Pakistan floods 2010

Abstract

Introduction: In late 2010, Pakistan suffered one of the worst natural disasters in living memory. Over 20 million people were displaced as one fifth of the country was inundated by fl ood waters described as a slow moving inland tsunami. In August 2010, the Australian government ordered AusAID to form a joint task force JTF 636 with the Australian defence force (ADF) to provide humanitarian medical aid to the people of Kot Addu, Punjab, Pakistan. This was the first large scale joint civil-military mission, combining large numbers of defence health personnel with an Australian Medical Assistance Team (AusMAT) made up of senior doctors, nurses and paramedics from several states and territories. Discussion: Several novel medical humanitarian interventions were put in place, with excellent outcomes for the over 11,500 patients treated during the 21/2 month mission. Ondansetron wafers: Diarrhoeal disease was a frequent presenting complaint, with 949 cases treated. Ondansetron wafers have recently dropped in price significantly, and are a safe, cost effective method of nausea control in children in mass treatment of gastroenteritis without the need for i/v fl uids or naso-gastric tubes. Reporting of the success of this method of rehydration may change humanitarian response protocols for gastroenteritis outbreaks in children. Worming: Mass worming initiatives have been shown effective in remote Australian communities, and in humanitarian initiatives. Clinical improvements in weight and height for age measurements have been reported. Over 8,000 people were wormed during the JTF 636 mission that may provide a lasting legacy of decreased parasite load and improved general health and well-being, particularly in children. Malarial treatment: Mass testing for malaria of over 6,000 patients, using Rapid Detection Test (RDT) kits, and the treatment of over 2,500 cases of positive or suspected malaria is unprecedented in Australian military or civilian responses. The use of RDTs on a mass scale, appropriate treatment in a region with high chloroquine resistant P. Falciparum, and the reporting of changing trends in malaria and other diseases to the nullDisease Early Warning Systemnull and the WHO led health cluster, will be discussed as a model for future deployments. Conclusion: The first large scale Australian joint civil-military medical mission to a disaster zone is widely considered a success. As well as benefiting the people of the area of response, epidemiological data submitted to WHO and the Pakistan Ministry of Health allowed changes to be made to treatment protocols for the regional population of over 5 million people.