With the public health crisis in Karachi dominating the headlines, it is easy to overlook the problems that the rest of the country faces when there is a mass-casualty event. Few will have noticed that there has been an outbreak of cholera in Upper Dir and that 160 people, mostly children, have been taken to various hospitals in the last three days. In the same week as the cholera outbreak, at least 10 were killed, including three children, when there was a sudden thunderstorm followed by a flash flood in Kalkot, Upper Dir. At least 5km off the Dir-Kohistan highway was washed away with landslides blocking other roads. This has led to a shortage of rescue equipment and further rain is going to add to the infrastructure chaos, while doing nothing to ease the health crisis, either.
Although the cholera outbreak and the flash floods have no direct causal linkage, they are illustrative of the fragility of infrastructure in remote areas such as Dir — which is mountainous, sparsely populated and difficult to reach even under ideal conditions. The Executive District Officer (EDO) Health has stated that a medical team was dispatched to investigate the outbreak, but it is obvious that the health emergency has overwhelmed local medical resources. The EDO is contradicted by a local resident who said that the relevant officials were absent from Upper Dir and that there were also officials unwilling to attend to their duties in such a remote place during Ramazan. What is not in dispute is that a very large number of people are extremely vulnerable to water-borne infections such as cholera. Upper Dir is not the only place that is poorly serviced in the remote northern parts of the country, and many more communities are at risk as the monsoon approaches. There is a national lack of preparedness for events such as both Dir and the ongoing tragedy in Karachi, with there being little sign that the government is going to take corrective measures any time soon.
Published in The Express Tribune, June 27th, 2015.
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