2005

It was Oct 10, 2005 — two days after the earthquake struck — when I reached Manshera with the relief team of the Pakistan Medical Association.

Our first stop was the Kid’s Blood Disease Organisation (KBDO) hospital at Shahnawaz Chowk in Mansehra. There were anaesthetists, gynaecologists, orthopaedic surgeons, general surgeons, physicians and voluntary medical students in our team. Landing at the Islamabad airport, we took a wagon to reach Mansehra, along with the volunteers of the Taraqi Foundation.

It was a long journey; we had already heard that a big building had collapsed in Islamabad but between Abbottabad and Mansehra we saw many damaged buildings — some of which were totally destroyed.

At that time there was very little traffic and nobody knew the actual extent of destruction caused by the earthquake. We saw distressed and tense faces everywhere and witnessed panic whenever there was an aftershock, which is a normal phenomenon after an earthquake of this magnitude.

In Mansehra, we came to know that the road to Muzaffarabad was closed and that Pakistan Army was working to open the main road.

We also came to know that Balakot had been totally destroyed. We met people from Abbotabad who told us that injured people were flooding the medical college hospital which was not able to cope with the number of patients.

A search for shrouds

In Mansehra, we saw an influx of people coming to find shelter, all of whom related tales of destruction and suffering.

The Abbottabad hospital was functional but there were many cracks on the hospital’s structure and there were fears that parts of the hospital may collapse soon. We saw doctors, nurses and paramedics working with fear in their eyes without the medical supplies needed for this kind of mega disaster.

Faisal Edhi of the Edhi Foundation told me that when Abdul Sattar Edhi heard about the earthquake, he instructed that all Edhi ambulances in Punjab and NWFP (now Khyber Pakhtunkwa) should be sent to the earthquake affected areas, filled with as much wheat flour and kafan cloth as possible.

It was a very wise decision; within two days we started seeing people desperately looking for kafan (shroud) cloth for the bodies removed from the debris. Balakot was totally ravaged and it took many many days to remove the dead bodies and in many places mass graves were dug for the putrefied bodies.

The Edhi foundation started distribution of flour, different kind of lentils and cooking oil, along with clean drinking water. In a very short time, Edhi volunteers were able to set up their network in the majority of the affected areas. They also brought small inflatable boats which were used to transport victims and food supplies on the rivers.

Volunteers were coming from every part of the country to help earthquake victims. Pakistani doctors from Canada, UK and the USA arrived with supplies and erected field hospitals and started performing procedures and operations on injured patients.

A big setup was established in Balakot by the volunteers of Midland Doctors Association, UK. A huge number of volunteers from Cuba, Turkey and the UAE also started relief work in disaster-affected areas.

Contributions from national and international NGOs started pouring in and people from all over the world sent their donations to the Government of Pakistan.

At the same time, we were shocked to hear that when the road to Muzaffarabad was opened after the second day of the earthquake, an organised group of people ransacked collapsed houses and cars on the roads in and around Muzaffarabad.

There were reported cases of kidnapping of young victims of the earthquake. Girls who had lost their parents in the disaster were smuggled to other parts of country and sold for prostitution. We also came to know that medical equipment, medicines, blankets, and tents stolen or looted from trucks and containers were also being smuggled to different parts of the country to be sold in the open market.

Very soon, the government rightly banned the travelling of children, especially girls, from the earthquake-affected areas. Check posts were established to inspect all trucks and vehicles leaving the area. We also witnessed massive corruption in the distribution of materials for the earthquake victims.

I felt ashamed of myself and wondered about the priorities of our different governments and the members of my profession.

With the unprecedented devastation, corrupt people in every department became active. The Army recovered many containers from influential peoples’ custody who were involved in the sale of materials otherwise meant for the victims. It was a truly sad state of affairs.

The disaster had struck everywhere. Garhi Dupatta, a small town near Muzaffarabad was shaken and we saw people living in tents. Balakot, which was once a bustling city, was completely destroyed. We observed landslides in many places. The Army had to drain water from lakes formed in depressions caused by the collapse of hills. We witnessed a great spirit among the victims, and in people everywhere from across Pakistan who tried to help in this national disaster.

I stayed in the area for six months with the relief team of the PMA, and during that time, I learned a great deal about this area and its people.

For the first time, I realised that from Muzaffarabad to Islamabad, there was no organised sewerage system or a proper system of clean water supply for the citizens. The sewerage from hotels, motels and houses is drained to small canals and rivers and it all ends up in the river Indus.

It was heartbreaking to note that this was the first time in their lives that many people saw a female doctor. A doctor (who has now become a Professor), from the Jinnah Post Graduate Medical Centre told me that when she reached a small village in an army helicopter the people in the area couldn’t believe that she was a doctor. Many women came just to shake her hands and to greet her with great gratitude.

I also witnessed the total collapse of basic and primary health care system in the area and realised that despite being the secretary general of the Pakistan Medical Association, I was totally unaware of the existing situation of people and their health in remote parts of Pakistan.

I felt ashamed of myself and wondered about the priorities of our different governments and the members of my profession.

In the last meeting of volunteers that I attended in Islamabad before leaving the area, I strongly suggested that the government utilise the huge funds it had received from all over the world in the construction of a sewerage system and the provision of clean drinking water.

We suggested that strict rules and regulations be introduced with regards to the rebuilding and construction of all cities and towns, starting from Rawalpindi to Hawalian, Abbottabad, Mansehra, Hazara, Muzzafarabad, Bagh, Balakot and Bisham.

We also suggested enacting environment-friendly laws and ensuring their implementation. We thought that there was a need for a mass campaign to create awareness about the environment, rivers, mountains and natural beauty in the area. We suggested that the government should spend money on the education of children in the area and organise the best possible basic education system.

2015

Two months ago, I visited the area again, travelling on the same road from Rawalpindi to Muzaffarabad and other parts of the earthquake-affected areas, and noted that the condition of the road was mostly the same. I was shocked to see that in every city and town, there were new multi-storied buildings constructed in violation of laws without any consideration for public safety.

It was also disturbing to note that in the last 10 years, we have not been able to build a proper sewerage and clean water distribution system. It seems the government officials have no realisation about the vulnerability of this mountainous area.

Revisiting the earthquake-devastated areas a decade later reveals that we have learnt no lessons from history.

I saw a seven-storey building in the place where the PMA Punjab had established its field hospital; even a doctor like me can see that it will not sustain a medium-sized earthquake. It was clear that nobody cared about rules and regulations when it came to construction.

I also visited some basic health units (BHUs) and rural health care centers (RHCs) in Hazara and Bisham.

It was very disturbing to see that nothing had changed in the last decade. These were healthcare centres without any trained health care professionals, like doctors, nurses and midwives. There were no medicines for patients and no proper facilities to deal with any kind of emergency. We failed to develop any organised system of heath care for pregnant women and children.

The schools are no better; there are lots of students but few teachers. Basic facilities, like classroom furniture, laboratories, libraries, toilets, water and clean environment were absent.

I wondered why the government has failed to take preventive measures against any natural disaster, like an earthquake or heavy rain. Despite massive donations from the international community and individuals, the government has done nothing to protect the environment for the humans and animals in the area.

Why did the government not care about schools and health facilities in this area?

Now, I understand why and how we, as a nation, have completely failed in achieving the Millennium Development Goals (MDGs). I also understand why we are not able to see the eradication of polio. It is very depressing to note that our government and people did not learn any lesson from the disaster of October 2005.

I felt that the government and people are just waiting for another natural disaster, aid and help from individuals and aid from countries to make money at the cost of our people and environment. What a waste of the precious last 10 years.

It seems impossible to convince the government to take the right actions because of the system we work under, but we can hope against all hope, that the government will declare an emergency in these areas on the 10th anniversary of the 2005 earthquake and take the following steps to improve the condition of unfortunate poor people of this area.

The government should strictly implement the rules and regulation related to the construction of buildings as per the need of the area. It is high time that the government make sure that all fountains, rivers and lakes are protected and all kinds of sources of pollution should be treated before it is released into the rivers.

It is very important to protect the trees, mountains, wildlife and natural beauty of this area for our future generations.

The government of KP and Kashmir should make sure that in the next five years, they build a proper sewerage and clean water system for every village, town and city. They should also organise a basic healthcare system to provide primary health care and make sure that every child should go to school in this area.

Ten years after the earthquake, we must realise that while we have lost a lot of time, there is still an opportunity to move in the right direction.

Published in Dawn, Sunday Magazine, October 4th, 2015

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