Lahore (AsiaNews) – Pakistani villages face a medical crisis which is rapidly assuming the same proportions as other predicaments they face. Other than post-earthquake logistical challenges like provision of heat and food, "it is very difficult to manage to give medical aid with the little we have".

Andreas Fabricius is a nutrition and first aid specialist who works for the German Caritas. He has been in Pakistan since 11 October, three days after the earthquake which has killed 54,000 people to date, injured more than 70,000 and left 3.3 million homeless.

Fabricius is an expert in operations in crisis areas: he knows the problems related to provision of water, food and meeting other essential needs of displaced and injured people. At the moment, he is the head of the health sector of Caritas in Pakistan and he has incorporated into his staff the medical team of the leprosy clinic in Balakot, which was totally destroyed by the quake.

"We went to Naran by Army helicopter because the area was completely impossible to reach by road, or on foot." The locals' wariness of those coming with army transport disappeared "as soon as they saw the staff of the

Leprosy Centre, which made our work much easier."

Survivors in the place have "more urgent needs than others: no one reached them for two weeks because not even helicopters could fly there." Nurses who once lived there all died as they tried to rescue the first people to be injured in the quake and no doctors have ever reached Naran".

Rural health services in Pakistan, like those in neighbouring India, are terrible: the government uses the term "remote" to denote villages where it would never set up dispensaries and where private enterprises have no interest in investing money because their potential client base would be among the poorest anywhere in the world. The doctor said: "They have never seen health professionals here, but we urgently need orthopedic specialists and surgeons to try to treat some of the survivors.

"A medical crisis exists. We have nothing and the little we can bring from outside needs maintenance. There is no blood and we have no way of knowing if donors are healthy. We don't have ice to keep drugs at the right temperature; the mountain climate is risky and electricity has not arrived. Anesthesia is just a dream for us, but operating without using any sedation is terrible".

The team of Fabricius is leaving Nala and is headed for a village 24km north of Battagram. They are taking surgical gloves, scalpels, disposable masks and other things which do not require special maintenance. "Thank God, the World Health Organisation (WHO) has offered to give us the equipment to vaccinate the people against measles, tetanus and hepatitis A, the epidemics most likely to break out now."