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. 2005 Nov 12;331(7525):1151.

In Pakistan's earthquake zone global relief has so far failed its test

Richard Villar 1
PMCID: PMC1283293

At over 1.83 metres tall and a former soldier, I do not cry easily, yet I am certainly crying now. The reason? Frustration following Pakistan's earthquake, perhaps the biggest disaster to strike this planet in my lifetime and something that the world's largest aid effort seems powerless to relieve.

I am in the Neelam valley, east of Muzaffarabad, helping to establish two small field hospitals. At the beginning the situation was hopeless, with large numbers of disaster tourists and their cameras, each seeking the one image that could establish their careers. Then there were the tedious meetings with aid agencies from around the world. The answer was clear. The people needed action, not discussion. Today I am in the little village of Panjgiran, in the company of Ahmad, a respected local in the throes of post-traumatic stress after losing his entire family in the earthquake. It was at 8 52 am on 8 October when, unexpectedly, the ground shot vertically upwards. Within three seconds it was all over with three million homeless and to date around 80 000 dead.

There is no way of reaching every person other than on foot

As I walk through the village, it is clear that there is no building intact. Ahmad shows me the pile of rubble that was once his house and the corner of the ruin from which he extracted his mother's corpse. We walk on, tears streaming down our faces, until we reach the school. This, too, has been flattened. Exercise books, once carefully written and cared for, now flap uselessly in the wind while opposite sits a group of four children. They are motionless; eyes open in incomprehension, orphaned that terrible day and, even now, with no one to care for them.

On we walk, the stench of death still lingering in the air, families grouped by the roadside, their most senior male member rising to greet me. I try to explain the problems; the endless, futile meetings, the lack of helicopters, and the size of the relief operation, but I can see my explanations landing on deaf ears. I see instantly what is needed. A tent for each family, a guaranteed food supply, and health care for their festering wounds.

I shake Ahmad by the hand, mumbling something useless such as “I'll do what I can,” and find myself a lonely spot on the mountainside overlooking the valley. Beneath me I see a blue, winding, picturesque river, but all around there is evidence of landslides, both old and new. Below also is the road, now impassable. Another helicopter flies overhead, and another, and another, and another. I jump to my feet and wave my arms violently, trying to attract the pilots' attention. “Panjgiran!” I yell, “Come on guys, give us some of your load!” I cup my hands around my mouth and shout the village's coordinates, “North 34° 26' 47.3”, East 73° 37' 12.3“!” But the helicopters carry onwards, clearly unaware that I even exist. So I sit down hard, childishly holding my head in my hands, as I realise that my efforts are wasted. Of course the pilots cannot see me, a tiny frustrated speck on the side of a massive 3000 metre mountain.

The problem is clear although the solution is not. No matter how many helicopters may be donated, no matter how much money is given, the end point of delivery is a small, destroyed household perched on a mountainside. Even if a helipad does exist it is likely only to be able to take the smallest of helicopters. In my time here I have seen several machines sink beyond their axles into the clay-like mud. Physically, there is no way of reaching every person other than on foot or, perhaps, encouraging the householder to come down. If they can, of course, with their festering wounds, neglected fractures, and half-starved bodies. Only yesterday I saw a 12 year old boy who had dislocated his right hip during the earthquake. It had taken him more than a day to reach me, carried by his father. His mother and his sister were long since dead, one beheaded by their corrugated iron roof on 8 October, the other smothered by sliding rubble.

In the distance I see the helicopters deliver their cargo to a military base and I know that that is the end of the line for the aid. There are few smaller helicopters to deliver the items further up the mountainside. I have also heard that there is a cash crisis and that relief flights may be suspended within the next few days. So I sit on my mountainside feeling helpless. Mad ideas flit through my mind. Employ 10 000 mountain guides to walk every ridge in Kashmir, or mobilise every soldier, sailor, and pilot in the globe. Yet even then only the surface would be scratched. At 8 52 am on 8 October global relief began its test; to date, it has failed. However deep we all dig, the end point is the 12 year old boy, or Ahmad, or the millions like them, stranded on remote mountainsides in the wilds of Kashmir. Tears of frustration are no help. It is just that crying is all I can think of right now.


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