Sick and injured people living in camps had access to appropriate medical facilities. But the prospect of return to rural areas with few health facilities was a daunting one for patients who wanted to go back to their homes. IOM responded by providing medical escorts for at least 120 patients whom it believed were at risk.

Patients escorted included weakened infants and the elderly, women with 32-week or more pregnancies, a one-week post-partum, individuals with major disabilities like unstable chronic illnesses, multiple amputations, spinal cord injuries and paralysis, poorly-controlled epilepsy, psychosis, pulmonary, cardiac and severe asthmatic cases.

Difficult road conditions, bad weather and landslides all posed major challenges. With most of the hospitals and health centers demolished in quake-affected areas, it was also difficult to find suitable medical facilities for the future treatment of seriously ill patients who insisted on returning home.

An IOM doctor, Noman Bukhari, escorted Andleeb, a 14-year-old coma patient and her family from Islamabad’s H-11 IDP camp to their home in Forward Kahuta in Bagh district, 250kms away over rough roads.

“It was a real challenge to ensure that her condition did not deteriorate. She was given neso-gastric feeds every hour and the emergency oxygen apparatus was functioning all the way,” said Dr Noman, who arranged the child’s transfer to the partially damaged but functioning Forward Kahuta Tehsil HQ hospital.

Since the earthquake, IOM medical teams have also medically screened nearly 70,000 IDPs in camps to ensure that they were fit to travel home. Of 69,572 people medically screened, 92% were declared fit to travel. Some 5,562 individuals had minor ailments or stable illness that allowed them to travel; 119 needed medical escorts and 153 were declared unfit to travel and referred for medical treatment.

“Sending people back home involves risk. So we hired local staff and set up a system to identify potential health problems linked to their travel,” says Bernard Kofi Opare, IOM’s Islamabad-based Health Coordinator. “From declaring people fit to travel to providing escorts and necessary medicines, we made sure that people could return in relative safety.”

Medical screening averted potential disasters on several occasions. In early May, four women at Fateh Jang camp in eastern Punjab had mature pregnancies and were advised by IOM doctors not to travel back home. They were moved to a medical facility at the H-11 camp in Islamabad, where they subsequently gave birth. Later, together with their newborns, they were provided with safe transport to their villages in Pakistan-administered Kashmir.