Pakistan's military operations in the country's Swat Valley have displaced several million people. In recent weeks, Comprehensive Disaster Response Services (CDRS) Pakistan, an emergency relief organization, has deployed medical teams to assist internally displaced persons (IDPs) from the districts of Swat and Buner in hospitals, camps, schools, and homes. CDRS's executive director, Todd Shea, recently returned from Pakistan, where he coordinated CDRS's response and visited several IDP camps. On June 18, at an event organized by the Wilson Center's Asia Program and co-sponsored by the Center's Global Health Initiative, he gave a sobering and candid account of the troubled state of the IDPs and of efforts to help them.

Shea said that while approximately 3 million Pakistanis have been displaced, only about 300,000 are in IDP camps. The other 2.7 million have been absorbed by host communities, with the majority based in Mardan, a district near Swat and Buner. Shea lambasted large relief agencies for overlooking these 2.7 million IDPs and the "internally affected persons" who are serving as hosts. The host communities, most of them impoverished and struggling to secure basic resources even before the arrival of the IDPs, are now stretched to the limit. Many homes in Mardan have taken in as many as 40 IDPs, and schools have been closed to accommodate the influx of refugees.

As for the IDPs themselves, Shea did not mince words. Supplies are running out, and the threat of disease is high. According to Shea, 60,000-70,000 displaced women are expected to give birth in the next three months. He expressed concern about the well-being of these pregnant women, who are approaching their delivery dates in hot, crowded environments with limited nutrition and hygiene. Meanwhile, significant numbers of IDP families fled Swat without fathers and husbands. A respected elder with whom Shea spoke in an IDP camp said that families are afraid to return home because they still fear the Taliban's presence.

Shea contended that general relief efforts have been woeful. One reason for this poor response is the provincial government of Northwest Frontier Province (NWFP), the restive area of Pakistan where the IDP tragedy has unfolded. The NWFP government, Shea argued, is completely inexperienced in disaster response. The efforts of other relief organizations are "hampered" by the inability of this "central agency" to do its job effectively.

The NWFP government's limitations lead to a second explanation for the insufficient response: coordination problems. Some of Shea's harshest criticism centered around the "disconnect" between small organizations such as CDRS and the larger responding agencies. He asserted that there is precious little coordination between Pakistan's army, the UN agencies, nongovernmental organizations, and the NWFP government. And he suggested that until someone is in charge who can coordinate the activities of all these groups, the plight of IDPs in Pakistan's northwest will only worsen.

Click here to see a recent New York Times profile of Todd Shea and CDRS.

Drafted by Michael Kugelman, Asia Program Associate
Robert M. Hathaway, Director, Asia Program, Ph: (202) 691-4020