MARDAN, 7 July 2009 (IRIN) - The health problems faced by internally displaced persons (IDPs) in the over 20 camps in Pakistan's North West Frontier Province (NWFP) are being made worse by a combination of lack of funds, a lack of women doctors and cultural constraints which dictate that it is not appropriate for male doctors to tend to women or girls.

The parents of Saira Bibi, aged 10, currently in the Jalala IDP camp in NWFP, refused to allow a male doctor to see her when she had acute stomach pains. The problem is widespread and doctors who have visited IDP camps say it adds to the health challenges currently being faced.

"I have heard women inside rooms in the homes of hosts or in tents moan in pain, but they won't let a male doctor near them," said Umar Usman, a medical doctor, who has visited IDPs in NWFP's Mardan and Swabi districts.

"The situation is in fact quite similar to that which arose after the earthquake of 2005. These people are from some of the same areas and the women cannot accept being treated by men," Usman said.

Eric Laroche, the World Health Organization's assistant director-general for humanitarian crises, who recently visited IDP camps, said the lack of female doctors was a problem.

"That is really a problem because, as you know, with Pashtuns [the largest ethnic group in NWFP] you need to be gender sensitive, and Pashtun women will not be treated by men, and there we have a major problem," he told the media in Islamabad.

There is widespread awareness about the issue. The NWFP IDP medical aid taskforce chairman Shafiq Sarwar said they were including "four or five female doctors" in teams sent to the camps to treat the women.

However, there appear not to be enough of them: "I have heard of teams coming with women doctors, but we have not seen them. My mother, who is 70, has pains in her back and side but… she refuses to see a male doctor," Shahzad Khan, 30, an IDP from Swat, told IRIN.

According to relief workers, most IDPs are women and children, so this represents a serious problem, but it is by no means the only one.

Shortage of medicines

WHO's Laroche has warned of shortages of medicines and said they could run out in the camps very soon. The lack of funds is a key factor.

The UN has appealed to the international community for some US$530 million to address the IDP crisis, of which $37 million is required to meet basic health needs.

"Within two to three weeks we won't have any more essential drugs for treating people in the camps," Laroche said, adding that the international community had failed to deliver.

Laroche also said the shortage of medicines was coinciding with the start of the rainy season when cholera, malaria and other diseases usually become more prevalent.

UK-based Islamic Relief warned earlier this month of the worsening health situation facing IDPs.

Some two million people have become displaced in recent months following fighting between Islamist militants and government forces in NWFP, according to the UN Refugee Agency.

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OCHA highlights

- Camps and shelters are being reinforced to prepare for the July monsoon rains.

- There are now a total of 45 humanitarian hubs, in and out of camps. The provision of water/sanitation and shelter materials is a priority for IDPs in host communities. In June, over 20,500 tons of food was distributed to IDPs in camps and host communities.

- Local authorities estimate that about 30 percent of IDPs from Buner have returned to their place of origin in the last three weeks.

- The Provincial Rehabilitation, Reconstruction and Settlement Authority (PRRSA) was created on 29 June.

(Source: Office for the Coordination of Humanitarian Affairs, 2 July update)

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