Published8 hours agoSharecloseShare pageCopy linkAbout sharingBy Rajini VaidyanathanBBC News, Sindh province, PakistanMore than 2,000 hospitals and health centres were damaged or destroyed in recent floods in Pakistan – and families and their children are battling malnutrition and infection in what’s now a public health emergency. Doctors like Ammara Gohar are on the front lines of the crisis as the UN launches a fresh appeal for the world to send more aid.”It’s very difficult for us. We attended to patients during Covid, but this is tougher because it involves environmental hazards,” says Dr Ammara, a gynaecologist four years into her medical career. She is working out of a school in rural Sindh province, the area worst affected in the floods, which has temporarily become the headquarters for the district health office after it was submerged. Here, Dr Ammara and her team load a van with boxes of medical supplies – everything from bandages to malaria tablets, hepatitis test kits to oral rehydration salts.”We’re taking this to people who’ve been completely cut off since the floods,” she explains. Pakistan flood survivors battle rising tide of diseasePakistan floods: Images show huge scale of devastationWith around 75% of districts in Sindh province still flooded – and many roads underwater – the only way people in isolated communities can access medical help is if it travels to them.So after an hour’s drive, we reach the banks of a huge lake which a few months ago was fertile land that fed people in this area. Having swallowed their crops, it’s now stagnant water where mosquitoes multiply, and a breeding ground for disease.Across the vast expanse live villagers who’ve been stranded for weeks.”These people cannot survive without support in disaster-hit areas,” Dr Ammara tells us.Her team of government doctors take to wooden boats to reach them, their efforts supported by the United Nations Children’s Fund (Unicef). “This is a medical crisis,” Unicef’s Aadarsh Laghari tells us, as the medical team paddle to a village needing help. “Access is one of the biggest problems – every day the medical needs of these communities are rising.”In the first three weeks of September alone, more than 140,000 cases of malaria were reported in Sindh, health officials say. But with many people in far-flung areas unable to get tested, it’s likely the true scale is much higher.And that’s why mobile medical units are so urgently needed.After we reach the shore, the team set up a health camp under the shade of a tree on the edge of the village, where cows had earlier been taking shelter from the sun.A banner is hung from the branches to advertise the clinic; supplies which had been carried here by land and by water, are now being unpacked and laid out on plastic tables.As a tannoy announces the arrival of the medical staff, a steady stream of villagers arrive, many of them women carrying young children. The village of Noor Shah was already impoverished but the floods have pushed people right to the edge.As patients line up, a nurse measures the arm of baby Saima, with Dr Ammara looking on. The tape wound around her tiny arm moves to the red area of the scale, indicating that Saima is perilously thin.”There are so many people like this baby,” Dr Ammara says. “At just nine months old she’s severely malnourished.”Many families are sleeping in the open in flimsy tents next to homes which were washed away, or have crumbled to rock.Marooned for weeks, they’re finally getting much needed medical help – but many say they’re still waiting to get food and access to clean water to drink and wash with.At another village close by, three-year-old Gulbahar is examined by Dr Ammara. He has scabs on his face and body and is weak – the result, Dr Ammara says, of drinking and washing with contaminated water.The UN says a lack of toilets has left people with no choice but to defecate in the same water, leading to outbreaks of illnesses. “Because of the floods we are seeing so many young children with these skin infections,” Dr Ammara says, opening Gulbahar’s mouth to examine his diseased gums.She hands his mother some medicines, but concedes her supplies will soon run out.While diseases spike, Pakistan’s already overwhelmed healthcare system lacks the resources to help all those who need treatment. Boats are also in short supply, as are doctors – meaning efforts like this remain limited.Many people we met in these remote communities blame the government for not doing enough. Dr Azra Afzal Pechuho, the Sindh health minister, said: “It’s like fighting a war which has no end to it. Until the water recedes, which is going to take another two, three months, we will still be seeing a lot of health issues.”She has called for doctors to volunteer extra hours. “Ten days, three days, four days – whatever they feel they can give to the flood-affected areas,” she told the BBC.Dr Ammara and her team are already working around the clock. Without the camps, Dr Ammara fears people won’t be able to survive.”It hurts, it really hurts, I can’t see people like this,” she says. “I feel bad that we can’t do more.”More on this storyPakistan dengue cases soaring after record floods15 SeptemberPakistan floods ‘likely’ made worse by warming15 SeptemberPakistan floods put pressure on faltering economy19 September

Published7 hours agoSharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesThe smell hits you first – freshly cooked rice, lentils and spinach, served in ladles from steaming pots. Dozens of families – including mothers with babies – are lined up with plates to get a serving of what will likely be their only meal for the day. “We are here because we are hungry,” says Chandrika Manel, a mother of four. As she kneads a ball of rice with her hands, mixing it with the lentils and spinach before feeding it to one of her children, she explains that even buying bread is a struggle. “There are times I [give them] milk and rice, but we don’t cook any vegetables. They’re too expensive.”Depleted foreign reserves and soaring inflation have devastated Sri Lanka’s economy in recent months. President Gotabaya Rajapaksa – who pushed through tax cuts that shrunk the state’s coffers and borrowed heavily from China to fund ambitious infrastructure projects – has been blamed for the crisis. The pandemic, which hit tourism, and the war in Ukraine, which sent oil prices rocketing, has only made the situation worse. But now Sri Lanka is on the brink of a humanitarian crisis, the United Nations Children’s Fund (Unicef) has told the BBC. The organisation found that 70% of the country’s families have cut down on food since the start of the year, and stocks of fuel and essential medicines are also fast running out. ‘My children are miserable’This is Ms Manel’s first visit to a community kitchen as she found her options disappearing: “The cost of living is so high, we are taking loans to survive.”The kitchen is a month old – Pastor Moses Akash started it in a church hall in Colombo after meeting a single mother who lived off a jackfruit for three days.”We get people who haven’t had a second plate of rice for the last four months,” Pastor Moses says. By his estimate, the number of people queuing up for food has grown from 50 to well over 250 a day. It’s not surprising given that food prices in Sri Lanka went up by 80% in June alone. “I see a lot of children especially, most of them are malnourished,” he says. ‘Living in my car for two days to buy fuel’What’s behind Sri Lanka’s petrol shortage?No medicine for kids in a collapsing health systemSahna, a pregnant 34-year-old who goes by her first name only, is also in the queue with her three young children. She is due in September and anxious about the future. “My children are miserable. They’re suffering in every possible way. I can’t even afford a packet of biscuits or milk for my babies.”Sahna’s husband, who is a labourer, earns just $10 (£8.20) a week to support the entire family. “Our leaders are living better lives. If their children are living happily, why can’t my children?” she asks. A looming humanitarian crisis By the time Sahna’s child is born, things are expected to get worse. The mayor of Colombo recently said that the capital has enough food only until September.With shortages of fuel and cooking gas, and daily power cuts, families are unable to travel to buy fresh food or prepare hot meals. Image source, Getty Images”Families can’t buy what they used to buy. They are cutting down on meals, they are cutting down on nutritious food. So we are definitely getting into a situation where malnutrition is a major concern,” said Christian Skoog, Unicef’s representative in Sri Lanka. “We’re trying to avoid a humanitarian crisis. We’re not yet at children dying, which is good, but we need to get the support very urgently to avoid that.”Unicef has appealed for urgent financial aid to treat thousands of children with acute malnutrition, and to support a million others with primary healthcare.Acute malnutrition rates could rise from 13% to 20%, with the number of severely malnourished children – currently 35,000 – doubling, says Dr Renuka Jayatissa, president of the Sri Lanka Medical Nutrition Association.The crisis has brought forth a sense of solidarity, with people often relying on the kindness of strangers. But even kindness and hope are becoming precious commodities. Dr Saman Kumara at Colombo’s Castle Street hospital says that if not for the goodwill of donors, his patients – tiny newborns – would have been at great risk. He says his hospital is now “completely dependent on donations” for essential medicines and equipment, and urged more donors to come forward as patients’ lives are in danger.Back at the community kitchen, Chandrika is scooping the last morsel of food into her son’s mouth. “My best days are done. But our children have so much ahead of them,” she says. “I don’t know what will happen as they grow up.”You may also be interested in: This video can not be playedTo play this video you need to enable JavaScript in your browser.More on this storySri Lanka warns petrol stocks about to run dry17 hours agoHow soaring cost of living is hitting Sri Lanka hard12 JanuaryWhat’s behind Sri Lanka’s petrol shortage?22 hours agoHow Sri Lanka’s war heroes became villains13 MaySri Lanka profile18 November 2019

SharecloseShare pageCopy linkAbout sharingDoctors across Sri Lanka say hospitals are running out of medicines and essential supplies as the country’s economic crisis worsens. They fear a health catastrophe if international help doesn’t arrive soon.”Day by day things are running out. If we get to the point where it’s zero, then I don’t know what will happen,” says Dr Gnanasekaram anxiously. As secretary of Sri Lanka’s Association of Medical Specialists, the surgeon has been busy compiling lists of which medicines are running low at hospitals in the capital Colombo. “We are short of medical drugs, anaesthetic drugs, implants, suture materials. We are nearly exhausting the stock.”Healthcare services are going to collapse unless there’s immediate relief,” he says. I meet Dr Gnanasekaram between consultations – he says he’s hoping this interview will encourage international donors to come forward. If supplies aren’t replenished soon, the doctor warns of dire consequences. “If that happens there may be a situation where we won’t be able to save patients’ lives.”Sri Lanka is in the midst of its worst economic crisis in history. The country imports around 85% of its medical supplies. But with foreign currency reserves running low, essential drugs are now difficult to obtain. At his office in Sri Lanka’s largest children’s hospital, Lady Ridgeway, medical director Dr Wijesuriya shows me a piece of paper with a list of essential drugs on it. Next to the name of the medicine, there’s a column showing availability. Some like atracurium – used in anaesthetics – have only two months of stock left. But as I scan the list further, other drugs are in even shorter supply. There’s only two weeks left of the painkiller fentanyl, while three different types of antibiotics are already “out of stock”. For now Dr Wijesuriya says he’s managing these shortages with substitutions. He remains optimistic that the government will find a way to get him what is needed for his patients. Image source, Getty ImagesFrontline doctors are far less upbeat. Many say they’ve been told by the government they can’t speak openly to the media about the situation, with only union representatives and hospital directors authorised to do so. In a statement Sri Lanka’s government initially denied medicines were running out, even as doctors reported problems. A day later the Department of Government Information issued a correction, admitting there is a shortage of some drugs and equipment.

SharecloseShare pageCopy linkAbout sharingNepal’s prime minister has made an urgent plea for vaccines to his UK counterpart Boris Johnson, as the Himalayan nation experiences a devastating second wave of coronavirus.Speaking to the BBC, KP Sharma Oli said it was Britain’s responsibility given the historic ties the nations share.Mr Oli said the sacrifices of Nepal’s Gurkha soldiers serving the UK should make Nepal a priority for UK Covid aid.Nepal reported a high of 9,000 daily infections last month.”I want to convince the UK Government, particularly Prime Minister Boris Johnson, about the situation in Nepal and how we are suffering,” Mr Oli said. Nepal, which has one of the highest rates of positive tests in the world, saw a surge of cases in May, recording more than 4,000 deaths over the course of the month. Like its neighbour India, Nepal has struggled with shortages of beds and oxygen supplies. The situation has eased recently in places like the capital Kathmandu, but the virus is now spreading in rural areas.At the start of February, Nepal was reporting around 100 daily cases, but by early May that figure had jumped to as many as 9,000 daily infections. A national lockdown which began in April remains in place but many say it came too late.The country’s borders with India remain open. Critics say that failing to close them allowed the Delta variant detected in India to spread quickly into Nepal as migrant workers returned home. The Himalayan country has received some international aid, including 260 ventilators and 2,000 PPE kits from the UK. But Mr Oli said it was vaccines he needed. Fewer than 3% of Nepal’s population of 30 million has been fully vaccinated. Short on vaccines, Nepal faces looming Covid crisisIndia’s neighbours are battling new Covid wave”If we vaccinate people, then we can control Covid-19, otherwise it will be hard for us,” Mr Oli said.Nepalese authorities have ordered supplies from China, but many elderly Nepalis who received their first dose of the Astrazeneca jab are now unable to get their second, after supplies promised from India were delayed because of the crisis there. Prime Minister Oli said he was making the direct appeal to the UK, as Nepal’s “oldest friend”.”The Gurkhas have served the UK for many years, keeping their lives at risk,” he said. “People who are serving in Britain have their families in Nepal. So that is a very deep connection.”A spokesperson for the UK Foreign Office told the BBC it “stood shoulder-to-shoulder with Nepal during this pandemic” and was “one of the first countries to send health experts and life-saving medical equipment to Nepal”.”The UK is a leading donor to COVAX, the international initiative to procure and distribute vaccines equitably,” the spokesperson added. “We have committed £548 million to the scheme that will provide more than a billion vaccines to developing countries, including Nepal, this year.”image copyrightReutersMr Oli said his country’s foreign minister had spoken to UK counterpart Dominic Raab to discuss the issue, but he was trying to establish direct telephone contact with Mr Johnson.The appeal to the UK comes as the US has announced it will send vaccines to Nepal as part of a donation of 7 million doses to Asia. Mr Oli has faced criticism of his handling of the pandemic and for failing to take the virus seriously. He previously claimed that it could be washed away by gargling guava leaves and turmeric, and said Nepali’s have stronger immune systems because of their diets. Last month, as case numbers were rising sharply, he said the situation in Nepal was “under control”.Prime Minister Oli, who remains in power after a recent vote of no confidence, also drew criticism for holding mass political rallies earlier this year as MPs in his own party withdrew support for him.