Quake Survivors Now Mired in Squalor
Shortly after a cold rain had finally quit, German relief volunteer Waggas Sajid walked the muddy paths of this city’s most disease-ridden tent camp for earthquake survivors. Picking his way through mounds of rotting garbage and excrement, he felt like a character in Dante’s “Inferno.”
“This place is like hell,” said the 26-year-old paramedic from Frankfurt. “People are living together in squalor. Everyone is coughing, and the babies get sicker every day.
“I cannot imagine how they will survive. Hell cannot be any worse than this.”
Situated on the site of a destroyed government college, it’s known as the Old Government Camp. The name is misleading because neither the government nor any other relief group had anything to do with the impromptu compound until a team of German doctors stumbled upon it last week.
What the team found was an unsightly collection of 350 tents and more than 2,000 people that sprang up on a dirt-caked cricket field days after last month’s magnitude 7.6 earthquake.
Although scores of camps housing tens of thousands of refugees in the city are run by the Pakistani government and domestic or foreign relief groups, Old Government Camp had no sponsor. People just began showing up there and erecting their hovels.
Without help from Pakistani soldiers and international aid officials, conditions at the unsanctioned site quickly deteriorated -- worsened by cold nights and days of rain.
Doctors blame the outbreak of infectious disease, including hundreds of cases of diarrhea and acute respiratory infections, on a shortage of toilets, foul drinking water and the occupants’ close quarters.
The German medical team, from the group Humanity First, discovered the camp after arriving in Muzaffarabad a week ago.
Its members reported the situation to foreign health officials, who said they did not even know that the camp existed. Since then, several groups have rushed to the camp and have been shocked by the squalor.
“These are deplorable, appalling sanitation conditions -- absolutely and completely inadequate,” said Dr. John Watson, a communicable disease monitor for the World Health Organization in Muzaffarabad.
“There has been no access to latrines. People are relieving themselves indiscriminately. This is a recipe for an epidemic.”
For weeks, health officials have warned of the possibility of widespread death from cold and exposure if residents of isolated mountain villages did not move into tent camps in the lower valleys for shelter, food and healthcare.
Experts including Salahud Din, a Humanity First physician from the Netherlands who has helped set up a medical clinic at Old Government Camp, wonder whether such a move is wise.
“People might be better off back up in the mountains, taking their chances against the elements in their own villages, than to endure conditions like this,” Din said.
At this teeming camp, even some of the smaller tents house 18 people. Infants crawl on dirt floors and through puddles, ignoring the carpets their mothers have spread on the ground.
Dozens of goats scavenge from garbage mounds as chickens and feral cats wander among open campfires where women cook their daily meals, shooing away ever-present flies.
Many of the tents are made of a single layer of burlap, and rain drips inside as steadily as a hospital IV machine. Some residents have dug trenches to divert the rainwater, but others have no tools to do so.
Worst off are families with slapdash shacks made from sheets of corrugated metal that lean against a center pole, with no way to stop the wind and rain.
There was only one tank for drinking water, which soon became contaminated. Without latrines, residents relieved themselves just outside their tents, Din and other doctors said.
Volunteers from the aid group Oxfam have constructed a second water tower and installed sets of latrines around the camp’s perimeter. They are emphasizing better sanitation.
But doctors still worry that the worst is yet to come.
On his first visit last week, Watson diagnosed 170 cases of acute diarrhea -- “sick men, women and children -- lots of them,” he said.
Officials say treatment has helped reduce cases of diarrhea, which could lead to worse illnesses such as cholera.
Doctors also found cases of gastrointestinal infections, vomiting, meningitis, pneumonia, measles, scabies, chickenpox and hepatitis -- illnesses that can spread easily in the absence of proper sanitation and clean water.
Among adults in the quake-stricken area, respiratory illnesses are the second most-pressing medical problem after quake-related injuries, according to the World Health Organization.
But for children younger than 5, respiratory infections are the No. 1 concern, a trend that worries Din, the Humanity First doctor.
“Once children come down with respiratory illnesses,” he warned, “it can spread through the camps like wildfire.”
Although the doctors say Old Government Camp is perhaps the worst of disease incubators, widespread illness also poses a problem elsewhere.
Pakistani health officials report 8,000 cases of respiratory illness and 7,000 cases of diarrhea. There have also been hundreds of cases of tetanus, resulting in scores of deaths among the 3.2 million people left homeless by the earthquake, they say.
Officials also note that 17,000 pregnant women in the quake-affected area are expected to give birth by Christmas, leading to what may be a new generation of patients.
Some mothers living in places such as Old Government Camp will suffer from lack of medical care, doctors say.
“This is the second wave of the disaster,” Watson said. “The sheer magnitude of the problem is difficult to comprehend if you haven’t been there to see it for yourself.”
Frankfurt orthopedic surgeon Umair Bajwa, 30, has seen the squalor daily since he began making rounds last week.
The Pakistani-born physician, whose family moved to Germany when he was an infant, also speaks Urdu, enabling residents to describe their woes without being hampered by a language barrier.
“I feel very empathetic toward these people,” he said. “No one should have to live like this.”
In one tent, Bajwa encountered a young child coughing so hard that his face had turned a purplish red. He spoke urgently with the mother in Urdu.
“I haven’t seen this child before today,” he said afterward. “I told the mother -- no, I pleaded with her -- to please bring that boy to see me as soon as possible” at the new tent clinic he had helped set up at the camp.
Next, he approached a man standing in the entryway of a misshapen tent.
“How many people are living here?” the doctor asked.
“Thirteen,” the man replied.
“The tent is too small,” Bajwa said. He noticed a rusty bucket of water nearby. “Are you drinking that water?”
The man, a 30-year-old father of three named Mansoor Hussain, shot a guilty glance at his wife.
“No,” he told Bajwa. “We use it just to wash our hands.”
Slowly, however, the father opened up. He worried about his 1-year-old daughter’s persistent diarrhea.
“We’re living day by day,” he said. “We don’t worry about winter coming. We’re worried about what’s going to happen today and tomorrow, not some blizzard coming in two weeks. My child is sick today.”
On the camp’s outskirts, Bajwa tends to the most destitute of residents.
Shar Khan had lashed together a wood and burlap shelter in an unlikely place: between the newly built women’s latrine and garbage dump where two cranky goats foraged for food. Hundreds of flies hovered near the tent’s opening.
Khan’s daughter has diarrhea that will not subside.
Bajwa implored Khan to move, saying the surroundings were making his daughter sicker.
The young man listened but said he did not know where else to move his tent. At first, he said, the smell was so bad the members of his family could not sleep. But now they were used to it.
Later, finishing his rounds, Bajwa walked wearily back toward his field clinic. A young boy emerged from the twilight and whispered in his ear.
The doctor reached for his wallet and handed the boy some money, saying to no one in particular, “You know it’s going to the right place.”