Pakistan

After seeing the situation worsen over the last 2 weeks, the Real Medicine team, in partnership with the HOAP Foundation, has conceptualized a rudimentary health care system that will be centered at Jabri and will serve both the acute and long term basic health care needs of the earthquake affected population. The health care system as envisioned by Real Medicine and HOAP will integrate clinical services, primary prevention and health education initiatives.

The plan for the health care system was formulated after field visits by Omar Amir of Real Medicine and Dr. Ahmed Nawaz of HOAP in Shawal Moizullah and Thalatta Union Councils and after discussions with the HOAP field workers and volunteers at the Jabri camp, the former government dispenser in the area, the HOAP leadership, and the local people in Shawal Moizullah. The plan was presented by the Real Medicine and HOAP team at the W.H.O. cluster meeting on January 9 in Balakot city that was attended by UNICEF, IOM and Oxfam among others. As a result of the meeting, W.H.O will support Real Medicine in meeting the crucial health care needs of Shawal Moizullah.

The salient points of the basic health care system proposed by Real Medicine/HOAP are as follows:

• The basic health unit at Jabri that was destroyed by the earthquake will be revitalized and run by Real Medicine and HOAP for the next 6 months.
• Real Medicine will hire a doctor who will be permanently stationed at the Jabri camp for the next 6 months. Another doctor will be mobile and will visit each village in Shawal Moizullah and Thalatta Union Councils.
• Real Medicine will hire 3 nurses/technicians at least 2 of whom will be female nurses/Lady health visitors (LHV) from the Shawal Moizullah area. One nurse will be stationed at the Jabri camp and will keep family folders and health records. One female nurse will be mobile and responsible for the Aladi zone while the other will be responsible for the Kaleesh zone. The nurses will all report to the doctors at the Jabri camp.
• The nurses will be responsible for outreach and health education and will focus on women's health, pregnancies and neonatal care since this is an area of critical need.
• Workshops for proper wound care, primary prevention of ARI, skin diseases, and sanitation will be conducted.
• Health education materials for primary prevention and early warning signs for disease developed by W.H.O. and the government of Pakistan will be used.
• In consultation with UNICEF, a vaccination program against measles will be implemented by conducting surveys using HOAP's volunteer network together with the nurses and doctor coordinating the process.
• Oxfam will help HOAP/Real Medicine implement a water and sanitation project.
• HOAP/Real Medicine will implement a basic health education component in the 25-30 schools that are being rebuilt by HOAP in Shawal Moizullah.
• W.H.O. in collaboration with the government of Pakistan will rebuild the basic health unit using a prefabricated structure by mid February at which point the HOAP/Real Medicine medical staff will work there.
• In the meantime W.H.O. will provide 1-2 medical tents to HOAP/Real Medicine that will serve as OPDS for the basic health unit until the prefabricated structure is ready.

After 6 months, the government and local community will take over the health care apparatus once they have recovered sufficiently from the earthquake.