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World Health Organisation (WHO) and Ministry of Health have set up an Early Warning and Response Network (EWARN) to quickly identify and respond to outbreaks of disease in the quake-hit areas.
Trained surveillance officers would impart training to health staff in disease tracking and response and a further 200 public health specialists would be deployed to gather data from existing health centres, WHO officials told a media briefing.
The surveillance would begin in Muzaffarabad and spread out to other reachable affected areas.
The WHO officials said although no major outbreaks of disease had been identified, however, risk factor still exists. Access to safe water, adequate sanitation and nutritious food are on priority to keep people healthy and prevent disease.
The first report on the epidemiological status would be available by week's end. All health partners are being asked to inform the Ministry of Health of any outbreaks of disease. The Ministry of Health and WHO continue to deliver large quantities of supplies to the affected areas with more than 50 vehicles currently transporting medicines, medical supplies and water and sanitation supplies from Islamabad to different locations.
Medical and surgical teams increasingly report seriously infected wounds among the injured. There is a shortage of tetanus toxoid vaccine and anti-tetanus immunoglobulin. The Ministry of Health has vaccination teams operating in Muzaffarabad and all accessible areas in the district and are vaccinating children from 9 months to 12 years old against measles and providing Vitamin A supplements.
Approximately 3000 children have been vaccinated. Vaccinations are also taking place from Peshawar to Mansehra. The officials said that around 13,000 earthquake victims have received surgical treatment so far. Severely injured people continue to be airlifted to Islamabad for urgent treatment.
Pakistan Institute for Medical Sciences (PIMS) continues to receive patients but the caseload is lower than on previous days. To reduce the number of medical air evacuations to Islamabad, Ministry of Health with support from WHO would establish a referral system between the existing health providers in Muzaffarabad.
The Abbas Institute of Medical Sciences (AIMS) together with four field hospitals is able to cover the number of required surgeries.
However, there is a shortage of bed space and resources for post-operative care. Also, many patients simply have nowhere to go after they have been treated. The district government of Punjab will be making 4000 additional hospital beds available for the treatment of earthquake victims.
The onset of winter coupled with a lack of shelter is a serious health concern that needs to be resolved quickly to avoid health problems such as hypothermia, shock and death. Warm blankets and winterised tents are urgently needed.
According to the latest situation report from the United Nations Office for the Co-ordination of Humanitarian Affairs, temporary shelter for about three million people is a priority requirement.
Despite contributions (32000 tents already delivered, 150,000 currently in the pipeline), thousands more tents are needed.
About donations towards WHO appeal for Pakistan earthquake, the officials said total cash and in-kind donations was $11,170,185 or (51.48 percent) of $21.7 million appealed for.

Copyright Associated Press of Pakistan, 2005

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