Pakistan hospitals, camps are overwhelmed

After a long trek out of the Swat Valley's conflict zone, wounded Pakistanis find there are not enough beds or medicine for them.

By Mark Magnier

May 15, 2009

Reporting from Mardan, Pakistan — Shaista Behran lay on a hospital bed with a battered leg and a burdened psyche after watching several members of her family diebefore her eyes.

The 8-year-old and her family fled the village of Wodkhi in Pakistan's war-torn Swat Valley last week, making it as far as the area's biggest town, Mingora, when a mortar shell exploded nearby.

"I saw my brother, two sisters and my mother die in front of me," she said, her words halting and barely audible, as a fly settled on her matted black hair. "Then everything went dark and I woke up here in the hospital."

The pus and blood had soaked through the dirty bandage on her left leg as she lay on her side in the overloaded women's ward of District Headquarters Hospital No. 1 in Mardan. The staff wasn't sure how she got here and hoped one of her relatives would show up soon to help her.

The injured come by taxi, on foot, in cars and by truck, collateral damage from a conflict many of them don't understand, as the Pakistani army and Taliban militants battle it out in the picturesque Swat Valley, destroying property and lives.

On Thursday, the fighting continued unabated. The current conflict started last month when the army attacked Taliban militants in the neighboring Buner and Dir districts and then in the valley, causing people to flee in panic.

The army said Thursday that 54 Taliban fighters and nine soldiers had been killed in Swat in the preceding 24 hours. The offensive has driven at least 800,000 civilians from the valley, with about 80,000 now living in camps south of the conflict area.

Dr. Shahid Durrani, head of orthopedic surgery at the hospital, said most of the cases the staff has handled were caused by bomb blasts or traffic accidents related to the conflict.

Many injuries are 2 or 3 days old by the time patients reach the main hospital in Mardan, the first city on the road out of Swat. By that point many wounds are dirty, infected and healing all wrong.

Dr. Rahman Khalil, another orthopedist, said the hospital was handling three times its normal load of patients, forcing the staff to release many early to make room for newcomers. Several days this week, far more patients arrived than there were beds in the wards.

A few beds away from Shaista, Roheeda, who didn't know whether she was 13 or 14 -- people often don't keep close count in rural areas -- nursed a wounded right arm. A shell hit her house in Anghapur village in Buner, causing part of a wall to collapse on her.

Her family -- her father and mother sat attentively on the bed beside her -- made it to Mardan by bus, and several days later she reached the hospital. They had no idea who was responsible for the mayhem that had uprooted so many people, but wished it would end soon so they could go home.

"The army, the Taliban, we think both are responsible," she said as her family nodded. "All the forces were firing without caring where it went. Innocent people are getting killed."

After the hospital does what it can, patients must tend to themselves. At a makeshift camp along the road between Mardan and the Swat Valley, hundreds of people huddled under tents made of blankets draped over ropes. Sumandar Khan, a thirtysomething laborer, tried his best to tend to his wife, Bakht Zameena, whose leg had been chewed up by shrapnel.

Having just returned from the hospital, they found themselves camping in the dirt with little more than a bundle of clothes, a plastic bucket and a few onions and tomatoes.

"Some people brought some food last night," Khan said. "We're poor and can't afford medicine. Yes, we're worried about the future."

Imtiaz Ali, 21, a student volunteer from the town of Takht Bhai, north of Mardan, said people who couldn't make it to hospitals desperately needed medicine and medical care.

"Look, these people here have nothing," he said. "And not a single government official has come by, nobody. Please tell them to come. These people badly need help."

The flood of displaced humanity living in close and often unsanitary quarters has increased the risk of epidemics, experts warned this week. Those staying in government-run camps say the demand for medicine far outstrips the supply.

"If you need tablets, the doctors say they're not available," said Naik Amul, 30, a teacher from Kanju in Swat now living in the Jalala camp. "At best, they give you one or two tablets, which aren't what you really need and aren't enough to help."

Often forgotten in the rush to provide food and shelter are the mental costs of the crisis. "People are in bad shape psychologically," said Ali. "People try and comfort each other, but many have seen their entire lives destroyed."

A few feet away, Naseem Ijaz, 36, a pharmacist, sat under an awning at a table on which hundreds of packets of pills were scattered. A woman came up holding a baby and explained her symptoms. He scrounged around and pressed a couple of tablets into her hand.

"Yes, a lot of people are unhappy," Ijaz said. "But these medicines have been donated. I'm a volunteer and so many people are in need.

"The government hasn't even given us a fan," he added, wiping sweat from his brow. "We desperately spray for the mosquitoes and there's a real risk of diarrhea, scabies, malaria, you name it. We're simply overwhelmed."