12-19-05,9:45am

MUZAFFARABAD, 16 Dec 2005 (IRIN) - Sitting in his bed in a field hospital, Safir, 3, is coughing heavily, while his mother, Meerjan, gives him water to soothe the outbursts. The reason is pneumonia, say doctors at the field hospital run by the Pakistan Islamic Medical Association (PIMA) in Muzaffarabad, capital of Pakistan-administered Kashmir.

“My son had been coughing for over three days before we came to this hospital,” Meerjan said. “I gave him some oral medications, but they were not of help and that’s why we came here,” she added.

Meerjan and her family were badly affected by the 8 October earthquake that ripped through northern Pakistan and Pakistan-administered Kashmir, with their house in an outlying village in the mountains completely destroyed by the disaster. With no shelter, they moved down to Muzaffarabad and accommodated themselves in a camp just near the PIMA field hospital.

“We examined the child and diagnosed him suffering from very severe pneumonia with wheeze,” Dr Asif Iqbal, running the pediatric section of the PIMA field hospital, explained.

Wheeze is a high-pitched whistling sound near the end of each expiration caused by spasmodic narrowing or inflammation of the airways.

“There are four to five danger signs of pneumonia and wheeze is one of them,” Iqbal said.

“It is so cold at nights, that’s why my son got sick and I am sick too,” Meerjan said. “Children cannot cope with this cold and get sick. We were given only one blanket and one quilt for the whole family,” she said.

Although no major epidemics have been reported in earthquake-hit areas of northern Pakistan and Pakistani-administered Kashmir, the steady increase in acute respiratory infection (ARI) in the area continues due to freezing temperature at nights and overcrowded tents, where the overwhelming majority of survivors live, according to doctors.

“As far as we are working in the field hospital, the number of children with pneumonia is gradually increasing,” Iqbal added.

His colleague from the pediatric department of the Abbas Institute for Medical Sciences (AIMS) in Muzaffarabad, Tahir Aziz, said: “Children are living in camps under insufficient arrangements, if one child gets a respiratory infection, in the same tent many children are living as well, so close proximity also leads to increasing pneumonia cases.”

“We are treating a lot of children with pneumonia. As we expected there are still many cases of pneumonia, other ARIs plus gastroenteritis,” Aziz maintained, warning that with colder weather ahead the number would increase further.

Because of the cold, lack of proper shelter and warm clothing in the camps, many children suffer from acute respiratory infections, including pneumonia, his colleague Iqbal, continued.

“Around 60 percent of children we attend at the hospital are suffering from pneumonia,” he claimed, adding that dozens of children were examined every day at the hospital.

The government acknowledges the problem. Syed Anwar Mehmood, Federal Health Secretary, told journalists in the capital, Islamabad, on Tuesday that severe cold weather had gripped the entire quake-affected region, with cases of pneumonia and respiratory diseases increasing. However, he added that sufficient stock of medicines was available for the treatment of the diseases, the Associated Press of Pakistan (APP) reported.

Meanwhile, the World Health Organization (WHO) warned on Monday that the threat to health in quake-hit areas remained particularly acute, with the combination of severe cold and cramped living conditions leading to an increase in the risk of hypothermia and respiratory infections.

The most recent Weekly Morbidity and Mortality Report (WMMR) published by the Pakistani government and WHO issued on 9 December, said that during the reporting period between 5 November and 2 December, a total of 30,319 consultations were reported in quake-affected areas in the under-five age group, of which 20 percent (6,160) were due to ARI.

In the latest week covered the rate of ARI-related consultations amongst under-fives was even higher and stood at some 30 percent. The weekly reported figure of ARI amongst the under-fives more than doubled from 965 to 2,044, the report added.