Hopkins brings relief to shaken Pakistan

Anjali Pant, International Fellow with the Department of Emergency Medicine at Hopkins Hospital, and Daksha Brahmbatt, a faculty member at the Hopkins Public Health School's Center of Disaster and Refugee Relief and a registered nurse, are no strangers to the aftermath that disasters leave in their wake. As part of the Hopkins response to Hurricane Katrina, they faced the staggering health crises from homeless survivors, many so far below the poverty line that they were unable to afford even basic medical care. Many were suffering silently, without medication, until relief teams from around the nation were able to establish field hospitals and restart medical care.

With the Pakistani earthquake of Oct. 8, a new crisis sprang to the world's attention, releasing a public health disaster that engulfed the Islamic nation so deeply that rescue operations are still actively ongoing. Rural villages, many without basic healthcare even before the earthquake, were plunged deeper into medical crises with the magnitude 7.2 temblor. Many are perched within one of the mountainous regions in East Asia, where snowfalls and unpredictable weather are all too common. The United Nations has promised $580 million for relief efforts, pledged to Pakistan from donor nations, including the United States. Nevertheless, international observers worry that the money will not be distributed quickly enough.

Alongside Italo Subbarao, a Disaster Fellow at the Hopkins Center for Event Preparedness and Response, the Hopkins team is working with the International Rescue Committee to provide medical care to a population stricken by measles, pneumonia and blunt trauma from the quake. We were able to interview Pant and Brahmbatt, currently active in the more remote Pakistani provinces, with responses provided by Pant.

Were you prepared for the devastation that faced you after the earthquake?

No, neither of us were. We had some idea from pictures and news coverage (although that was quite brief, wasn't it, in the US!).The reality, however, is quite different. To be surrounded by the type of destruction we are seeing daily in some of these cities is a new experience for all of us. I went to Balakot, and that city was completely devastated, very few to no standing buildings left.

Daksha went to Muzzafarabad, 90 percent of buildings were destroyed and damaged, and every person she met had lost at least one person from their family. People are scared ... They do not want to sleep in their homes, they do not want to return to schools (where hundreds of children died) and they are scared of what will happen long term.

They are really surviving day to day. ... Today let's try and get a tent, today let's get food, where is the water. Health is one of the latter priorities for these people who are trying to survive. Mental health has not been addressed on any large scale, although when we have seen patients, there is a consistent underlying layer of anxiety.

Amazingly, people are resilient and generous with us, and grateful for our efforts.

They are all fasting for Ramadan and when they become aware that we are not, immediately offer tea, food, whatever they can, even after they have lost so much.

Is this your first rescue mission?

This is both of our first disaster response of this extent. All three of us were involved in Katrina, but the devastation here is of a different scale.

Do either of you have any personal or familial ties to the area? If so, how did this affect your response?

No, none of us do. I view this as there are people in need, and I may be able to contribute in some way working as a member of the International Rescue Committee team.

What is the best thing we in the US can do to help the people affected by the earthquake?

Everyone wants to help when there are others in need. The best way is to give money and support to those agencies that are on the ground here.

What are the conditions like in the region? What is a typical day like for you?

There is no typical day. The conditions vary from location to location. We were in Abbottabad for some time initially, and we had an office and were staying in a local hotel.

In Mansehra we are staying in a house that International Rescue Committee has arranged. We also have an office here.

In Muzaffarabad we are staying in tents in a UN compound as there is little to no infrastructure left in that city.

The days vary. We may be setting up temporary hospitals using large tents and medical supplies, we may be doing clinic work where we see up to 120 patients in 4 hours, we may be traveling to various health facilities doing needs assessments, we may be helping with logisitics, helping with filing and paperwork, and it all has required teamwork.

We are constantly aware and reminded of the fact that we are in a geologically active region, since we experience frequent aftershocks. We are lucky to have a fantastic team of national and expatriate staff here working together.