Progress Reports

A Disaster of Unparalleled Magnitude
As July 2010 drew to a close, the worst floods in the history of Pakistan began on their path of destruction. The unusually heavy monsoon rains that triggered the massive flooding soon caused the deluge to spread. Within a matter of days, nearly one-fifth of Pakistan was submerged. The scale of the disaster was so huge that the UN was compelled to pronounce it 'absolutely daunting.' Unprecedented damages afflicted all sectors of the country's economy. Many lost their homes, farmland was washed away, and millions of dollars worth of livestock drowned.
Critical infrastructure, including health clinics, power stations, roads, bridges and water supply systems were destroyed. The education system was also badly damaged with schools destroyed or used as temporary shelters. As a result, many children in the flood affected regions won't soon be able to return to school. According to the Government of Pakistan, over 20 million people, including nearly 9 million children were affected by the disaster. Read more

The Initial Relief Phase
The needs of the affected communities have evolved with a continual change in external factors. Save the Children has responded to these changes by modifying strategies in ways that would best serve flood survivors, at different points in time.
When the disaster first struck Pakistan, homelessness and contaminated water supplies ensured that diarrhea and malaria were two of the most common diseases amongst the affected communities. To combat the situation, Save the Children focused on supporting Diarrhea Treatment Centers as part of its health response in Punjab and Sindh provinces and on creating awareness about the ways to prevent and cure gastrointestinal infections and other diseases. Save the Children also distributed long lasting insecticide-treated bed nets for the prevention of malaria. In addition, as many of the flood victims were displaced from their homes, the agency provided humanitarian aid through mobile health teams that travelled from one locality to another to deliver lifesaving medical assistance.
The post-disaster mental traumas faced by the flood victims, especially children, made it essential that Save the Children provide emergency psychosocial support through both its child protection and education programs. The focus has also been on reuniting children separated from their families because of the floods with their loved ones and providing them with a safe and secure environment in which to play and learn.

Winter Complicates Matters
Floodwaters have receded and many of the displaced communities have returned to their homelands. But temperatures have plummeted, introducing new threats to already vulnerable people. Cold weather continues to impact the rate of respiratory infections and malnutrition – two of the biggest killers of children. Every year 85,000 children die from pneumonia in Pakistan: the leading cause of death for children under five in the country. Freezing conditions are expected to fuel the spread of disease.
Save the Children has modified its response to the evolving needs of the flood victims. Government demands to revitalize static health facilities have led to the agency targeting health facilities, as opposed to mobile teams, for its support. Similarly, health education is now focused more on diseases like pneumonia which are a direct consequence of the change in weather. Save the Children has also started distributing winterization kits which are composed of sweaters, quilts, cotton beddings, socks and caps.
In Rajanpur district of Punjab, Save the Children has also started providing shelters made of bamboo logs and plastic sheeting. These structures are sturdy against the harsh winter winds and are built at the flood affected families' places of origin.

Health and Nutrition
Soon after the floods, there was a lack of access to quality primary health care services at the community level. Ambulance service was limited because roads and bridges were washed away and a lack of health care providers, medicine and supplies meant that flood survivors in critical need of health care, would have to do without. The situation was dire. Cases of water borne diseases were quickly spreading. Pregnant and lactating women and newborns and had little to no access to the health care they desperately need to thrive.
A lack of awareness in the prevention of common and communicable illnesses and a lesser tendency towards health-seeking behavior and utilization of primary health care services was a matter of concern, ultimately leading to unhealthy practices. Lack of health care and food was expected to have serious implications on the already compromised nutritional status of children and pregnant and lactating women.
In response, Save the Children's emergency health program aimed to improve the situation by offering a variety of health services including general outpatient consultations, mother and child health care services, emergency referrals of complicated cases, revitalization of health facilities that were damaged by the floods, and complementary health education. Presently, Save the Children is operating 16 mobile health teams and 72 static health care facilities.
So far, Save the Children's health program in Pakistan has reached a total of 735,012 beneficiaries. The agency's nutrition response, which has focused on providing nutritional care to children and pregnant and lactating women, has thus far provided aid to an additional 38, 371 beneficiaries.

Water, Sanitation and Hygiene
According to a World Health Organization report, the high density of population in the formal and informal IDP camps, coupled with the widespread practice of open defecation rendered the public health situation critical. For those who managed to leave camps and return to their original settlement, every day has been a struggle for survival. They have lost everything, and for most, the purchase of hygiene items, the rehabilitation of their water supply and sanitation infrastructure and the improvement of hygiene practice is out of reach without external support.
Save the Children is working to improve water, sanitation and hygiene (WASH) promotion facilities in relief camps, schools, health centers and villages in Punjab and Sindh provinces. To date, approximately 117,500 people have benefitted from enhanced WASH facilities.

Shelter and Non Food Items
Shelter and non-food items (NFI), clean water, food, and medical care were the most immediate needs of affected communities. To date, Save the Children has provided 85,478 families (683,821 people) with shelter materials and non-food items. After performing a needs assessment, shelter teams are providing tents or shelter kits containing plastic tarps, poles, hardware or other non food items to help families construct temporary shelters. Other commodities, distributed individually or packaged into household kits and hygiene kits, are helping families cook food, prevent diseases caused by insect bites or due to poor hygiene, and keep their shelter and environment safe and healthy.

Food
Save the Children continues to provide food assistance to over 140,000 families. This has been made possible through rations provided by the World Food Programme which include wheat flour, high energy biscuits, vegetable oil and a peanut-based, ready-to-use-supplementary food for children.

Livelihoods
The floods affected some of Pakistan's most fertile and productive land and devastated the livelihoods of small traders, subsistence farmers and herders. Extensive damage was done to agricultural equipment and infrastructure, such as generators, water mills, field retention walls and irrigation systems. Hundreds of thousands of livestock also died in the floods. The overall damages levied on the economic sector and infrastructure, including power supply lines, also impacted casual laborers' access to employment opportunities.
In response to the widespread destruction, Save the Children helped expand livelihood options for those who had lost all means of subsistence. The agency's livelihoods program for vulnerable flood-affected communities focuses on the development of market based solutions that are realistic and sustainable.
Since the beginning of the flood response, Save the Children has distributed 34,265 food vouchers to families including 268,640 people in the most vulnerable communities of KPK, Sindh and Punjab.

Education
The floods partially or fully destroyed many school buildings all across Pakistan. Traumatized children need a protective learning environment to come to terms with their experiences and to regain a sense of routine and normalcy that is so critical to their wellbeing.
Save the Children has been implementing a large scale education program in the flood-affected areas with a view to improving access to education for the most vulnerable and neglected communities. The focus is on emergency education, school rehabilitation, capacity building, community awareness and educational needs assessment. To date, Save the Children has reached 123,448 people, including 114,299 children, in its emergency education program.

Build back better
Over the course of the next two years, Save the Children will aspire to target the most vulnerable and marginalized communities and provide them with a holistic package of support with the theme of 'Build Back Better' as the major consideration. Save the Children will strategically select those geographical areas that have the largest gaps in services and a significant vulnerable population, and will concentrate all its programs in those locations.
The agency aims to increase communities' resilience against any future disaster through integrated Disaster Risk Recovery (DRR) programming. By the end of the strategy period, Save the Children will seek to have improved communities lives to a better level than before the floods and empowered them with a greater ability to mitigate the impacts of any future disaster.
Save the Children's goal for the next two years is to address the immediate, intermediate and longer needs of four million flood survivors through multi-sector integrated programs in a sustainable manner by the end of 2012 in the targeted districts of Khyber Pakthunkhwa, Punjab and Sindh provinces of Pakistan. Programs and initiatives will support the most vulnerable categories of children and their families – women, orphans, and disabled persons – in the targeted districts of Khyber Pakthunkhwa, Punjab and Sindh provinces of Pakistan. This represents over 20 per cent of the affected population of which at least 55 per cent (2.2 million) are children.

A Silver Lining
Our work over the next two years will be about applying Save the Children's core values of accountability, ambition, collaboration, creativity, and integrity, to offer programs of the highest quality, that address children's needs and rights.
We must help children not only to recover, but to thrive. The hope is that one day they come to see that the devastating 2010 floods had a silver lining: they were a catalyst for change in their homes, schools, and communities, helping communities become safer, healthier, happier, and more educated than before.