The COVID-19 situation in Pakistan is rapidly evolving, necessitating an equally adaptive response. The first instance of a locally transmitted case was on March 13, 2020. Within a month, 48% of all COVID-19 cases in Pakistan were found to be the result of local transmission1. As of April 16, 2020, Pakistan has conducted 78,979 tests of which 6505 have tested positive. Of the confirmed cases, 4736 are active cases and 1645 have recovered. The total reported deaths are 124 so far. In addition to increasing pressure on ill-equipped health facilities, there is a lack of Personal Protective Equipment (PPEs) in Pakistan. This is a matter of concern for all essential workers but is especially worrying in the case of healthcare providers, contributing to both rising discontent and a rapid pace of infections. The medical fraternity fears that the health sector in Pakistan may collapse as a result2. At least 17 doctors and five paramedics in Quetta and 16 medics in Khyber Pakhtunkhwa (KP) have so far tested positive for COVID-19. Two doctors are reported dead in Gilgit-Baltistan and Sindh3.

In addition, the lockdown in Pakistan to be lifted on April 14 has been extended for the next two weeks. While certain industries have been allowed to resume operations, the loss of livelihood for vulnerable segments of society is inevitable and is a cause for concern. As a mitigating measure, the cash distribution of the PKR 144 billion through EHSAAS program has started on April 9 and will distribute PKR 12, 000 each to 12 million families. More than 800,000 individuals have signed up for the nationwide ‘Corona Relief Tiger Force’ as a standby force for distribution of food door-to-door if the situation demands.

The Non-Governmental Organizations (NGOs) in Pakistan have generated PKR 4 billion for the COVID-19 response, facilitating distribution of rations, provision of PPEs, and food drives4. Gender and religious minorities are the most vulnerable and in need of assistance in these programs, along with the daily wagers who lacks income during the lockdown.

CoronavirusCOVID-19

6,505 Confirmed Cases

124Reported Deaths

10%population is above the age of 50

48%locally transmitted

1-UNICEF COVID-19 Situation Report 14/04/2020 https://reliefweb.int/report/pakistan/pakistan-covid-19-situa-tion-report-no-3-reporting-date-6-12-april-20202-UNOCHA - COVID-19 – Situation Update 15/04/2020 https://reliefweb.int/report/pakistan/pakistan-covid-19-sit-uation-update-14-april-20203-Coronavirus: Why Pakistan's doctors are so angry https://www.bbc.com/news/world-asia-522439014-UNOCHA - COVID-19 – Situation Update 15/04/2020 https://reliefweb.int/report/pakistan/pakistan-covid-19-sit-uation-update-14-april-2020

IRC Pakistan Country Update April 16, 2020

IRC’S RESPONSE

Pakistan confirmed its first two cases of COVID-19 on Feb 26, 2020. However, in just 7 weeks’ time period, we have gone from category level 1 - alert to category 5 - widespread transmission that merits a full-fledged response. In this rapidly changing and highly volatile situation, the IRC has been working on strengthening its response capacity by focusing on measures to promote staff safety and to streamline flow of information so that the organization can effectively launch a response at scale. The ‘COVID-19 Country Support Team’ (CST) was constituted, which aims to help reduce risk of infection for staff and clients; as well as to reduce the risk in/at IRC offices/accommodations and ensure business continuity for IRC relevant operations. IRC’s COVID-19 response is geared towards pandemic containment and mitigation spectrum and Master Response Plan (MRP) is developed along these lines. Hence, IRC is primarily focusing on extending emergency response support, in accordance to and fully aligned with priorities identified in the ‘National Action Plan (NAP) for Corona Virus Disease (COVID-19) Pakistan’ and any subsequent GoP amendments. Our Master Response Plan (MRP) builds upon and expands our global emergency response learnings and is helping our teams, partners and local authorities to plan, prepare and respond to COVID-19 effectively via objectives below:

Contain disease transmission.Minimize morbidity and mortality resulting from the COVID-19.Immediate health system’s support leading to strengthening (provision of supplies/PPEs, equipment, providing technical support, training personnel involved in COVID-19).Mass awareness to mitigate the impact of the pandemic and prevent overburdening of health and social services through the dissemination of verified, timely information.Provide targeted mental health and psychosocial support, particularly PFA and stress management, to health workers, staff and clients. Provide targeted mental health and psychosocial support, particularly PFA and stress management, to health workers, staff and clients.

FUNDING

To launch the COVID-19 response, IRC mobilized an internal funding amount of $150,000 for the response in Pakistan. The implementation started on March 19, 2020. In addition, IRC has submitted proposals worth more than €4 million to multiple donors. If the funding comes through, the proposed activities will assist in strengthening and building the capacity of the existing health system, effectively integrating Health with WASH, Risk Communication and Community Engagement.

RESPONSE TO DATE

Community Engagement

Transformation Facilitators (TFs) i.e. project volunteers at IRC have been trained and mobilized for risk communication. As the TFs hail from diverse backgrounds with reference to age, ethnicity, religion, sex, and financial standing, this channel ensures reach to marginalized populations as well, such as religious and gender minorities, along with female-headed households. In the lockdown, the TFs use informal networks, on and offline, to keep their respective communities apprised of the rapidly evolving situation and to help address concerns on time.

Mass AwarenessIRC Pakistan’s key messages signed off by the National Health Emergency Response and Preparedness Network and National Disaster Management Authority are being used for Mass Sensitization. A comprehensive Radio, SMS and Robocall campaign has been launched in Sindh and Balochistan. Themessages have been translated into local languages and the short audios and text messages explain preventive measures to our communities. Strategic partnerships with corporations such as PTCL are also ongoing for the digital media campaign. Contextualized IEC material has been printed and distributed in Balochistan, KP and Sindh, and material provided to Police, DC office, Health Department, Assistant Commissioner Offices, Social Welfare Department. It is currently displayed and was previously distributed at busy intersections, EHSAAS program offices, mosques, parks, schools, BHUs, police stations and madrassas.

Community mobilizers sensitize families, with special focus on women and girls, on COVID-19 prevention in Ghotki, Sindh.

52,500Examination

gloves

260Surgical Gloves

1,950Surgical N95

respirator

52,160Surgical Mask

692Heavy-duty

Apron reusable

562Heavy-duty

gloves reusable

1,550Coverall

41Infra-red

Thermometer

32Alcohol-based

versions

530Goggles

442Face shield

Guard

10,000Biohazard bags

15,000Disposable

Gowns

100Chlorine Granules -

Bleaching Power/HTH (25KG Bag)

30Long rubber Boots /

Gum Boots

40Plastic Drum (200-250

L / 50-55 Gallons) with water taps

40Handwashing drum

iron stand along with soap holder

40Hand Wash large

size 220 ml

Provision of Personal Protective Equipment (PPEs)

IRC procured and dispatched PPEs and other essential items for staff across all field offices and has provided PPE kits to 2500 front line workers in Quarantine facilities in Quetta, Sukkar, Dera Ismail Khan and Peshawar.

Program Adaptation All IRC staff is currently Working from Home (WFH). However, staff working on the response are present on the frontline, working alongside the government to contain the spread of the virus, distributing IEC material and guiding our communities.

Budget realignments and reallocations are also underway. Channeling of DFAT funds from one of its ongoing projects has enabled the installation of handwashing stations, provision of PPEs to WATSAN Cell and TMA Staff in KP, and support to WATSAN Cell in the disinfection of public places and quarantine centers. Similarly, IVAP is being transitioned to provide call center support to the Department of Health KP in tracing cases, proactive outreach of suspected individuals for screening, and facilitate the automation of data, in close coordination with UNHCR and PDMA. This will also help KP PDMA and DoH to provide uninterrupted supplies to isolation centers across the province and may include a component of telemedicine.

IRC Pakistan under all its projects has submitted proposals to the respective donors for realignment while still maintaining the niche of the projects and once approved will allow IRC to respond to the COVID-19 related needs on the ground.

Coordination with Government

Coordination continues with the respective district administrations and Provincial Disaster Management Authorities (PDMAs), along with Social Welfare and Health departments in the respective targeted districts. The needs assessment and priorities determined by the COVID-19 National Action Plan feed into IRC programming and the implementation is also facilitated greatly by the respective government authorities.

To serve at the front line and to facilitate activation of Minimal Initial Support Package (MISP). , 15 of our healthcare providers are full time deployed at government-based health facilities of Peshawar and Swat. As part of our MRP and MISP protocols, this is to ensure continuation of critical support provision and service delivery of reproductive health and otherwise

Data collection and information management capacity is a critical gap, as pointed out by KP PDMA. Lack of reliable and timely data about needs at the quarantine sites, health facilities and isolation units negatively impact efforts to keep the critical supply chain intact. This technical assistance will facilitate timely and evidence-backed decision-making . IRC is hence providing this support through adaptation of the existing IVAP structures and processes. Additionally IRC has also initiated its own Rapid Needs Assessment so that the response is better aligned with the needs on ground.

Banners are displayed in high risk areas with similarly high footfall, such as around hospitals, in Chaghi, Balochistan.

Collaboration with Humanitarian Actors

IRC has been nominated to lead the Health Working Group of Pakistan Humanitarian Forum and National Humanitarian Network and in coordination with technical leads shall also assist in developing the Terms of Reference (TORs) focusing on Health, MHPSS and WASH sectors. Likewise, IRC is conducting remote sessions on Safeguarding and COVID-19 with partner organizations in Balochistan, such as Balochistan Education Foundation (BEF), Developments in Literacy (DIL) and Tameer-e-Khalaq Foundation (TKF) around prevention, reporting and response actions to be adapted and implemented with field staff and clients in the current situation. IRC is also an active participant in the food cluster meetings for Sindh and WASH cluster in KP, while coordination continues with UN agencies such as WHO.

Feedback from BeneficiariesIRC’s Hotline is operational from 8:00 AM to 5:00 PM, five days a week, with operators able to communicate in all regional and local languages. Clients from IRC’s program areas have contacted IRC both through the Hotline and SMS to seek support or provide feedback regarding the organization’s COVID-19 response. To date, a total of 99 clients have reached out from KP and Sindh. Of the total calls and messages received, 76% consisted exclusively of positive feedback for IRC’s efforts in the respective communities, while the rest were requests for further assistance.

The major needs highlighted were:

• Sanitization and PPEs• Display of more IEC material• Cash and food for vulnerable households• Germicide and chlorine disinfection in respective areas• Provision of face masks and hand sanitizers

IEC material was preemptively disseminated and distributed in Ghotki, Sindh, providing guidance at the doorstep of vulnerable community

members.

Vehicles of CHIP, a partner of IRC, display banners as they tour the city and broadcast PSAs on COVID-19 in Mardan, Khyber Pakhtunkhwa.

IRC hands over supplies of PPE to the district administration in Dadu, Sindh.

IEC MATERIAL DISTRIBUTION92,998

People targeted

Sindh 70,000Khyber Pakhtunkhwa 22,998

Buner: 15,000 Swat: 7,998

Ghotki: 50,000 Sukkur: 20,000

ORIENTATION OF OFFICE AND FIELD STAFF ON COVID-19 AND

IPC MEASURES

97People targeted

Khyber Pakhtunkhwa

ROBO CALLS739,685

People targeted

Balochistan 226,746

Dadu: 287,568 Ghotki: 225,378 Chagai: 17,585

Killa Abdullah 90,046Nushki: 26,652 Pishin: 84,569Kharan: 7,896

Swat: 18Peshawar: 79

DIRECT REACH

AWARENESS RAISING CAMPAIGNS/SESSIONS

1,574People targeted

Khyber Pakhtunkhwa

Swat: 622Peshawar: 902

Buner: 50

MEDICAL SUPPLIES25,000People targeted

Khyber Pakhtunkhwa 9,250

Sindh 9,250Balochistan 5,500

Islamabad 1000

Ghotki: 3,750 Sukkur: 5,500 Quetta: 5,500 DI Khan: 5,500

Peshawar: 3,750 Islamabad: 1,000

SOCIAL MEDIA REACH 4,990 People targeted

Islamabad

Sindh 512,946

PROVISION OF HYGIENE RELATED ITEMS

30People targeted

Khyber Pakhtunkhwa Peshawar: 30

REACH OF IRC PAKISTAN TO DATE

864,374 DIRECT REACH

IEC Material Distribution320,694

People targeted

Sindh 254,694Khyber Pakhtunkhwa 66,000

Swat: 40,000 Peshawar: 26,000Ghotki: 129,815 Dadu: 124,879

RADIO CAMPAIGN17,820,000

People targeted

Sindh 16,620,000Balochistan 1,200,000

AWARENESS RAISING CAMPAIGNS/SESSIONS

12,228People targeted

Khyber Pakhtunkhwa

BILLBOARDS

800,000 People targeted

Islamabad

Buner: 2,045 Peshawar: 6,019

Swat: 4,164

Quetta: 1,200,000 Karachi: 16,620,000

INDIRECT REACH

MEDICAL SUPPLIES770,184

People targeted

Khyber Pakhtunkhwa 285,084

Ghotki: 115,500 Sukkur: 169,400Quetta: 169,400

Swat: 90Peshawar: 115,594DI Khan: 169,400

Islamabad: 30,800

Sindh 284,900Balochistan 169,400

Islamabad 30,800

REACH OF IRC PAKISTAN TO DATE

19,723,106 INDIRECT REACH