The reason for this is that it hit on Saturday and the children were at school. The teams that are reporting back say 70 to 80 percent of infrastructure was destroyed, including schools.
"The tragedy of the children mortality is unbelievable. One team came across a school with 350 children buried under rubble. They went to the next community and there were 106.
"The needs are unbelievable. People are asking for coffins and burial cloths to bury the dead.
"The primary needs are for shelter, health and water. Shelter being winterised tents, health being mobile units."
He said clean water was needed because landslides had polluted the rivers.
"Co-ordination (with other agencies) has been going very well. We are having regular planning meetings. The governments have been very co-operative in terms of allowing teams to come in."
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Dr Unnikrishnan, Action Aid co-ordinator for quake response in Bangalore:Unnikrishnan stressed the need to address psychosocial issues from the outset and deal with spinal and hip fractures that can lead to paraplegia if not treated promptly and followed up with rehabilitation.
"Psychosocial and disability care are two issues that are neglected by a lot of agencies on the ground who may say they are not (about) life-saving so let's do them later.
"The repeated tremors and aftershocks have created panic among people. This will take a heavy toll unless we respond now. There is no contradiction between psychosocial care and saving lives - they are not competing agendas."
He said previous disasters showed that dealing with personal trauma in the immediate aftermath could prevent serious problems emerging later on such as children not going to school, alcoholism, domestic violence and suicide.
ActionAid already has psychosocial workers on the ground in India and others were on their way to the earthquake region in Pakistan.
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Wasim Bhat, programme officer for Save the Children in northern India:"There is an immediate requirement for shelter, especially for tents. Due to large structural damage to homes, families are camping out in the open. Some have set up their own temporary shelters. But now we are in the middle of autumn and winter is approaching, so the nights are very cold.
"This is a very tough situation for people who have lost their homes, especially children. As of yesterday evening, supplies had not reached Uri, but today I am hearing that supplies have been air-dropped in by the central government, including tents - but I cannot verify that these supplies have reached the people.
"One of the very challenging parts of the whole relief exercise is that a significant stretch of the area is not accessible. Yesterday, there was a landslide on the Uri road that blocked it and cut off villages. In some remote areas, link roads have been cut off too, and there are reportedly high casualties.
"I would say that the current priority is shelter. It seems that a mixture of concrete and stones is used to build houses here - materials that are locally available. And these are less resistant to earthquakes then bricks.
"People also need food, potable water and later they will need schooling. The children I saw were running around trying to work out why so many people were visiting their villages. But the elders we spoke to say that children are bearing the brunt and there is a risk to them from the lack of potable water."
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John Ryan, press officer for British search and rescue group International Rescue Corps:"We have two sections of our team in Muzaffarabad. Four more people, with the bulk of our equipment, are moving from Islamabad.
"This morning, they pulled a 12-year-old alive from a building in Muzaffarabad. Sadly, they searched two schools and didn't find anyone alive. People can survive in destroyed buildings for five to seven days, so the team will go on until all hope is gone.
"They're in a fairly rural area. The buildings are two-storey houses, and most of them have completely collapsed.
"Coordination on the ground seems to be very good. People desperately need more aid, but aid is coming in."
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Adeel Jafferi, media officer for Islamic Relief in Islamabad:"People are still afraid. There are still aftershocks, and people are afraid that with the cracks in the structure of their homes, the homes could still come down and people could be trapped or killed ... I'm not ashamed to admit, it was absolutely terrifying.
"Pakistan has never suffered an earthquake of this magnitude. On the day it happened, ordinary people were rushing to aid victims, despite the shock they felt themselves.
"I saw people on the street who were completely out of their minds with fear, and yet when they saw the need to help people and heard the screams from under buildings, they ran immediately and started helping.
"Around Islamabad, Rawalpindi and the Punjab, the buildings are stronger, but in the villages which have been wiped out they are like the houses in Bam (where an earthquake in December 2003 killed 31,000 people in southeastern Iran). They are mud brick, very raw structures.
"That's always the situation in rural areas - you find the worst casualties because the houses just aren't built to withstand that kind of shock."
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John Tulloch, coordinator in New Delhi with the South Asia regional delegation of the International Federation of Red Cross and Red Crescent Societies:Tulloch said the quake may have made as many as 4 million people homeless, although it was too early to be sure about numbers. He added that access remained one of the biggest obstacles facing aid agencies.
"A lot of roads have been blocked by landslides, and even where the roads are accessible, we're talking mountainous terrain and bad roads. For instance, the Afghan Red Crescent said we could start moving 2,000 tents and 60,00 blankets, but it's to get it where it's needed.
"As resources begin to pour in, then it's the age-old problem of distribution and getting it to those who really need it."
Tulloch said the threat of disease was also a major concern.
"It's always a risk because with such a huge effect on infrastructure you have sewage systems broken and water becomes a big issue - and not just access to any water, but clean water. So water and sanitation issues become paramount.
"At the moment, it's obviously the rescue operation. Shelter is important. A lot of people have nothing to cover themselves. And basic food. But then it's water and sanitation issues."
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Amjad Jamal, spokesman for World Food Programme in Pakistan:"For the time being, we have a problem transporting commodities, as the road network is damaged and we can't get to all the affected areas, particularly those in the mountains. So we will need to use helicopters, although this is going to cost a lot. But to meet immediate requirements, this is what we will have to do, and we can request them from the government.
"In terms of when we still start to deliver aid, before we can procure locally, there are legalities to go through. Food from headquarters is likely to take two to three days to arrive, but we will be in the affected areas as soon as we can.
"Overall, people need food, water and tents. As it's the winter season, they also need warm clothing and jackets. Different agencies are co-ordinating different areas of the relief effort and so far the co-ordination is working well. The government is giving us information on the road network, as access to the affected areas is currently the main problem.
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Zainab Raza, team coordinator in Islamabad for Church World Service/ACT International:"According to the media and newspapers here, the number of casualties is nearly 40,000 although information is very difficult to get from the ground. The government is still only quoting 18,000-19,000. The worst affected areas are Azad Kashmir and areas in the North-West Frontier Province.
"So far we have already sent in shelter kits for 6,000 families and food items for 6,000 families in these areas. Our plans are that will provide aid for 15,000 people.
"In terms of access, landslides are creating problems around Muzaffarabad. People are saying there are no survivors in some villages. This is a hilly area and there has been heavy rain. But our teams have gone in. We are doing needs assessment and the reports will start coming in today.
"What we have heard so far is that people are lying out in the open and whole villages have been wiped out. They need shelter, medicine and health services. We plan to set up medical camps to provide vaccination and first aid services to 100,000 people and we hope that we can get these up and running this week.
"So far co-ordination among NGOs is going well. Our biggest worry for the next few days is that the aftershocks will continue. People are afraid to go inside buildings because of aftershocks.
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