The Hosts with the Least

(Click image to enlarge)Zulfiqar Alam (center), program officer for CARE in Pakistan, visits with IDPs living in a school in Kanghar village, Mardan district. (2009 Rick Perera/ CARE) (Click image to enlarge)Jamshid, 35, brought his daughter Muqaddas, 9, to a CARE-sponsored medical clinic for treatment of her coughing and chest pains. They have no access to health care in their village, which has taken in four families. (2009 Rick Perera/ CARE)

They say it's better to give than to receive – but for the people of northwestern Pakistan, who have opened their homes to families escaping conflict, giving is starting to hurt.

The majority of the 2 million or more internally displaced persons (IDPs) are sheltering in private houses, schools and public buildings in districts bordering the conflict area. Host families and communities are generously sharing what little they have, but as time passes, worries grow.

Who will feed all these extra mouths, when there is no work for newcomers and what little cash they brought is running low? How will families cope with inadequate and overwhelmed water and sanitary facilities? What will happen when schools now serving as shelters reopen after summer vacation?

"There are 88 people from Swat staying in our three-room school," said Jamshid Khan, a teacher at the Government Primary School in Kanghar village. "They have no money and no food. Local people are giving as much as they can, but we need help from the outside world."

Zahid Mahmood, program coordinator for CARE in Pakistan, said CARE's priority is to reach people living in host communities. "Although 80 percent of IDPs [internally displaced people] are living in communities, they are less visible than those in tented camps, and get less help. In some cases, even hosts have been driven to leave home and go to the camps, where at least there is some measure of support."

The normal population of Pirano Banda village, 50 or 60 families, has almost doubled with the influx of 50 displaced families. Permanent residents say they're worried about what will happen if their temporary visitors have to stay for the long term.

"My electric bill has more than doubled since I've taken in three IDP families," said Bashir Ahmad of Pirano Banda, a volunteer at a mobile medical clinic sponsored by CARE. "The price of staples like flour, sugar and vegetables has nearly doubled. Of course we want to help those in need, but how long can we go on like this?"

Life here was hard even before the crisis, he said. "We had no proper facilities for the sick or for pregnant women, no ambulance service to the nearest health facility. And monthly supplies of medicines would run out after a week."

With the arrival of the monsoon rains, host communities could face even more health problems from waterborne diseases like diarrhea, said Zahid.

"Our medical clinics are open to all who need them, IDPs and hosts alike. But they are costly to operate, and we need donor support to reach more people in need."

CARE is also seeking funding to meet other crucial needs, like kitchen and hygiene items for IDPs living in host communities. The shortage of basic household equipment creates extra hardships – in some cases, for example, children must fetch water many times a day because of the lack of storage containers.

The seven extended families staying in the Kanghar school have just one small cooking pot between them, said Mr. Khan, the teacher. "The school staff have lent them whatever we can spare, but we are poor ourselves."

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