CONTENTS

1. General Conclusions

 2. Introduction

3. Water & Sanitation

4. Nutrition

5. Health

6. Livestock

1. GENERAL CONCLUSIONS
 

• The lack of rain in Pakistan, in particular in Balochistan and Sindh, is creating a threat to certain sections of the population and to livestock.

• The situations prevailing in terms of drought effects and emergency responses differ not only in respect of the provinces of Balochistan and Sindh, but also between districts of these areas.

• Although the Government is providing some food assistance to the affected population, there is a need for additional food assistance for certain groups within the population who are deemed vulnerable either in camps or affected areas. Vulnerable groups including – pregnant and lactating women, malnourished children and the elderly, require special attention both for food and health, and these groups should be closely monitored.

• There is particular concern for the nutritional status of children, and women of child-bearing age.

• Whilst there are normally migratory patterns for people and livestock in these areas, in Balochistan the lack of rain is causing irregular displacement resulting in the need for the GOP and other agencies to provide emergency assistance.

• The emergency conditions could to some extent have been avoided if there had been more coherent and successful development activities in the past. These in turn relate to fundamental problems relating to institutional issues and governance and the need for provincial authorities to be able respond to social and environmental concerns.

• There is a need for provincial governments to develop proper water resource management and policies for livestock and rangeland management.

• In the water sector in Balochistan it is recommended that there be regulation of the utilization of water for irrigation purposes and instead the promotion of the use of these water points for drinking water supply to drought affected people. There is a requirement for provision of improved water distribution facilities at the camps. The mission also recommends regular monitoring of water supply quality and effective measures for sterilisation, sanitation and hygiene promotion.

• No immediate measures are needed in Sindh except that sanitation and hygiene promotion programmes should be introduced among the drought-affected population to improve their general health.

• Concerning livestock attention should be given to destocking programmes linked to the provision of credit facilities.

• It is important to prepare for the likelihood of conditions worsening should there be insufficient rain this year in certain areas.

• In addition to there being a need for technical support and material inputs there is a need for assistance to provincial governments in ensuring that coordination of programmes is undertaken, and that the situation is closely monitored.

Pakistan, except for its north-eastern part has an arid to semiarid climate. Average annual rainfall in the country ranges between 250mm to 500mm. Balochistan province received little or no rain during the last four years (1995-99). The continued drought has caused severe water shortage for human, livestock and agriculture uses in many areas of the province. Many drought victims have lost their livestock, which is a major source of income. It is feared that the situation will get worse, and will stretch the Government’s resources, if the next rains also fail. Sindh did not receive any rains during 1999. The effects of drought are less severe in this province as compared to Balochistan but another dry spell would also create serious water shortages.

In March 2000 the Government of Pakistan (GoP) appreciated the UN’s concern with regard to the drought which led to UN agencies and NGOs reviewing the situation. Based on their reports, UNDP requested DFID to field a mission to review and determine the immediate and long-term non food needs of the drought victims. The DFID team consisted of experts in the fields of water supply & sanitation, nutrition & health, epidemiology & public health, and livestock & veterinary services. WHO and UNICEF experts also assisted this team. This non-food mission had the following objectives:

• To review existing information and to meet all external and local agencies active in drought response
• To undertake extensive field visits to verify the available information
• To analyse the drought situation and submit recommendations in the case of either normal rains or no rains occurring in the next rainy season
• To assist UN agencies in developing a coherent strategy in responding to the drought.

The mission was however able to analyse quite substantial data regarding water and sanitation issues, and in this sector it was furthermore possible to estimate costings for possible interventions. Some cost estimates are also listed in the health sector.

Given the long term problems existing in Baluchistan and Sindh a drought is bound to exacerbate matters regarding health and nutrition. The conclusions in the report for these sectors are of a more general nature and serve to underline the need for more stringent and long term monitoring of the situation in parallel with a coherent coordination of emergency and rehabilitation programmes.

In considering the serious problems perceived by the mission concerning the lack of clarity and planning as regards both ongoing and future programmes, a proposal for UN assistance regarding coordination of emergency activities has already been prepared and is under review.

3. Water & Sanitation

The mission visited the drought-affected areas in Balochistan and Sindh and held discussions with the concerned line agencies and other foreign and local agencies, actively involved in drought-related activities.

Balochistan

The mission’s findings in Balochistan are that major surface water sources and most of the karezes have no water. Shallow groundwater reserves have seriously declined but the productivity of deep boreholes is not affected. The failure of rains and extreme water scarcity has caused reduced crop production and adverse effects on agriculture and fodder supply for livestock.

The recommended immediate measures in Balochistan include the following:

• regulation of utilization of water for irrigation purposes and the promotion of use of water points for drinking water supply to drought affected people

• provision of improved water distribution facilities at the camps,

• regular monitoring of water supply quality and effective measures for sterilisation, sanitation and hygiene promotion.

It is expected that the community will contribute US$ 291,000 in cash and kind. The remaining US$ 941,000 will be provided by the government through local resources and donor assistance.

The cost of low-cost rural roads is estimated at US$ 5,900,000, of which the community’s share will be US$ 700,000.

Sindh

In the drought-affected areas of Sindh, the surface water sources have dried up but the groundwater table has not much declined.

• No immediate measures are needed in Sindh except that sanitation and hygiene promotion programmes should be introduced among the drought-affected population to improve their general health.

The mission is of the opinion that the current water shortage is not entirely caused by the drought. The main reason is the lack of planning and management of water resources and lack of maintenance of the water supply services. Major line agencies in the water supply and sanitation sector are PHED and SAZDA. Most of the water supply schemes transferred to the user communities are non-functional. Water-borne diseases are common in the area because of poor sanitation and almost total lack of awareness about hygienic practices. The temporary camps of drought-affected people in Balochistan are facing greater sanitation problems because of concentrations of people and livestock. Social problems, because of different, and sometimes rival, tribes staying together are also a great concern to the government. It might be difficult to disperse the camp population if the drought continues through the next rainy season.

As the lack of water supply is more the consequence of lack of management and preparedness rather than poor rains, the proposed mid-term and long term measures are the same for both areas, whether the next rainy season brings good rains or no rains at all. These measures include:

• Removal of subsidy on electricity charges to private irrigation tube-wells
• Installation of new water supply schemes, preferably non-motorised, in the drought affected areas
• Rehabilitation of existing water schemes in the drought-affected areas
• Implementation of motorised schemes in selected areas where simpler schemes are not possible
• Inclusion of sanitation and hygiene promotion as an integral part of any new intervention in water supply
• Focus on appropriate and affordable technologies in all new interventions in the water and sanitation sectors
• Community mobilisation and training for sustainable transfer and O&M of functional water supply schemes
• Construction/improvement of 300km of rural roads in Balochistan and 110km in Sindh through low-cost labour-intensive methods to provide jobs to the drought-affected people and to improve access to markets
• Preparing a contingency plan for government response if the next rains also fail
• Close monitoring of the above activities.

• Checking of further degradation of water resources and enforcing water policies with emphasis on water demand and pollution control
• Review of all water demands for drinking, agricultural and industrial uses and eliminating wastage
• Exploration of new water resources after exhausting most economical use of the existing water sources
• Declaration of water resources as a national resource and allowing further exploitation only under license
• Promotion of sanitation and health education in drought-affected communities
• Use of appropriate and affordable technologies in any new intervention in the water and sanitation sectors
• Close monitoring of borehole drilling, particularly in the private sector
• Clear definition and assigning of institutional responsibilities
• Improvement of overall water management and enforcement of sustainable use of freshwater
• Exploration of further groundwater resources by using advanced groundwater-prospecting techniques
• Construction of groundwater recharge schemes and construction of small dams to tap runoff water
• Distribution of water quotas amongst different users to maximise social benefits of available water resources
• Implementation of environmental protection and water quality standards
• Formulation of water-licensing policies through institutional reforms
• Establishment of a water resources management body to carry out reforms in the water sector
• Construction/ improvement of 700km of roads in Balochistan and 200km in Sindh, through labour-intensive methods to improve access to markets and socio-economic conditions of the drought victims
• Protection of hand-dug wells and equipping them with corrosion-resistant hand-pumps
• Construction of rainwater-harvesting schemes, such as small dams to enhance the availability of fresh water
• Advice to local communities in to developing/ improving individual/ communal rain harvesting systems
• Establishment of community-based programmes to improve local communities’ awareness regarding O&M of the water supply schemes, sanitation and hygiene practices
• Provision of community-based training programmes in maintaining simple water supply schemes
• Preventing local communities or their livestock’s direct access to surface water ponds by introducing safer and simple methods of water extraction
• Construction of improved surface water ponds and dams to collect flood water for human and livestock use
• Construct recharge dams for enhancing groundwater.

            C.

• Development of a GIS/MIS for information collection and dissemination concerning drought-related issues
• Review and reformation of the existing policies on water resource management
• Development of research programmes for efficient use of water in agriculture and fodder production
• Development of efficient, affordable and sustainable water supply, sanitation and hygiene promotion services
• Development of a national water quality standards and national sanitation policy
• Development of research programmes on public health, with reference to the health conditions and their causes in the drought-affected areas.

It was not intended that this mission should examine food supply or food production in the drought affected areas. These matters are covered by the recent FAO/WFP Special Report, the findings of which are fully endorsed by the mission.

The mission wishes however to emphasise certain points:

• There is a need for food assistance to certain groups within the population either in camps or affected areas who are deemed vulnerable.

• There is particular concern for the nutritional status of children and women of child bearing age, particularly in Balochistan where there are people living in camps and population movements.

• Government resources are only able to meet the food needs of part of the affected population.
• Some NGOs and private parties are also distributing small quantities of food and other items.

• Most of the relief has reached urban and nearby areas but the more distant areas have not been reached. The worst affected are the remote areas, especially along the Afghanistan border.

• Additional food aid assistance will be required for the affected population to meet the gap and the Government has welcomed WFP food aid assistance. It is noted that WFP initiating an emergency programme to address this issue.

• There is currently no independent monitoring of the food distribution system.

Studies undertaken this year by various agencies, including the provincial Governments, had pointed to a decline in the food security in the area, resulting in increasing rates of malnutrition, losses in the number of livestock and population movements towards water sources.

Using the mid upper arm circumference (MUAC) as an indicator, the mission assessed a limited number of cases in the two provinces. The level of malnutrition found is not unusual given the prevailing conditions of rural Pakistan, however this should be further explored and regular monitoring is required.

Balochistan

The situation in Balochistan was found to be worse than that in Sindh. Nine camps had been set up containing a total of approximately 10,000 people, and here there is a risk of deterioration of the situation. Thus Balochistan should be the primary focus of any intervention.

There has been a shortfall in the agricultural production in Balochistan (whilst there has an excellent harvest in Pakistan as a whole).

The Government of Pakistan has in fact taken the lead role in the supply of services including the supply of water, food aid and free medical services in the province both to the camps and affected villages.

Sindh

The needs assessment revealed that in Sindh the general situation was found to be stable with limited population movements and no IDP camps. The monsoon rains are predicted to be good and expected imminently.

Recommendations for UN interventions are as follows:

Recommendations for food assistance are covered in the recent FAO/WFP Special Report. The mission here wishes to reiterate the following.

• The UN should support co-ordination, monitoring and evaluation activities with a view to averting possible future problems.
• Setting up of targeted supplementary feeding centres through the fixed and mobile MoH health posts to address diagnosed malnutrition. These should target malnourished children and all pregnant and lactating women.
• Health & nutrition education programmes should also run alongside targeted feeding programmes. These could be run through NGO’s, the UNICEF LHW programme, or as an extension of the Area Development Programme.
• Micro credit and savings initiatives should be set up to enable women and men to develop livelihoods.

The general health status in the affected areas of Balochistan and Sindh is related to the poor living conditions, unhygienic storage of water, lack of proper sanitation, inadequate diet and limited access to health facilities.

Whilst in some health centres there may be indications of increases in the number of cases (for all ailments) reported, these increases may be the result of greater availability of facilities this year rather than any increase in disease or deterioration in the health of the population. The general situation is however likely to worsen should there be insufficient rain in the months ahead. Insufficient drinking water or suitable food will cause more problems and the need for medical assistance. People who are displaced as a result of the drought may be affected to a greater extent.

Sample data from health units suggest the following:

• There are some increases in the number of cases of Diarrhoea, Acute Respiratory Infections, and Malaria reported by some of the health units under study between March to May 2000 in comparison with the same period of 1998.

• Whilst there is normally an epidemic season from June to October there are indications of an early rise in the number of cases this year.

• There is a low level of preparedness and little experience concerning emergency planning and response. Nevertheless the mission was pleased to note the dedicated efforts of health personnel who had been posted at camps and transferred to problem areas. There also appeared to be a reasonable supply of drugs.

In considering that the most vulnerable populations are the rural drought affected areas which contain nomadic and semi nomadic groups in addition to more settled communities engaged in livestock and agricultural farming, and noting that some of these groups have moved to camps administered by the provincial authorities, consideration should be given to the following:

• Providing basic equipment and tents for temporary mobile health clinics.
• Providing emergency drug kits to established camps especially for the treatment of Gastroenteritis, Fever, Malaria (e.g. ORS, Ringer Lactate, Antibiotics and Analgesics).
• Improving laboratory diagnosis systems for Cholera, Malaria, Meningitis and Typhoid Fever, and providing simple laboratory equipment and reagents.
• Strengthening existing referral systems and emergency transportation of patients through the utilization of village buses.
• Supporting immunization programmes and providing support for the cold chain.
• Provision of water storage containers (sand filters), chlorine tablets, latrines, soap and mosquito nets.
• Provision of appropriate health education materials to be used by local health workers in camps and rural area. These health workers should also receive training in teaching health education.
• Training in emergency preparedness and setting up of basic disease early warning systems.
• Special attention should be given to vulnerable groups – pregnant and lactating women, malnourished children, the elderly.

6. Livestock

The mission fully endorses the findings of the FAO/WFP Special Report with regard to livestock and wishes to emphasize a number of points.

The drought this year has had a severe and adverse effect upon on the livestock industry in Balochistan.

• The districts most affected by drought districts account for 45 percent and 35 percent of the numbers of sheep and goats respectively in the province. In these districts heavy losses in the order of 45 to 55 percent for sheep and 30 to 40 percent for goats in terms of higher mortality and forced culling rates were noted.

• In these districts there has been a smaller number of new-borns and these have been sold, have died or have been sent to other provinces depriving the flocks of the replacement stock.

• Domestic production of sheep and goat milk is estimated by the Mission to be down by some 70-80 percent in the most affected districts.

• This year the limited edible biomass production has dried up due to the absence of rainfall and therefore there has been insufficient fodder for the maintenance of livestock.

• The Government has been providing feed and, during the first phase of its programme, the objective was to provide stock feed to 25,000 livestock farmers for ten weeks to maintain breeding stock. In some of the districts the amount of stock feed that is being provided has been adjusted to five weeks as the requirement outstrips the demand for relief’

• Lungworm infestation, liver fluke, ringworm and external parasites appear to be responsible for some of the morbidity. So the lack of access to veterinary products is a factor for mortality in animals.

• In general the livestock owners who have remained in their areas are generally more experienced or wealthier groups who have secured provisions of straw from their own fields or bought it from the market. They have eliminated old animals and sold the young ones earlier in order not to overuse pastures. They have also been able to secure necessary veterinary products. Owners who have left for relief camps were generally either poor families with limited means, unable to get through a difficult period.

• Nomadic communities have been more affected than sedentary ones, as they rely only on livestock and use water resources which do not belong to them. Sedentary farmers frequently do not allow nomads access to their water sources.

• Whilst the plight of livestock owners has been exacerbated by drought conditions, this situation should not cause us to ignore the fact that the underlying problems are man-made. Over stocking of animals is largely responsible for problems both of lack of water and depleted vegetation on rangelands.

1. Feed in terms of concentrates and roughage is urgently needed to maintain a minimum of about 1.2 million small ruminants’ selected breeding stock in the most affected districts. Concentrate requirements would amount to some 65,000 tonnes. As an alternative UMBs (urea-molasses blocks) for 32,000 tonnes could be provided. This feed should suffice for nine months until next lambing season.

2. Drenching medicines and non-dipping medicaments against internal and external parasites are needed.

3. There is a need for more monitoring of the situation in order to obtain a clearer picture. Although large numbers of livestock have perished it is difficult to provide precise figures. It will be useful to have the results of post-mortem examinations to enable the determination of the causes of death. It will be important to differentiate between mortality due to shortage of feed and mortality due to disease, and also to relate figures to a specific period of time. Furthermore it is also important to be able to distinguish between effective mortality, animals sold because of the need for cash, and animals consumed as food.

4. De-stocking of livestock in relief camps

Animals collected around relief camps not only have little chance of survival, but also ravage the areas around the camps through permanent grazing and thus endanger the resources of the local communities. It is therefore recommended that some of the livestock at the camps be destroyed and it is proposed that a government department, a UN agency or a NGO could supervise a programme whereby a bag of wheat flour (costing 7.5 US$) could be exchanged for one goat or one sheep. Animals would be slaughtered on site and the meat distributed at a rate of 1 Kg/family/day. The skin would remain the property of the owner, who can prepare it and sell it for cash.

5. Credit facilities.

Agencies could provide credit facilities to be made available prior to the next rainy season to enable pastoralists to invest in breeding stock and hence develop their livelihoods.

6. Price controls for fodder and wheat straw

Excessive prices only benefit intermediaries and should therefore be strictly controlled until the next rains arrive.

Recommendations for the longer term

The drought in Balochistan is an opportunity for the province to develop strategies for a sustainable future for livestock for which it will be necessary to address the following problems:

• the increasing numbers of animals
• the reduction of range resources due to expanding agriculture and lowering water tables
• insufficient veterinary services

• The development of a sustainable strategy for the use of natural resources, whereby livestock and agricultural production should be adapted to the actual availability of water.
• Departments for Agriculture and Livestock should work closer in developing a coherent strategy for the future
• The improvement of range lands through the planting and cultivation of appropriate trees and scrub vegetation,
• The development of proper management of ranges and herds especially regarding breeding and fattening of animals.

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