Fr Seán McDonagh,SSC offers an update on the situation in flood-struck Pakistan

On August 12, 2010, the government of Pakistan issued new flood warnings as the swollen Indus River rolled south through the Punjab and the Sindh Provinces. The flooding began on July 22 2010, when torrential monsoon rains soaked the province of Baluchistan and sent swollen rivers pouring across the Khyber-Pakhtunkhwa Province (formerly called the North-West frontier Province) before flowing south into the Punjab and on to the Sindh.

Entire villages and towns are still under water and transport has been severely disrupted as bridges and roads have been washed away. Health risks from diarrhoea, cholera and typhoid are imminent and the efforts by the government and relief agencies to get food, water-purifying tablets, mosquito nets and cholera prevention kits to the worst affected areas are hampered by the breakdown in the country's infrastructure.

Unprecedented

Dr Shaikh of the World Health Organisation said that, ''the magnitude of the crisis is unprecedented. Many people who depend on the land and animals for survival had their livelihoods simply washed away. After the Kashmir earthquake in 2005, relief workers had access to resources. Here everything is gone - crops, livestock, homes and communities. There is nothing left for people to fall back on.''

More than 450 relief camps have been set up across the Sindh to provide shelter, medicine and cooked meals for flood victims. However, many people are not going to the camps because of tribal enmities and cultural sensitivities.

That is the big picture which in one way or another will affect the lives of about 14 million poor people. I got a sense of how the unfolding tragedy will affect one institution and the people it serves in an email which my fellow-Columban, Robert McCulloch circulated on August 11, 2010. Fr McCulloch has spent over 30 years working as a missionary in Pakistan and so is very well aware of the pressures which ordinary people have to deal with on a daily basis in Hyderabad. He has been chairperson of the board of St Elizabeth's hospital in the city of Hyderabad in the province of Sindh and has helped to procure much needed medical equipment for the hospital for the past 15 years.

Predicted

In his email he describes in detail what the flooding will do to the hospital and the community it serves. ''The Indus River at Hyderabad is currently running at 230,000 cubic feet per second. The government flood warning agency has predicted that by mid-afternoon of August 13, 2010, this will have increased dramatically to 1,200,000 cubic feet per minute. This is almost a five-fold increase.

The flood waters will remain at that level for two days and then will fall back to 900,000 cubic feet per minute. It will continue at this level for a further eight or nine days. We are expecting an awful tragedy. We had a 'minor' flood five years ago and it did awful damage. I shudder to think about what these next 10 days will bring.''

In preparing for the on-rush of the Indus waters, the staff at St Elizabeth's have moved everything that was portable to the first floor of the hospital. Some equipment could not be moved. They expect that flood waters will inundate the X-ray department and ruin all the equipment. The flood waters will also severely damage the operating theatres. Given the volume of water and the fact that it will remain at a high level for nine days, there is a real concern that major damage may be done to the building also.

Fr McCulloch explains the importance of St Elizabeth's to poor people in the area. ''Along the Indus River south of Hyderabad there are 18,000 people for whom St Elizabeth's is the sole medical provider. Many of these people are, in practice, agricultural slaves, who work the land for powerful absentee landlords.

Unfortunately, the awful plight of these people is often forgotten by government relief efforts and even by aid agencies. We at St Elizabeth's will have to do what we can to help them and look after them. After the floods have receded we will need money to deal with the immediate medical needs of poor people whose health has been affected by the floods and who have nowhere else to go. The elderly, the young and pregnant are often most affected by such events.

''We will also be trying to support people who currently live in grinding poverty, but who now must face the challenge of rebuilding their homes and their lives. We will also have to repair the hospital so that it can continue to serve these poor people who have no other access to modern medicine.''