In Sindh, the floodwaters have receded in some places but are still present in many areas. Doctors Without Borders emergency teams are running six mobile clinics that visit over 24 different locations per week in the Dadu, Jacobabad, Sukkur and Shahadat Kot districts of Sindh. So far they have provided basic medical care to over 33,780 people, mainly for skin diseases, malaria, respiratory tract infections and diarrhoea.

In North Sindh and Johi town, our teams are seeing high numbers of cases of malaria. In the past two months, our teams have treated more than 12,100 people for malaria. Our teams are continuing to provide clean drinking water, with 4,148m3 litres already distributed. Our teams have also helped to distribute 562 hygiene kits to residents of remote flood-affected areas.

In North Sindh our teams are seeing high numbers of children with malnutrition at our mobile clinics. They have screened 9,246 children under five for malnutrition. Of those, 2,535 had severe acute malnutrition and 2,243 had moderate acute malnutrition.

In South Sindh, our teams in Dadu district are providing medical care through three mobile clinics visiting over 11 locations. Our water and sanitation teams have also provided over 444,460m3 litres of clean drinking water and have distributed around 24,600 relief packages to affected communities. In Sanghar district, our team have provided 5,120m3 litres of clean drinking water in the three worst-affected tehsils and have distributed 6,000 relief packages including tents, kitchen kits, hygiene kits and mosquito nets. The teams are also providing antenatal and postnatal healthcare in the district.

In Keamari Karachi district, Doctors Without Borders teams are working in Karachi tent city camp where they have set up more than 800 shelters, are providing more than 10,000  litres of clean drinking water every day, have installed 141 shower points and latrines, and have distributed 1,350 relief packages, including 600 mosquito nets, in collaboration with health authorities.

In Eastern Balochistan, the floodwaters have receded in many areas but the worst-affected districts of Sohbatpur and Jaffarabad are still largely under water, while pools of stagnant water are spread across other areas. Families living near flooded areas are vulnerable to water- and vector-borne diseases.

In Eastern Balochistan, Doctors Without Borders has five medical teams in Naseerabad, Sohbatpur, Jaffarabad, Usta Muhammad and Jhal Magsi districts. Our teams are providing outpatient primary healthcare to people affected by the floods, treating more than 1,000 patients daily. Areas of stagnant water are a major contributor to the rise in the number of people with water- and vector-borne diseases in Eastern Balochistan. Our teams are treating high numbers of people with malaria, severely malnourished children, and people with respiratory tract infections, diarrhoea and skin diseases, including ear infections. Doctors Without Borders has provided more than 10 million litres of clean drinking water in five districts of Eastern Balochistan.

In the past two months, Doctors Without Borders emergency teams have treated 11,533 cases of malaria with a positivity ratio of over 50 per cent. These numbers are concerningly high compared to previous years. We are also seeing high numbers of patients with malnutrition and have treated 3,965 children and pregnant and lactating women.

In October, Doctors Without Borders' water and sanitation teams installed a water filtration plant with a capacity of 270,000 litres per day in Jaffarabad district. The clean drinking water is delivered through water trucking to flood-affected villages and displaced person camps in Eastern Balochistan, which helps mitigate the risk of waterborne disease caused by contaminated water. The team has provided a total of 13,050,000 litres of clean drinking water in five districts of Eastern Balochistan.

Since 2008, Doctors Without Borders has worked in DHQ hospital in Dera Murad Jamali in support of the Department of Health (DoH). In recent months, Doctors Without Borders has bolstered this support, deploying additional medical and non-medical experts and increasing bed capacity from 40 to 69. Since September, our team has assisted 1,382 deliveries and admitted 1,142 children to the paediatric inpatient department.

In Western Balochistan, Doctors Without Borders has provided over 735 medical consultations in Chaman, and over 1,890 outpatient consultations in Quetta, mostly for patients with respiratory infections or acute watery diarrhoea. In Quetta, Doctors Without Borders water and sanitation teams have provided more than 2,190 litres of clean drinking water. A total of 740 relief kits including hygiene items, kitchen tools and mosquito nets have also been distributed to affected families.

In Charsadda and Nowshera districts, the floodwaters have receded and families have returned to their homes or are rebuilding their damaged houses. However, water sources in the flood-hit districts, including Charsadda and Nowshera, remain contaminated and are contributing to waterborne diseases in the area. To tackle this issue, Doctors Without Borders water and sanitation teams have been cleaning and repairing water sources since October. 

In Charsadda and Nowshera districts, four Doctors Without Borders mobile medical teams have provided 9,000 outpatient primary healthcare consultations for respiratory tract infections, eye infections, acute diarrhoea, severe skin infections and chronic diseases. Doctors Without Borders has also donated medical items to the hospital in Nowshera to support the isolation unit for patients with dengue fever. Doctors Without Borders emergency water and sanitation teams have installed water filtration systems, have provided 34m3 litres of clean drinking water and have cleaned and decontaminated 500 wells in flood-affected villages in Charsadda district. The aim is to clean 1,500 wells by the end of March 2023. In both districts Doctors Without Borders teams have distributed a total of 11,386 relief packages, including kitchen sets, hygiene items and 14,107 mosquito nets to affected families.

Doctors Without Borders teams in various villages in Dera Ismail Khan district are distributing around 5,000 winter kits to flood-affected communities.