CTF Pakistan Mission

Ref. No. 648/2010

Duration: 1 year Date Started: Oct 15, 2010

Date Ended: Dec. 30, 2011 HUMANITARIAN AID IN

FAVOR OF THE FLOOD

VICTIMS IN PAKISTAN

2/13/2012 CtF Pakistan Mission 2010 - 2011

This is a final report of the CTF project in the three Catholic dioceses of Pakistan in response to the needs of the flood victims in 2010. The project revolves around the five areas of intervention: emergency relief, rehabilitation (shelter), livelihood support, access to water, and formation.

HUMANITARIAN AID IN FAVOR OF THE FLOOD VICTIMS IN PAKISTAN

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HUMANITARIAN AID IN FAVOR OF THE FLOOD VICTIMS IN

PAKISTAN

C T F P A K I S T A N M I S S I O N 2 0 1 0 - 2 0 1 1

E X E C U T I V E S U M M A R Y

The 2010 Pakistan floods began in July 2010 following the heavy monsoon rains in the

Khyber Pakhtunkhwa, Sindh, Punjab and Balochistan regions of Pakistan. Present estimates

indicate that over two thousand people have died and over a million homes have been

destroyed since the flooding began.

Approximately one-fifth (1/5) of Pakistan's total land area was underwater due to the

flooding. At least 1,588 people have been injured, 222,600 houses and 4,600 villages have been

damaged or destroyed. The devastating floods brought severe impact on an already vulnerable

population. In addition to all the other damages the floods have caused, floodwaters have

destroyed much of the health care infrastructure in the worst-affected areas, leaving

inhabitants especially vulnerable to water-borne disease; it destroyed also the farms, crops and

deaths of their livestock (buffalos, cows, goats, sheep, etc.) which are the main source of

livelihood of the people, thus leaving them uncertain of their future. Unfortunately, another

wave of floods have swept recently (October 2011) in the province of Sindh that left some

homeless.

The Ministers of the Infirm (Camillians) through Fondazione PROSA (Camillian NGO) has

been giving assistance to social projects in the Catholic parish of Jhang District (Diocese of

Faisalabad) since 2006. PROSA has sent also the first assistance to the flood victims in the said

district. Then, in October 2010, the Camillian Task Force (CTF) team went to Pakistan and

conducted assessment (transit visit, interviews, focus group discussion) and needs analysis of

some places heavily affected by the flood in the three dioceses of Multan, Faisalabad, and

Hyderabad. (cf. Fig. 2, Appendix). Eight (8) villages were identified and coordinated for the

emergency intervention programs. The CTF has extended its efforts to assist the new flood

affectees of Sindh province last October 2011.

Based on the needs analysis conducted by the CTF team, the following programs were

identified, approved by CEI for funding and implemented from October 2010 –December 2011:


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1. SHELTER: To reconstruct and repair damaged houses; and to distribute winter package

(thick blankets, jersey, etc.) and sanitary kit per family. Under this scheme, houses were

built, reconstructed or repaired in the dioceses of Hyderabad and Multan;

2. HEALTH CARE: To address the possible outbreak of certain diseases such as dengue,

malaria and cholera through medical services, hygiene and sanitation programs. Under

this scheme, medical missions were conducted in the various settlements and

evacuation camps of the internally displaced persons (IDPs) in Hyderabad.

3. POTABLE WATER SUPPLY: To build a water purification plant in order to provide potable

water supply to the inhabitants. Under this scheme, a water purification plant was

constructed and installed in the village of Khusphur, dioecese of Faisalabad;

4. LIVELIHOOD: To generate initial capital for farm inputs and create alternative livelihood

and other job opportunities particularly in places where water is still standing in the

fields. Under this scheme, farm inputs were distributed to the farmers of Kott Addu;

5. FORMATION: To conduct workshop seminar on Pastoral Care in Emergency to

humanitarian workers particularly among Caritas personnel and CTF volunteers. Under

this scheme, a workshop seminar was conducted by the CTF to Caritas personnel and

volunteers of Pakistan.

Since the Camillian Task Force (CTF) has no physical based (established mission) in

Pakistan, it primarily worked in collaboration with the local Church through the bishops of the

three dioceses mentioned, Caritas Pakistan (national and diocesan offices), NGOs and the

religious congregations present in the area. It organized also a local group of volunteers in the

diocese of Hyderabad called the “Friends of St. Camillus”, tapped the parish development team

of Khusphur in the diocese of Hyderabad and established a joint effort activities (livelihood and

housing) with the Justice and Peace Commission (JPC) of the religious in the diocese of Multan.

The CTF mission to Pakistan has left a significant impact in the mission and ministry of

the Church in an Islamic country. The evangelical message has permeated in some remote

communities of Hindu, Christian and Muslim through acts of charity, and critical and healthy

collaboration with people of different ethnic and religious belief. It created an occasion of

pulling together the meager resources (human and material) of the community and put it

together for a common cause. It brought to light also the fragilities of the communities in terms

of structural – political conduct (leadership) and the organizational practices. This created a

challenge to the community that stirred them to dialogue and find ways of resolving pertinent

and urgent issues in the community.

The project was originally scheduled to be completed in one year from October 2010 –

November 2011. However, due to the an expected calamity (flood) which hit again in the same

district of Kotri last October and the request of the communities affected, the CTF had decided

to extend it until December 2011. The main focus of this intervention was more on distributing

non-food items (winter packages and medicines) to the affected families. The CTF has

distributed these packages in December 2011 together with the help of our volunteers in the

diocese of Hyderabad.


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METHODOLOGY

The methodology used by CTF during the assessment phase are the following: transit

visit, formal and informal interviews, focus group discussion and gender participation. The

transit visit was conducted through the collaboration of the Caritas personnel, JPC activists and

volunteers, men and women religious congregations and local NGO personnel. They were the

preferred partners since all of them are working in the territory and have sufficient knowledge

of the local culture. Formal and informal interviews were done among the inhabitants and

leaders in the district of Khushphur, Muzzafragarh, Kotri, Jamshoro, and Thatta, and the various

organizations who have been working in those areas. A focus group discussion (FGD) was also

conducted in some villages

allowing the populace to

participate in the planning and

implementation of the project.

There had been challenges

in involving women in the

discussion and implementation of

the project except in some

Christian communities. A big

success is the participation of the

women in the diocese of

Hyderabad. The Friends of St.

Camillus was organized in the

diocese of Hyderabad with

sufficient participation of women.

They were organized as volunteers who accompanied in the various medical camps conducted

in the said diocese. They helped also in the distribution of the relief goods through the

coordination of the Holy Family sisters. The religious missionaries of the Franciscan and

Dominican families, Columban and Holy Family sisters were very instrumental in the

Fr. Mushtaq and the women IDPs in the camp

Caritas personnel & CTF volunteers attending the conference


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implementation of the projects. Caritas (national and diocesan) organizations have provided as

with personnel, logistics and information. From this experience, the CTF’s partnership with

Caritas National came about. It developed into a long term partnership by developing together

a formation program for their personnel and other interested parties in the field of

psychosocial, emotional, and spiritual support in disaster capped us Pastoral Care in

Emergencies. A memorandum of understanding (MOU) was signed as a concrete token of this

partnership.

Thus, collaboration and networking became the key to success which gave way to a long

term partnership not only with Caritas but with the local churches. The support of the local

ordinaries and the parish priests became the fulcrum that keeps the “momentum” in the

implementation of the projects.

PROJECT RATIONALE AND GOAL

The projects (5) were implemented in the three dioceses on the grounds of the clear and

present needs of the areas identified and the resources (human and material) of the

stakeholders (CTF, as the primary actor and the collaborators) involved. Its primary goal is to

deliver immediate help to the communities affected by the flood to recover from such

miserable condition of their lives. The flood affectees have been in this condition not only

during the flood but even before and after due to extreme poverty and depravation (social,

political and economic). The secondary goal is to help local partners to take on the responsibility

of monitoring and sustaining the communities concerned right after the immediate

intervention. The CTF has been encouraging them to plan and to propose long term programs in

the line of health and development. An initiative has been developing already in Khusphur

through a local NGO - Organization for Cooperation and Development (OCD) that operates in

the area mentioned. Another initiative is in Kotri where the Friends of St. Camillus has been

organizing basic health education seminars in the villages.

BENEFICIARIES

Hindu women of Kotri


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A total of 2,048 families and 2,050 individuals had benefited from the various projects

(first 4) implemented in the three (3) dioceses of Pakistan, namely, Faisalabad, Multan and

Hyderabad. Of the total number of beneficiaries, 20 families had received the farm inputs (Kott

Addu), 53 had their houses reconstructed (Kotri & Muzzafragar), 1 dispensary was rehabilitated

(Shorkot), 675 had received the winter packages and sanitary kits (Kotri, ), 1,300 families had

benefited the supply of potable water (Khusphur), and 2,050 individuals had received medical

treatment and attention (Kotri, Jamshoro). (cf. Fig. 3, Appendix)

AREAS OF INTERVENTION

Five areas of intervention were identified and implemented, namely, shelter, health care,

potable water supply, livelihood and formation.

1. Shelter, clothing and sanitary kits

Most of the original houses in the villages were made of mud, bamboo sticks and reeds

which could hardly bear any strong

floods. These materials are economically

affordable and available in the area itself.

During the consultation with the

beneficiaries, majority of them chose to

use the same material, however,

fashioned and prepared in different way.

They formed bricks out of mud; used

steel girder as beams; and built the

foundation deeper than the usual. The

CTF had provided the raw materials and

the labor was by the community. The

volunteers assisted and monitored the

progress of the construction with the

supervision of a CTF member.

This method of working has

revealed the strength of the community

which led to the discovery of leadership

qualities of some members in the

community. However, there is still

remain a big hindrance to their

development, i.e., their legal rights to the

land. They live at the mercy and

exploitation of their landlords. This is

indeed a real challenge for development.


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In the other communities where resources (human) are limited, the local partner

organization has tapped the help of a local contractor. A raw house scheme was designed with

the basic facilities such as living room, kitchen and bathroom. The finishing touches of these

houses were relegated to the recipient as a counterpart to the project. However, these houses

were awarded only to those who have legal land titles or at least land rights. This is to ensure

permanency and future development of the community.

A total of 49 houses were built by

the CTF. The houses built were indeed a

big relief to the precarious situation of the

people. Moreover, it was not only the

physical structure that was rebuilt but also

the internal structure of the community

was reinforced and strengthened. For

them, the project has become a sign of

hope to their daily life struggle. It became

also a point of reflection of the major

stakeholders of the project on what more

can be done to ensure authentic human

development.

One dispensary in Shorkot was rehabilitated. It was damaged by the flood which sent

hundreds of families to travel far distances to satisfy their healthcare needs. The dispensary

caters the healthcare needs of the sugar cane growers (700+ families) in the village of

Francisabad and nearby villages. It is managed by the Dominican Sisters of Siena.

A total of 595 families had received the winter packages (quilt, jersey, caps, mufflers)

and sanitary kits (soap, alcohol, off-lotion, etc.) in different communities of the district of Kotri.

These are families who are non-beneficiaries of the housing reconstruction package. Most of

them, especially the children, were exposed to the harsh climate condition where temperature

during winter (December – February) went down to four (4) degree Celsius and below.

2. Health Care Delivery

The CTF had conducted ten (10)

medical camps in the district of Kotri and

other places. The team was headed by a

lady Hindu doctor together with volunteer

nurses from a nursing school in Karachi

and Hyderabad. A female physician is very

important in this mission since women are

not comfortable with male physician. The

team was able to check up and treat 2,050

Holy Family sisters distributing winter packages

packages

Medical mission in Francisabad, Shorkot


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patients where great majority of them were women and children. Medicines and vitamins were

given for free. Aside from medical treatment, the team gave also attention to health education

particularly to mothers, children and pregnant women.

The chief complaints of the patients were skin diseases (scabies, itch, allergy, rashes),

water-born diseases (gastro-enteritis, diarrhea), fever, cough, eyes, ear, nose and throat

infections. Many of them have complained of general weakness due to stress and sleepless

nights.

The members of the team were not only prepared with scientific and technical skills but

they were also prepared with pastoral healthcare skills. A training on pastoral healthcare was

conducted by the CTF Pakistan mission local coordinator. The team was equipped with a

consciousness of holistic approach to healthcare. They did not only give medicines to patients

but learned to listen to their painful and heartbreaking stories. They offered psycho-spiritual,

emotional and social assistance by listening and journeying with the IDPs (internally displaced

persons). The experience became a great learning experience of the team. They learned to be

more patient and enduring, a virtue which sometimes is hard to be found.

A follow up medical camp in five villages identified was conducted two months after the

first camp. This is due to some pertinent cases observed that need further attention.

Meanwhile, a basic health education was conducted by the Friends of St. Camillus with the

collaboration of Caritas Hyderabad.

3. Access to Potable Water Supply

The provision of potable water supply in Khusphur village was a deliberate choice of the

CTF among the villages that need such facility. The program of providing a water purification

plant (that can purify 20 gallons of water per minute) and a water (purified) reservoir with a

capacity of 10,000 gallons came after a series of technical preparations. The preparation

evolved in three steps: community consultation, review of scientific articles regarding health

situation of Pakistan, and the conduct of laboratory water analysis.


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BLESSING OF THE WATER PURIFICATION FACILITY BY MONS. JOSEPH COUTTS

The community consultation was conducted by the St. Fidelis’ Parish Development

Committee headed by the parish priest. This committee was primarily formed to address the

problem of those families whose houses were destroyed due to heavy rains. The result of the

consultation was further verified by the research done and consultation with some government

sanitary personnel on the overall health situation of Pakistan in that particular district.

According to records and survey, the prevalent illness and chief complaint of the community is

water-borne disease. There is a high percentage of cases of Hepatitis B & C among the

populace. This has been aggravated by the contamination to the main water supply of the

community by the floodwaters. Then, a water analysis was conducted by two different

laboratories (public and private) to determine the condition of the water. The results had shown

a high concentration of solid particles and salt in the water and is not advisable for human

consumption. There is also a big probability of the presence of certain harmful bacteria.

After all these processes, the purchase of the water purifier which has a reverse osmosis

facility and the construction of the plant were started. The development committee (KDC)

oversaw the construction of the facility.

All materials and supplies were purchased

locally. The plant has been in operation

since October 2011. Its operation is taken

over by a local partner NGO –

Organization for Community Development

(OCD) after a formal agreement (MOA)

has been entered with the CTF.

At present, the project aims to

continue by moving towards health

promotion and awareness education. The

OCD is now studying and preparing a


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project proposal that will comprehensively address the health problem of the community. The

provision of a potable water supply was only an entry point towards developing a long-term

project for health and development.

4. Livelihood

Kott Addu is one of the villages that was devastated by the flood in the district of

Muzzafragar. Damage to properties and plants were evident. This is a Hindu community of

about thirty-five (35) families working as cotton, sugar cane, and wheat growers. They have

only few animals (goats, sheep, buffalos) left. They live close to the southern section of the

Indus river, thus prone to flood. They don’t receive much help from the government because

they are a minority– discriminated, except from some Christian organization and churches. They

are also tied up to debts lent by the money lenders and their landlords. Their big problem was

the rehabilitation of the fields and the capital to start anew for the next wheat planting season

(January-February).

The main goal of this project is to help the farmers augment their source of income

through providing farm inputs and learning new skills and technologies to hurdle with the harsh

environment that they are now experiencing. This assistance has enabled the farmers to catch

up with the planting season and be able to harvest above subsistent level.

The implementation of the project was directly under the supervision of the CTF through

the help of Caritas of Multan and the Justice and Peace Commission of Pakistan (JPC). The

community leader was in-charged of organizing and getting the list of beneficiaries, and

canvassing of prices of the farm inputs such as seeds, fertilizers and pesticides. He was also

tasked to monitor and give report to the CTF regarding the progress of the project after the

harvest season. Out of the original thirty-five (35) families targeted, twenty (20) had received

farm inputs since the other families were dependents of the identified twenty (20) families

beneficiary.

Hindus of Kott Addu received the farm inputs


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5. Formation on Pastoral Care in Emergencies

It has been observed by the CTF after a month of doing assessment that, most of the

assistance rendered to the flood victims were focused on the provision of their immediate

material needs such as food, water, shelter and healthcare. Less attention was given to the

psycho-emotional, social and spiritual interventions. Most of the victims were mentally and

psychologically disturbed in various degrees. Much psychological disturbance (provoked by

stress and helplessness) were noticed among women who were deprived of venues or

occasions wherein they could express their fears, strong emotion of uncertainties and their

desires and opinions, due to certain cultural limits.

The CTF had organized an eight-day workshop training seminar on Pastoral Health Care

in Emergencies in the dioceses of Hyderabad and Multan. PHC in Emergencies is a module

developed by the CTF that incorporates the psycho-medical approach with the pastoral

approach in handling problems related to mental health provoked or aggravated by a chaotic

situation due to natural or man-made disasters, especially among children and women. This is a

holistic approach to giving and establishing psycho-social support to victims of calamities. The

workshop was divided into two sessions: a] lecture on fundamentals of PHC in Emergencies and

b] the skills building for emergency caregivers.

The primary target of this workshop were the CTF local volunteers and the personnel of

Caritas Pakistan representing from the seven (7) dioceses. Fifty-four (54) participants have

completed the first module. The workshop was facilitated by a psychologist, child psychiatrist

and a priest. The second module was scheduled last October, however, due to visa problem, it


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was reset to early next year. The next module will focus on skills building and techniques on

how to approach victims of disasters and build community support. This training is not directed

to diagnosing mental health cases but to mitigate or prevent situation of mental health problem

through building strong community support and referral system in case of evident mental

health issues.

The program is sustained by an agreement entered into with Caritas National (Pakistan)

and the partnership that has been built over the months during the immediate intervention and

rehabilitation phases of the CTF humanitarian intervention activities in the southern part of

Pakistan (Punjab and Sindh).

FINANCIAL RESOURCES

The project has been primarily financed by the Episcopal Conference of Italy (CEI)

through the Commission for Charitable Interventions in favor of the Third World with an

amount of seventy-thousand euro (70,000.00 EUR) or (92,250.00 USD). Other contributions

came from our non-profit organizations such as PROSA, Milan and SOS-DRS, USA, from the

various Camillian Provinces and delegations, individual benefactors and the CTF Central for

administrative expenses. The local contributions were labor force and logistics.

All materials and supplies were purchased locally. This allowed the local economy to

recover from the losses that it sustained and the resumption of the normal economic activity.

The project has contributed also to the generation of short term job contracts especially among

farmers and laborers whose income is heavily dependent on agricultural activities.

The original budget was 115,250.00 USD. The actual overall cost of the five projects has

amounted to 99,891.00 USD (76,839.23 euro) excluding the administration expenses and the

transportation costs sustained by the CTF staff from Rome. The exchange rate was based on the

rate of November 2010 which is 1USD to 84 PKR or (1EUR to 109.20PKR). Some adjustments

were made in the original plan due to changing situations and needs during the course of the

implementation. (cf. Fig. 1, Appendix).

SOCIAL IMPACT AND FUTURE CHALLENGES


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Our humanitarian mission to the people of Pakistan in the southern region has brought

great relief to the precarious situation of the internally displaced people (IDPs). Our presence

and the help extended have revitalized their frail hopes for a brighter future. This hope evolves

from this unwanted experience of being displaced in their own land due to the flood.

The flood opened up several wounds that were unexpected. Aside from the physical

wounds sustained by the IDPs, social, political and spiritual wounds were exposed. Many of

them live in small communities of 20 – 25 families particularly among the Hindus and some

Muslim and Christian communities in the remote villages. The cohesiveness of the community

was distorted and personal conflicts inevitably succeeded. The attention given to vested interest

provoked by envy and material depravation over community’s welfare became the rule of the

day. Survival is the name of the game they played. The fragility of their leaders became also

evident and mistrust of their constituents was the prevailing effect. This is not only true among

the civil leaders but also of the Church’s as well. Their grief and sorrows turned out into a real

cry to the highest one or divine whom they believed have punished them. In other words, the

physical, social, political and spiritual pain rendered them vehemently powerless and hopeless.

They harbored these pains not only during and after the flood but even before because of their

social condition of extreme poverty, violence and discrimination.

Because of this, the approach adopted by the Camillian Task Force (CTF) was

participatory. From the assessment up to the implementation phases, the involvement of the

community of beneficiaries and other people’s organizations as stakeholders of the project

became the path towards the success of the projects. It occasioned also the participation of

women in the consultation and implementation process in certain places. It healed the inner

wounds through symbolic acts of concern and reconciliation. It made the community to

distinguish who are the authentic leaders and discover the potentials of potential leader/s and

emerging forms of leadership. The presence of outsiders (humanitarian missioners) in their

communities became a challenge to them to reunite and to care for those members who are

less attended or ignored like the elderly and women.

On the other hand, it became an occasion for the CTF as well as with other organizations

that were involved, to sharpen their methodologies and strategies especially in the aspect of

their familiarity, sensitivity and respect to ethnic cultures. Here, familiarity was not only gained

through magnificent literatures studied but through interpersonal dialogue with the IDPs, a

hands on experience of the humanitarian workers.

Another notable impact is the spontaneous formation of a stable group of young

volunteers (e.g. Friends of St. Camillus) who were immersed into the situation and involved into

the implementation of the projects. The building of better form of partnership in a more stable

manner with various local stakeholders (e.g., Caritas, Khusphur Development Committee (KDC),

Organization for Community Development (OCD), Justice and Peace Commission (JPC), parish

youth organization, etc.). was in placed as a fruit of their reflection on how to sustain the

beneficiary communities.


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Despite great success, the challenges ahead are already foreseen. While it is true that

the seed of hope was planted in the ground of the IDPs, but it needs to grow and bear much

fruit for the community and for others. The relief operations or humanitarian interventions are

not enough to assure them of a better future. There is a new challenge to sustain them through

community development programs and measures. Poverty reduction and disaster risk

mitigation could be an interesting venture in this area. Proper care and intervention of the

people’s mental health condition especially to the victims of calamities is often given less

attention by humanitarian actors. Studies shown that, the cognitive and affective aspects of the

person are often destructed and distorted after calamities. It is then desirable to invest on this

aspect since the probability of a long-term and real recovery from this traumatic experience

depends on the mental health condition of the people.

= = = = = = = = = = = =


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APPINDEX

Fig. 1 Notes on Budgetary Adjustments

1. There have been a 400% increase of expenses on the winter packages because CTF has

decided to extend the distribution of the packages in November and December 2011 among

the flood affectees of the Diocese of Hyderabad. This is due to the request of the

communities affected during the recent flood that hit the area late last year.

2. There was also an increase (100%) of expenses in the installation of the water purification

plant in Khusphur due to the delay of its implementation caused by the long process of

securing legal permission, untoward organizational difficulties and miscalculation of the

budget estimate. The work had started in January 2011 instead of November 2010 as

scheduled, and the price of the materials went up already.

3. From the budget plan of the water purification plant, several items were combined together

such as the construction of the room for the plant and the communitarian labor (labor) and

the construction materials and electrical supplies (materials).

4. The had been a reduction (83%) of expenses of the livelihood project due to the reduction

of the number of beneficiaries. From the original target of 36 families, only 20 had qualified

to receive the farm inputs and technical supervision after a thorough assessment of the

beneficiaries. The remaining 16 families were not really tillers of the land but seasonal

workers of the farm tilled by the 20 recipient families.

5. There was also an increase (100%) of expenses in the pastoral formation seminars due to an

increase in the number of participants and demand for such training. The trainings were

conducted in two different places for the convenience of the participants who were coming

from the seven dioceses of Pakistan.

Fig. 2 Geographical Coverage


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Fig. 3 Statistical Report

ACTVITIES AREAS NO. OF BENEFICIARIES

Families Individuals Women Children

Reconstruction of houses

53 houses

Kotri 26

Jati 12

Sujawal 11

Kott Addu 3

Khusphur 1

Winter pax and Sanitary kits

Khanpur 50

Khuda kee Basti 30

Kotri 595

Medical Camps Khanpur 307 105 186

Goth Karokhath 249 88 131

Goth Karamdin 242 82 148

Jamshoro TC1 166 66 91

Jamshoro TC2 252 101 144

Wapda Colony 80 24 52

New Sabzimandi 198 94 50

Khuda kee Basti 210 68 132

Hathri da Thana 233 108 120

Hala Naka Ph.1 113 42 50

Livelihood Kott Addu 20

Potable water supply Khusphur 1300

TOTAL 2048 2050 778 1104

CTF Pakistan Mission

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