This record is a partial extract of the original cable. The full text of the original cable is not available.

UNCLAS SECTION 01 OF 10 ISLAMABAD 016641 
 
SIPDIS 
 
STATE ALSO PASS TO USAID 
USAID/W FOR A/AID ANDREW NATSIOS, JBRAUSE 
DCHA/OFDA KISAACS, GGOTTLIEB, MMARX, RTHAYER, BDEEMER 
AID/W FOR DCHA/OFDA 
SOUTH ASIA RESPONSE MANAGEMENT TEAM 
SOUTH ASIA EARTHQUAKE TASK FORCE 
DCHA/FFP FOR JONATHAN DWORKEN 
ANE DEPUTY ASSISTANT ADMINISTRATOR MARK WARD 
BANGKOK FOR OFDA SENIOR REGIONAL ADVISOR TOM DOLAN 
KATHMANDU FOR OFDA REGIONAL ADVISOR WILLIAM BERGER 
ROME PASS FODAG 
GENEVA FOR RMA AND NKYLOH 
NSC FOR JMELINE 
EUCOM FOR POLA/J3/J4/J5 
BRUSSELS FOR USAID PLERNER 
NEW YORK FOR TMALY 
SECDEF FOR SOLIC/PKHA, USDP/J3 
JOINT STAFF WASHINGTON DC FOR J3/J4/J5 
HQ USEUCOM VAIHINGEN GE FOR J3/J5 
 
 
E.O. 12958: N/A 
TAGS: EAID AEMR ASEC MASS ECON KMDR KPAO OIIP OPRC PGOV PREL PK
SUBJECT: PAKISTAN - EARTHQUAKE:  PROTECTION SECTOR REPORT 
 
 
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Summary 
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¶1.  Due to the enormity and complexity of this emergency and 
the major focus on providing shelter to villages in the 
mountains, it has been extremely difficult to monitor relief 
distributions in order to ensure that vulnerable 
populations, including those without effective male 
protection, are identified and receive adequate assistance. 
In the urban areas, especially in Muzaffarabad city, one 
month after the earthquake there has not been a registration 
of vulnerable populations and a prioritization of needs. 
The U.N. High Commissioner for Refugees (UNHCR), the lead in 
camp management under the cluster system, does not have 
enough presence on the ground in order to manage the camps. 
However, the numbers of unaccompanied children are extremely 
low and the government is working with the U.N. Children's 
Fund (UNICEF) to register children in order to assess their 
needs.  The international community is still trying to meet 
the population's basic needs such as shelter, but much more 
needs to be done to identify and provide assistance to 
extremely vulnerable populations such as women-headed 
households and children at risk.  End summary. 
 
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Current Situation 
----------------- 
 
-- Relief Distributions 
 
¶2.  The emergency relief operations are extremely 
complicated given the mountainous terrain and lack of 
information about population movements.  The provision of a 
safe, warm place to live is the first line of protection for 
vulnerable populations as winter approaches.  To date, the 
bulk of the relief operations have centered on providing 
shelter for people remaining close to their homes in the 
mountains.  However, in order to get these provisions to the 
population, the relief community has had to rely on the 
government of Pakistan (GOP) military, air drops, and relief 
agencies trekking or airlifting supplies to the mountain 
villages. 
 
¶3.  Women in Pakistan are severely disadvantaged and 
discriminated against, and many fear that the current relief 
distribution only reinforces this situation.  The issue of 
ensuring that vulnerable groups receive adequate supplies is 
extremely difficult to monitor given the logistical 
difficulties of this operation and the lack of information 
about vulnerable populations.  Partner organizations asked 
about this issue have replied that they must rely on the 
villages to distribute supplies fairly.  One partner 
organization reported that they sent teams to villages to 
identify the most needy and vulnerable families.  These 
families were given tokens to take to a distribution site 
the following day.  The following day only men attended the 
distribution site, and there was no follow-up to determine 
whether the neediest families received the supplies.  Women 
reportedly received tokens, but no women claimed the relief 
supplies for which these tokens were issued.  Because there 
was no monitoring, it is unclear whether the women who 
received tokens were able to access the aid for which the 
tokens were issued. 
 
¶4.  In urban areas there are many reports that women without 
effective male protection are made to sit in tents at GOP or 
GOP military sites while relief supplies are distributed to 
males first, leaving what is left for unaccompanied women. 
In most distribution sites, only men are visible standing in 
lines.  In addition, the USAID/DART has received many 
reports that women are being left behind in the villages to 
tend to what is left of their property and livestock while 
the men and the children come down to the valleys and urban 
areas to receive aid.  Some of the men who have come down to 
the valleys to receive aid report that there are women- 
headed households that are still in the mountains that may 
not be able to travel with their families. 
 
¶5.  Some organizations are trying to ensure that families 
that do not have effective male protection or vulnerable 
families that have taken in separated children are receiving 
adequate relief supplies.  These organizations do state that 
they could be doing more to ensure that such families are 
identified and receive adequate relief supplies.  Some 
report that the first wave of relief distribution was so 
overwhelming that they simply have not asked the questions 
about vulnerability and that systems are not set up to 
ensure that these cases are being identified and addressed. 
Setting up these systems will require more resources so that 
the GOP military and individuals involved in the 
distribution are trained and sensitized to this issue.  More 
female workers are needed to distribute relief supplies to 
vulnerable populations.  Additionally, work needs to be done 
with communities so that communities ensure that vulnerable 
families, especially those without effective adult male 
protection, are receiving adequate relief supplies both in 
the mountains and the urban areas. 
 
-- Camp Management in NWFP and AJK 
 
¶6.  With the push to get shelter supplies to the mountain 
areas there has been less attention focused on camp 
management and services in the valleys and urban areas.  In 
the North-West Frontier Province (NWFP), the GOP is pushing 
to establish large IDP camps.   In Azzad Jamu and Kashmir 
(AJK), the government's policy on establishing IDP camps is 
unclear.  The U.N. High Commissioner for Refugees (UNHCR) 
has the lead in the U.N. cluster system for camp management, 
but UNHCR staff on the ground have stated that it does not 
have sufficient resources, staff, mandate, or leverage to 
manage the camps.  UNHCR only has a minimal presence of 
international staff on the ground. 
 
¶7.  In NWFP, UNHCR stated that the GOP military is doing a 
good job trying to set up the camps, but the major 
difficulty is finding sufficient land on which to build the 
camps and organizations to provide services to the camps. 
The GOP military reported that it cannot take care of a 
large number of people in camps and is looking for serious 
help from the international organizations.  The government 
in NWFP is trying to set up large camps, because it believes 
that many people will migrate down to the valleys in the 
coming weeks.  UNHCR does not believe that there will be a 
massive migration from the Allai Valley and therefore does 
not want to put its resources into establishing large camps. 
UNHCR is providing the military with 18,000 tents and a very 
general site plan for the camps, and it is identifying the 
gaps in non-governmental organization (NGO) assistance in 
the camps.  UNHCR stated that it will only provide 
assistance for six months and that it does not have the 
ability to provide assistance to the GOP if there is a 
massive movement to camps. 
 
¶8.  In NWFP the GOP military is trying to get the government 
to take over the responsibility of managing the camps. 
UNHCR reported that it believes the biggest issue is the 
unregistered spontaneous camps.  UNHCR is not concerned with 
individuals camping near their homes in a few tents or less; 
however, it is extremely concerned over the spontaneous 
camps.  These camps are being sponsored by political parties 
or religious organizations.  The conditions in these camps 
are unacceptable due to lack of sanitation facilities. 
UNHCR has advised the GOP to zone the area and give specific 
zones to NGOs to monitor and deliver services to the 
spontaneous camps.  The GOP should then decide on which 
camps should be moved into larger camps and develop a long- 
term plan.  The International Committee of the Red Cross 
(ICRC) reported when they went into these spontaneous camps 
they found vulnerable families such as women headed 
households that needed assistance.  At this time there has 
not been a registration of these spontaneous camps in either 
NWFP or AJK. 
 
¶9.  In Muzaffarabad city there are many spontaneous 
unregistered camps, and to date the GOP has only sanctioned 
two camps run by local NGOs.  The GOP has not stated its 
policy with regard to establishing IDP camps in 
Muzaffarabad, and the military in AJK does not have the same 
resources to manage the camps as in NWFP.  There are many 
gaps in the camp services, but water and sanitation is the 
biggest problem at this time, and security is also a 
problem.  USAID is coordinating with the U.S. military to 
build hundreds of latrines for these camps, and other NGOs 
such as Medecins Sans Frontieres (MSF), Islamic Relief and 
Oxfam are also building latrines for the camps.  At this 
time, UNHCR does not have the resources on the ground to 
effectively manage the camps.  This problem is compounded by 
the fact that there are few international NGOs on the ground 
in Muzaffarabad city providing services.  It is clear that 
additional assistance is needed in order to provide basic 
services for the population of the registered camps as well 
as the spontaneous camps.  In camps that USAID visited, 
people are still lacking basic necessities such as shelter. 
In addition, the GOP needs to decide which camps it will 
close and which camps it will allow to remain open so that 
basic services can be provided that meet international 
standards. 
 
¶10.  No international organization is taking the lead 
monitoring the movement of people.   For example, in AJK 
there is no agency monitoring the movement of the population 
or any agency receiving individuals when they arrive in 
Muzaffarabad to provide basic information on emergency 
relief.  Organizations do not want to draw people to urban 
areas, but people are wandering the city looking for 
shelter, tents and supplies.  People do not have access to 
an ongoing reliable flow of information of where they can 
access emergency relief. 
 
-- Health 
 
¶11.  The U.N. World Health Organization (WHO) has stated 
that as many as 60 to 80 percent of the basic health centers 
and other health care facilities were destroyed in the 
earthquake-affected areas.  One of the biggest protection 
issues facing women is the lack of female doctors and 
nurses.  Some Pakistani doctors report that women have died 
because they could not be examined by male doctors.  The 
lack of female health care workers is severely limiting 
female patients' access to health care. WHO and other health 
agencies report that more female doctors and nurses are 
urgently needed in the earthquake-affected areas. 
 
-- Child Protection 
 
¶12.  The U.N. Children's Fund (UNICEF) is the lead on 
protection activities for the protection cluster.  The GOP 
imposed a national ban on the adoption of children for a 
period of six months.  Islamabad has also restricted the 
relocation of children from quake-affected areas to prevent 
the abuse and trafficking of children affected by the 
earthquake.  UNICEF, together with the Ministry of Social 
Welfare (MoSW), has begun registering all children currently 
living in emergency settlements across quake-hit areas of 
Pakistan and AJK.  The GOP wants to have some sort of 
statistics of affected children including those 
unaccompanied, with specifications regarding their age and 
gender groups to facilitate future planning.  In a joint 
effort with the ICRC, the National Database Registration 
Authority (NADRA), and several other national and 
international NGOs, MoSW intends to devise a comprehensive 
strategy to deal with the problems of orphaned, unattended, 
separated, injured and missing children.  Organizations are 
concerned that the MoSW is setting up institutions in other 
cities such as Peshawar that will care for unaccompanied 
women, children and separated children with vulnerable 
families. 
 
¶13.  In conjunction with MoSW, ICRC is identifying 
unaccompanied children and tracing their families.  There 
are very few reports of unaccompanied children by ICRC, 
UNICEF and NGOs, and there are only a few unconfirmed 
reports of attempted kidnapping.  It is clear that the MoSW 
will need a great deal of technical assistance and support 
in providing care and services for unaccompanied children, 
separated children with vulnerable families, women-headed 
households with children, and child-headed households.  This 
is extremely critical in AJK where the government's 
infrastructure was severely damaged and many government 
workers were killed or lost their homes and other family 
members.  International organizations and NGOs will have to 
advocate for establishing good practices in the area of 
child protection and monitor the work of the government. 
 
-------------------------- 
Response of USAID Partners 
-------------------------- 
 
¶14.  The provision of a safe, warm place to live is the 
first line of protection for vulnerable populations.  IOM, 
Save the Children (SC), ACTED, Catholic Relief Services 
(CRS), the International Refugee Committee (IRC), and GOAL 
are providing winterized tents, shelter kits, blankets and 
other materials for rebuilding.  In addition, many partners 
are starting to focus on doing more to identify vulnerable 
families such as female-headed households and ensuring that 
they receive adequate assistance. 
 
¶15.  In the registered and spontaneous camps, water and 
sanitation are critical needs, and many of USAID's partners 
are working to establish water supplies and latrines.  In 
Muzaffarabad, USAID is working with the U.S. military to 
build latrines in camps where latrines have not been built. 
In camps where latrines are being built, USAID's partners 
are working to ensure that women have safe access to these 
facilities. 
 
¶16.  Credible reports from organizations including UNICEF 
cite fliers and other information about religious madrassas 
opening up.  It is critical that the schools are opened 
quickly not only to counter madrassas but also to try and 
bring normalcy back to children's lives.  In Muzaffarabad, 
USAID has worked closely with UNICEF and the U.S. military 
to coordinate the removal of rubble from school sites and 
set up tent schools as quickly as possible.  USAID and 
UNICEF have worked closely with the Ministry of Education to 
identify school sites, including girls' schools, for rubble 
removal and tent distribution.  USAID is also establishing 
cash-for-work (CFW) programs in Muzaffarabad to remove 
rubble from additional school sites.  USAID partners are 
establishing school-in-a-box programs and will be addressing 
psychological and social needs. 
 
¶17.  International NGOs such as SC, World Vision (WV), and 
IRC have set up Child-Friendly Centers.  These centers are 
set up to support play and educational opportunities.  These 
organizations are reporting that vulnerable families are 
identifying themselves.  Additional programming needs to be 
established to help identify these vulnerable families 
without effective male protection, vulnerable families with 
separated children, and children-headed households. 
However, organizations are struggling to provide additional 
resources to these families.  With USAID assistance, WHO has 
established permanent teams to provide mental health 
assistance in the region. 
 
------------------------------------------- 
Gaps, Additional Needs, and Recommendations 
------------------------------------------- 
 
¶18.  The first wave of relief distribution was so 
overwhelming that many organizations simply have not asked 
the questions about vulnerable families focusing on women 
and children.  Adequate systems are not set up to ensure 
that these cases are being identified and addressed.   These 
systems will require more resources so that the GOP military 
and individuals involved in the distribution of relief 
commodities are trained and sensitized to identifying 
vulnerable families and ensure that they receive relief 
supplies.  In addition, more female workers are needed to 
distribute relief supplies to vulnerable populations and 
address health care issues for female patients.  Work needs 
to be done with communities so that they ensure vulnerable 
families, especially those without effective adult male 
protection, are receiving adequate relief supplies both in 
the mountains and the urban areas. 
 
¶19.  A registration and prioritization system must be 
created for vulnerable women and children in the urban 
areas.  UNICEF and the GOP are registering children, but the 
purpose of this registration is unclear.  In addition, it 
will take a considerable time to register all children in 
the quake-affected areas.  Once identified, these groups 
must have access to relief supplies, psychological and 
social help, and other resources. 
 
¶20.  UNHCR stated that they will only provide limited 
assistance for six months and that they do not have the 
ability to provide assistance to the GOP if there is a 
massive movement to camps.   The GOP and military have 
better control over the situation in NWFP than in AJK. 
While there is more control, information, and planning with 
the registered camps in NWFP, there is still a critical need 
for additional services in the camps, including latrines and 
security.  In AJK, the information concerning which 
spontaneous camps will be kept open and where additional 
camps will be built is extremely confusing.  To date in 
Muzaffarabad city, the government has only designated two 
camp sites.  There are still significant needs in these two 
camps for basic services.  However, the water and sanitation 
issues are finally being addressed in most of the camps. 
The GOP needs to decide which spontaneous camps will be kept 
open and designate additional sites.  Many of the conditions 
in the spontaneous camps are unacceptable.  UNHCR needs to 
identify additional partners to provide basic services in 
the camps and needs to address the spontaneous camps in both 
NWFP and AJK.  UNHCR needs additional staff and more 
resources.  More international NGOs are needed to work in 
the camps to provide basic services on a long-term basis. 
This is an extremely urgent issue that is being overshadowed 
by the critical need to get shelter to the mountain areas 
and the lack of enough UNHCR staff on the ground. 
 
¶21.  More assistance needs to be provided for female 
patients.  The lack of female health care workers is 
severely limiting female patients' access to medical 
services. WHO and other health agencies report that more 
female doctors and nurses are urgently needed. 
 
¶22.  More technical assistance should be provided to the 
MoSW.  This technical assistance would help the GOP deal 
with the issue of unaccompanied children now and create a 
long-term plan to handle these issues in the future. 
 
¶23.  It is clear that the MoSW will need a great deal of 
technical assistance and infrastructure support in 
identifying and providing care and services for 
unaccompanied children, separated children with vulnerable 
families, women-headed households with children, and child 
headed households.  International organizations and NGOs 
will have to advocate for establishing good practices in the 
area of child protection and monitor the work of the 
government in this area.