DEC Response in Pakistan following the

2010 Floods

Final report – July 2013

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Background The Pakistan flood of 2010 was one of the most severe natural disasters the country had to face, affecting nearly 18 million

people. The crisis began in July 2010 following heavy

monsoon rains in the Khyber Pakhtunkhwa, Sindh, Punjab and Balochistan provinces.1 The

floods submerged 17 million acres (69,000 km2) of Pakistan's fertile crop land, killed 200,000

heads of livestock and washed away massive amounts of grain. At its worst, approximately 20% of Pakistan's total area was underwater. Almost 2000 people were killed and over 1.7 million homes were destroyed, exceeding the combined total of individuals affected by the 2004 Indian Ocean tsunami, the 2005 Kashmir earthquake and the 2010 Haiti earthquake.

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The country suffered extensive damage to crops and physical infrastructure. The total economic impact of the floods is estimated to be around $10 billion.

Overview of DEC Appeal and Members’ Response The Disasters Emergency Committee (DEC) launched an appeal within the UK on August 2, 2010 – one of the first to undertake this

3 - which mobilized more than GBP 71 million

4 for

relief and recovery work for the Member Agencies. All the fourteen DEC Member Agencies launched substantial humanitarian response which contributed to an unprecedented global humanitarian response

5 by a large number of agencies from all over the world joining hands

with national government and local organizations. It is the sheer scale of the response that ensured that despite the large number of people affected, there were no large-scale deaths following the floods.

DEC member agencies directly reached around 260,000 households,

6 or more than 1.8

million people, in the first six months of the response, providing emergency food supplies, shelter and non-food items, water and sanitation, emergency healthcare and nutritional support to affected families.

Table 1: Utilization of DEC funds by Member Agencies (GBP)

Agency Phase 1 (6 months response)

Phase 2 (6-18 months response)

Allocation Expenditure Allocation Expenditure

Action Aid 1,563,240 777,659 1,391,579 NA

Age UK 750,292 750,246 1,232,828 1,232,874

British Red Cross

4,037,972 4,037,612 1,268,750 1,269,110

CAFOD 1,197,507 427,802

1,268,750 2,038,438

CARE International UK

1,176,641 1,080,275 1,019,640 1,116,006

Christian Aid 1,725,151 810,151 552,728 1,467,725

1 Dr. Niaz Murtaza, Khurshid Alam and Sahar Bhatti. Disaster Risk Reduction in Pakistan: The Contribution of DEC

Member Agencies, 2010-2012. July 2012 2 Think Ahead. PAKISTAN FLOODS 2010 - The DEC Real-Time Evaluation Report. March 2011

3 The International Federation of Red Cross and Red Crescent Societies (IFRC) and DEC were the first to launch

their appeal – both were launched on the 2 August, and the UN appeal was launched over a week later on 10 August, 2010. 4 This includes funds (£29 million) that were raised and retained by the members themselves. DEC total funds

includes this in the appeal total as the members are, in essence, the DEC and their appeal income does rise considerably when a DEC appeal is launched. 5 The UN initially launched an appeal for US$460 million, which was later revised to US$2 billion as the magnitude of

the disaster became evident. 6 There was some disparity in the reported number of households reached, appearing as 260,346, or 254,208.

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Concern 750,449 750,449

1,516,578 1,516,579

Islamic Relief 982,138 982,353 1,376,780 1,325,197

Merlin 1,080,843 722,947

1,268,750 1,626,641

Oxfam 5,526,692 2,886,367

1,268,750 3,909,074

Save the Children

3,124,304 2,215,429 1,506,842 2,430,294

Tearfund 1,671,435 535,000

1,209,793 2,346,226

World Vision 1,413,338 1,270,224 679,428 822,544

TOTAL 25,000,000 17,246,815 15,561,196 21,100,738

Collectively, DEC members reached nearly 1.3 million vulnerable people with response in various sectors, including livelihoods, permanent shelter, water and sanitation and healthcare in the recovery phase (phase 2). Although the total pot of GBP 71 million looked small compared to the need, given the magnitude of the disaster that unfolded, DEC funds were crucial for Agencies to launch early response and subsequently attract funding from other donors.

Table 2: Beneficiaries reached by DEC Member Agencies

Phase 1

Emergency shelter 290,000 beneficiaries

Food aid 1,000,000 beneficiaries

Access to clean water 510,000 beneficiaries

Access to emergency toilets 160,000 beneficiaries

Mosquito nets 200,00 beneficiaries

Blankets 37,000 beneficiaries

Help to restart farming activities 26,000 beneficiaries

Phase 2

Water and sanitation 231,804 beneficiaries

Shelter 18,932 beneficiaries

Livelihoods 279,714 beneficiaries

Health 807,363 beneficiaries

Policy and protection 139,041 beneficiaries

Education and training 425 beneficiaries

Capacity building 10,340 beneficiaries

Others 37,272 beneficiaries

Total 1,284,575 beneficiaries

Early Response by Member Agencies Many of the DEC Member Agencies mobilized their response within hours of the floods, taking advantage of their long established presence in the most-affected provinces. Availability and expertise of local staff allowed immediate access to areas which would not have been open to international teams, due to security issues and travel restrictions imposed by the government. For this reason, the response in Khyber Pakhtunkhwa (KPK) was much faster than in other regions, such as Punjab and Sindh. Agencies responded to the most important sectors during the displacement phase, i.e., food, emergency shelter, non-food items, emergency water, sanitation and health, which together accounted for almost 90% of the DEC budgets in the first phase (Figure 1).

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In KPK, a little more than half of DEC members chose to work with local partners, whereas in Punjab, the majority chose to implement directly. DEC members working with partners report benefits of rapid mobilization, greater understanding of needs, familiarity with culture, politics and community dynamics and greater security. Organisations who chose to implement directly report hiring mostly national staff, as did the majority of those who worked with partners.

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DEC Member Agencies met or exceeded nearly all programme targets – some, like CARE’s primary health care services, nearly doubled their targets. The few targets which were not met were largely due to changes in the context, such as security, population movement or changing needs. Besides supplying food and household items in the first six months, water and sanitation interventions including hygiene education (WASH) made a significant difference to the lives of displaced communities. DEC members provided access to clean water to 74,277 people, hygiene promotion to 71,686, hygiene kits to 58,013, and latrines to 24,180 people. Emergency needs for food, WASH, shelter and health appear to have been well covered.

Figure 1: Expenditure on different activities in Phase 1

A few organizations also began limited livelihood activities in this phase of the response, and several others initiated this in the second phase. Oxfam initiated a quilt-making programme

for women that provided cash income for them, addressed winter needs and was based totally on local labour and material purchase.

8 Save the

Children provided cash grants of US$100 to 2,455 flood-affected female headed households to meet their immediate nutrition and livelihood needs in Shikarpur and Jacobabad districts of

7 DARA. Report on the DEC Member Agencies Performance in response to the 2010 Pakistan Floods, December

2011 8 Think Ahead. PAKISTAN FLOODS 2010 - The DEC Real-Time Evaluation Report. March 2011

Household items 4,048,717

31%

Food 3,768,589

29%

Livelihoods 1,947,611

15%

Shelter 1,279,135

10%

Water & sanitation 995,501

8%

Health 571,052

5%

Others 300,717

2%

Expenditure (£)

Household items

Food

Livelihoods

Shelter

Water & sanitation

Health

Others

Box 1: World Vision’s WASH Impact in Sindh In a household survey for a World Vision evaluation, 97% of the participating households reported washing their hands with water and soap after defecation. This compared favourably with a McRAM assessment of September 2010 which had instead concluded that only 26% of people were washing hands with soap and water after defecation in the Sindh province. During focus group discussions conducted during this evaluation, women mentioned hygiene-related behavioural change not only in children but in men too, especially with regard to washing hands before eating and usage of latrines instead of open defecation. (Source: World Vision. End of Programme Evaluation Report for DEC-funded WV Relief Program in Sindh (July 2011)

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Sindh province.9 Christian Aid also distributed cash grants to 200 flood-affected families in

Agra, Khairpur District to start or re-establish small enterprises. Of these, 99 were women and many were widows. The beneficiaries utilized the cash to set-up or re-establish small businesses, such as grocery stalls, handicraft-making and fishing ponds.

10 Besides this,

Christian Aid also distributed agricultural vouchers to 2,500 families for use in purchase of fertilizers, equipment such as spades, wheelbarrows, and sickles; vegetable seeds; and spraying equipment for pesticide. ActionAid undertook cash-for-work programme based on the needs expressed by communities to help them earn cash mainly for rehabilitation of their damaged houses.

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On reflection on their response in the first six months, several organizations noted that it would have been more effective to include cash-for-work schemes, or unconditional cash grants for the purchase of food and NFI, when available in markets.

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Response in Recovery Phase Of the total allocations of GBP 42 million made through DEC appeal funds, nearly GBP 23 million (or 55%) went to activities in the recovery phase (6-18 months).

Figure 2: Expenditure in phase 2

In terms of volume of work, provision of water and sanitation, livelihoods, shelter and healthcare absorbed most of the resources, helping people to return to their villages and re-establish their lives and livelihoods.

9 Save the Children. DISASTER RESPONSE PHASE 1 REPORT 2 (narrative) – DEC Form 13a

10 Christian Aid. DISASTER RESPONSE PHASE 1 REPORT 2 (narrative) – DEC Form 13a

11 ActionAid. DISASTER RESPONSE PHASE 1 REPORT 2 (narrative) – DEC Form 13a 12

DARA. Report on the DEC Member Agencies Performance in response to the 2010 Pakistan Floods, December 2011

Water & sanitation 4,767,282

23%

Livelihoods 4,046,256

19%

Shelter 2,019,710

10%

Health 1,697,664

8%

Protection 106,358

0%

Other programme

255,301 1%

Programme support & delivery

8,208,136 39%

Expenses (£)

Water & sanitation

Livelihoods

Shelter

Health

Protection

Other programme

Programme support& delivery

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Some of the key achievements by different agencies in these areas are shown below:

Agency Water &

sanitation Health & Nutrition Livelihoods Shelter

ActionAid Installed 200 hand pumps; constructed 271 toilets

- Agricultural inputs to 2000 farmers; 600 families provided cash for work; 2073 household kitchen gardens; over 1500 backyard poultry and goat rearing support.

492 houses repaired.

AgeUK - Training in home-based care; eye camps (12,802 people screened); 1292 people provided mobility aids; 1188 cataract operations.

- -

British Red Cross

3456 household toilets constructed.

- 1551 households assisted with cash grants.

Cash grants provided for 505 house repairs.

CAFOD 525 hand pumps repaired; 473 new water schemes constructed; 450 toilets constructed; 506 village technicians and 550 hygiene promoters trained; 1832 bio-sand filters constructed.

- 300 people provided cash for work

-

CARE - Nutritional supplement for children and people living with disabilities

728 households provided cash for work and microbusiness support; 400 families assisted with backyard poultry.

-

Christian Aid

- Ante-natal and post-natal consultation; child vaccination; nutritional supplement for children and pregnant women (29,000 beneficiaries).

44 families provided milking cows

191 permanent houses constructed

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Concern - - 8500 families provided cash for work; 1000 cash grants; 12803 livestock inputs; kitchen 5810 garden support; 710 small business support; skills training

-

Islamic Relief

4 ponds; 4 solid waster collection points; 600 toilets

Trained 30 birth attendants

500 Agricultural inputs; 100 households provided goats; 130 backyard poultry.

-

Merlin - Support to 29 static health facilities, 6 mobile health units, 4 labour rooms; trained government health staff in malaria case management, acute malnutrition and standard WHO protocol.

- -

Oxfam Constructed 7 water supply schemes, 80 communal water tanks, 3681 bathing/ toilet facilities; provided 120451 water storage containers; constructed 65 WASH facilities in schools; 1050 solid waste management kits distributed.

- - -

Save the Children

- Identification and treatment of malnourished children and pregnant women; Training of government health staff.

Tearfund 1768 bio-sand filters distributed; 2977 hygiene kits distributed; 3122

- Agricultural inputs to 1900 farmers; 13621 goats distributed to 4544

1391 houses provided construction material

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latrines constructed.

women beneficiaries.

World Vision

640 toilets and bathing facilities constructed; 600 arsenic filters provided.

- 2418 families assisted with cash for work; 400 women supported kitchen gardens; 400 women backyard poultry; cash vouchers to 50 women; 100 masons trained.

-

Disaster Risk Reduction A strong emphasis was laid by DEC Members on disaster risk reduction (DRR) and community resilience in their work on WASH, livelihoods and shelter during the phase 2. All fourteen DEC member agencies included DRR programming in their work, either by mainstreaming DRR activities in different sectors or by having stand-alone DRR work in the form of community-level disaster risk management and preparedness work. Community-based Disaster Risk Management (CBDRM) has helped increase people’s resilience through community-based organizations developing contingency plans for dealing with disasters, developing linkages with external governmental and non-governmental stakeholders involved in preparedness and response activities and undertaking micro-mitigation work within communities.

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As was noted in the DEC study on DRR (2012), the ability of INGOs to undertake DRR activities increased significantly with the establishment of the Pakistan DRR Forum, “an informal group of civil society organizations voluntarily coming together on issues of common interest in the field of Disaster Risk Reduction and Management (DRR/M) and Climate Change Adaptation (CCA), at the national level in Pakistan”.

Shelter work carried out by Member Agencies was generally seen by communities as the most important form of mainstreamed DRR work in terms of enhancing their resilience. Agencies involved in housing construction, such as Plan, CAFOD’s partner Catholic Relief Services (CRS), Islamic Relief and Christian Aid’s partner Muslim Hands have developed housing models which provide greater protection during floods. Christian Aid’s partner trained masons in its vocational training programmes to build flood-resilient houses. Tearfund’s houses can hold 7-8 family members on the roofs during floods, and are cyclone-resistant. Due to the low material cost, maintenance is easy, without the need for high technical expertise, making the structures sustainable.

Health and hygiene work had important DRR outcomes. Communities generally felt that the hygiene training done by agencies (such as British Red Cross, Concern, CARE, Merlin, Plan, Tearfund, World Vision, Islamic Relief, Save the Children and Oxfam) has helped families maintain adequate hygiene standards during disasters and reduce the risks of epidemics. In addition, Merlin has helped the government to set-up a Disease Early Warning System (DEWS) at local levels so that epidemics can be checked early before they cause a second public health disaster. Merlin has also contributed to DRR outcomes by building the capacities of government health personnel so that they can tackle health emergencies in future on their own. Sanitation activities schemes also enhanced the resilience of communities. Toilets built according to Sphere guidelines have reduced risk of ground water

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Dr. Niaz Murtaza, Khurshid Alam and Sahar Bhatti. Disaster Risk Reduction in Pakistan: The Contribution of DEC Member Agencies, 2010-2012. July 2012

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contamination as well as the risk of diarrhoeal and malarial diseases (e.g., by Save the Children and Islamic Relief). Elevated and well-constructed hand pumps (e.g., by Islamic Relief, Plan, Tearfund and CAFOD’s partner CRS) have improved the quality of water for communities during disasters and reduced the risks of diseases.

Capacity building Twelve of the fourteen agencies (ActionAid, Age-UK, CAFOD/CRS, CARE, Christian Aid/CWS-P/A, Concern, Islamic Relief, Oxfam, Plan, Save the Children, Tearfund and World Vision) are also involved in CBDRM activities with the objective of increasing disaster preparedness. CAFOD’s partner CRS has developed a comprehensive and versatile CBDRM manual. CBOs are linked up with local government authorities and other relevant stakeholders for early warning information, and help with evacuation and relief aid. CARE and CAFOD/CRS are setting up pilot projects to help communities receive early warning information through SMS with the help of mobile phone service providers in the private sector. ActionAid has facilitated the establishment of the Thatta Disaster Response Network in Thatta district in Sindh which links CBOs in 15 villages where it has undertaken CBDRM work. Concern’s CBDRM programmes focus at Union Council (a cluster of around 6-7 villages) level to ensure optimum coverage of villages. Tearfund has developed Disaster Management Committee (DMC) in fifteen villages and equipped with necessary materials and linked with DDMAs. Several agencies have undertaken prevention and mitigation activities within communities, e.g., Christian Aid’s house construction, Oxfam’s reforestation programme within villages (prevention) and the micro-irrigation construction, repair and maintenance activities done by CAFOD, Save the Children, Islamic Relief, and World Vision. In Oxfam’s WASH activities, capacity building of community and partner staff was an integral part of its response. Operational and management trainings were organized for 406 WASH committees (separate for men and women). The WASH committees were trained to be able to operate and maintain the rehabilitated/newly constructed water systems as well as trained on hygiene promotion. All repaired WASH facilities were handed over to the WASH committees with tools and were trained at the end of the project as part of Oxfam GB’s exit strategy to ensure complete community ownership of the facilities.

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Advocacy Several of the Member Agencies were active in advocacy at various levels. One of the best examples was Age UK’s advocacy with the protection cluster which led to successful formation of a task force under the cluster.

15 This taskforce had its aim to help and guide the

cluster regarding Ageing and disability issues and their specific needs. Age UK held two provincial and two district level advocacy workshops and established ageing network comprised of representatives from the government and civil society. ActionAid Pakistan has started an advocacy campaign through a number of advocacy tools with women’s rights as the cross-cutting theme.

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Oxfam GB. DEC Form 10 – Member Agency Management response to the Pakistan RTE 15

AgeUK. DISASTER RESPONSE PHASE 1 REPORT 2 (narrative) – DEC Form 13a

Box 2:Building capacity and reducing future risks The hygiene promotion activities have improved long-term hygiene practices and reduced disease risk. .............. The hand pumps and latrines being provided in villages will last several years and reduce the risk of diseases from water and sanitation problems. Similarly, the health equipment given to partners and the government will likely last several years and help in disease control during future disasters.” (Source: Dr. Niaz Murtaza and Annie Devenport. Evaluation of CARE’s DEC Phase 1 and DFID Dadu projects)

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Participation and Involvement of Beneficiaries in the Response A significant feature of the Pakistan response by DEC Member Agencies was in the strong emphasis put by all on community participation, beneficiary involvement and accountability. Even where agencies were directly operational – that is, not working through a local partner-NGO – they consulted and involved communities in beneficiary selection and implementation of activities. As the local feudal lords or politicians attempted to politicize aid to meet their personal interests, Member Agencies used participatory approaches through village committees for beneficiary selection as well as to explain the purpose of their programmes at the onset. The list of beneficiaries was shared with influential people and the village committees argued that they had identified these families on the basis of vulnerability. There was also strict monitoring by project staff to effectively manage the social pressure. The outcome was that local committees played a significant role in mitigating the social pressure.

16 There was active engagement of village committees in general they

managed the pressure from local elites well.

Accountability to beneficiaries All Member Agencies had put in place various measures to promote accountability to beneficiaries and transparency in their programmes. Several followed key elements of HAP standard to set up complaints mechanism and information sharing. At least three Agencies (CARE, Merlin and Tearfund) had staff with specific remit on accountability and quality. The mechanisms included installing complaints and suggestion boxes in appropriate locations, sharing contact details of partners’ senior staff, providing hotlines and toll-free numbers, displaying beneficiary entitlements at distribution sites and identifying individuals within organizations to whom complaints were to be taken, amongst others. A few used pictorial

diagrams to ensure the illiterates could understand how to use the complaint mechanism. About half of the member agencies report displaying beneficiary selection criteria, and several posted the list of beneficiaries.

17 One Agency (Merlin) established Patient Charters which were

displayed at health facilities to explain available services, patient rights, contact information for any complaints, hours of operations and shifts of staff. British Red Cross’ partner, Pakistan Red Crescent Society, instituted weekly radio and television programmes run by its volunteers to facilitate communication with beneficiaries through interactive segments allowing for viewers/listeners to call in and ask questions live on air. These programmes received wide public coverage and acceptance of programme achievements during the flood operations, and covered a variety of issues affecting the population including restoration of family links, shelter, livelihoods, water and sanitation and health, as well as cross-cutting themes such as the role of women.

Evaluations and Lessons from the Response DEC organized a real-time evaluation (RTE) conducted by independent external evaluators which examined the first phase of response. The DEC Real Time Evaluation, World Vision’s evaluation, and to a certain degree the CARE evaluation focused specifically on DEC funding, while those of Concern, Tearfund and the British Red Cross presented overall evaluation of

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ActionAid. DISASTER RESPONSE PHASE 1 REPORT 2 (narrative) – DEC Form 13a 17

Think Ahead. PAKISTAN FLOODS 2010 - The DEC Real-Time Evaluation Report. March 2011

Prior to this emergency CRS had strong informal feedback mechanisms, such as staff sharing cell numbers with beneficiaries, but lacked formal feedback mechanisms or a system for tracking complaints. During the project period, such mechanisms have been piloted, including hotlines, suggestion boxes, and help desks, all of which were explained to beneficiaries verbally and through a pictorial leaflet. Tracking sheets have been introduced to log beneficiary suggestions and complaints as well as the response and subsequent actions taken, with an indicator of time taken to respond.

Islamic Relief Pakistan (IRP) came under pressure from the local government to use beneficiary lists provided by the latter for house construction. IRP used a community-approved criteria based on vulnerability factors, instead of the Government list.

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the relief phase, including programmes funded through other donors’ resources. Islamic Relief’s evaluation focussed on its rehabilitation work. The Real Time Evaluation was generally considered useful in terms of joint learning process as findings and recommendations were clearly presented and disseminated through workshops in Islamabad and London. All DEC members responded to the Real Time Evaluation recommendations, indicating follow-up actions that would be taken. Some of the important lessons that emerged from different evaluations are as follows:

1. Addressing gender issues require more than training and orientation: Agencies have generally used gender-disaggregated data well and developed programmes designed to address women‘s special needs. A general pattern that emerged in all evaluations was that while the agencies involved women in project implementation, there was a need to give them an enhanced role in project decision-making process. CARE noted in its narrative report for phase 1 that rapid scale up of staff at the field level meant that new staff were not as familiar with protocols and policies in gender initially as was desirable. This situation was not unique to Pakistan, and happens in most emergencies, despite significant investment in training and orientation. This was addressed to an extent by ensuring that all staff engaged with women in camp management and decision making through community meetings which involved women. 2. Participation is more that information sharing and beneficiary involvement in selection: As was noted in one evaluation, despite stated emphasis on beneficiary participation, there was little opportunity for beneficiaries to contribute to project design and implementation. Although sharing information and involvement of communities in beneficiary selection were emphasized, meaningful participation that could enhance ownership was often lacking.

18 This

was also noted in the DEC RTE which observed that there was a need to enhance the use of local capacity through greater reliance on local partners, staff and village committees and through local purchases.

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3. Persistence on principled stand pays even if that sometimes requires one to take a firm position different from Authorities’: Beneficiary selection was the area of most significant conflict with local authorities. In some cases, the authorities withheld approval insisting that beneficiary lists provided by them be used for house construction. As was demonstrated in Islamic Relief’s operation, when agencies took a principled stand on independently verified lists and adopted a community-based approach and mobilized community support for community-verified beneficiary list, did the authorities finally relent, although this caused some delay in getting approval. 4. Agencies need to ensure cultural and contextual appropriateness of items distributed: Some agencies distributed candle water filters for individual households. As was observed in one evaluation, such filters require replacing the candles and are not the most appropriate in

the local context. 20

There are other locally appropriate solutions (sand filters and clay pot filters which were later distributed by some agencies). A similar observation about inappropriateness of candle filters was also made during a Tsunami evaluation in Sri Lanka some years ago.

5. Exit strategy ought to be built into all programmes right from the start: In areas where agencies did not have ongoing programmes or presence, the response did not prepare a formal exit and sustainability strategy. The work was completed, the objectives achieved and the programme was closed.

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Tearfund. Pakistan Floods Response REAL TIME EVALUATION REPORT, December 2010 19

Think Ahead. PAKISTAN FLOODS 2010 - The DEC Real-Time Evaluation Report. March 2011 20 Tearfund Pakistan Floods Response REAL TIME EVALUATION REPORT, December 2010 21

Stephen D. Houston. Final Evaluation Report - Baluchistan Integrated Village Rehabilitation Project – Islamic Relief. 13 September 2012