KARACHI, October 27, 2005 (IslamOnline.net) – With the number of people seriously injured in the devastating quake that battered several areas across Pakistan earlier this month on the upswing, doctors predict a medical nightmare in trying to save the wounded.

"A large number of patients with gangrene have either been amputed or have died or those who don't get amputations in the next couple of days will die," Dr. Naveed Shah, a general and trauma surgeon in Karachi, told IslamOnline.net on Thursday, October 27.

He said that debris, sand and other foreign elements are usually present in the wounds of such patients.

"So instead of stitching the wound, it should instead be washed and made sterile. Skin grafts were made after the wound heals," Shan added.

A massive quake, measuring 7.6 on the Richter Scale, has killed more than 53,182 people in Pakistani-administered Kashmir and neighboring northern towns.

The quake, the worst natural disaster in Pakistan's history, has left more than 3.5 million people homeless.

Shah, the director of the reputable private hospital Naveed Clinic, expected that as communications to remote areas hard-hit by the killer quake are restored there will be "a deluge of injured persons towards the major cities."

"It is estimated that there have been over 50,000 deaths. Extrapolating from this figure it can be expected that there must be at least 300,000 severely injured patients, many of whom will lose their lives and limbs unless proper treatment is provided".

He stressed that there is no way such a high number of injured people can possibly be treated in the hospitals of Rawalpindi, Abbotabad and Peshawar.

"In fact if all the hospitals in the country are utilized even then all the seriously injured patients can not possibly be provided proper treatment," he lamented.

There are estimated 100,000 hospital beds in Pakistan, a country with a population of 120 million people.

Like colleagues across Pakistan, a very caring Shan is trying his best to help the few number of survivors who have been admitted to his clinic.

"I was at my home when the earthquake came. It seemed as if the earth was lifted in the air and then settled down deep," Syed Alfat Shah, a 26-year-old soldier in Pakistan army, told IOL from his hospital bed.

"As many as 30 members of my biradari (community) have died. My house has been completely destroyed. I was brought about from the debris by a Pakistan Air force officer four days after the earthquake struck," he recalled fighting back his tears.

"Then I was shifted to Combined Military Hospital in Mansehra [in northern Pakistan] but there was no space. I was lying on the floor," he said.

The young patient, who hails from Balakot in the Pakistan-controlled Kashmir, was moved to Karachi by Professor Tipu Sultan, an anesthesiologist at the Civil Hospital Karachi and a former vice chancellor of Dow University of Health Sciences (DUHS).

Sultan and Dr. Shafiq-Ur-Rehman, a professor of surgery at the CHK, have been serving the earthquake survivors in Mansehra and were part of the doctors team of the Pakistan Medical Association (PMA) that brought 24 severely wounded patients to Karachi for further treatment.

A Kashmiri mother comforts her child, at a local hospital in Lahore, Pakistan.

Though the government is providing the some three million people driven homeless by the quake with tents, many of them were still without any relief.

Sociologists, architects and economists have been articulating strategies to save the precious lives who have been stuck up in Kashmir in winter and rough weather.

Arif Hasan, a noted architect and sociologist, believes the resettlement of three million displaced persons would be impossible without participatory development in which the indigenous community has an active role.

He suggests that cheap and quake-resistant technology should be pursued during reconstruction.

Dr. Nabeel Zuberi, an assistant sociology professor at the University of Karachi, underlined the need to categorize children, adults and the elderly in the ravaged areas to compile a database which was presently non-existent.

"The demography should be studied. Only then services can be provided and predictions made on a scientific basis," he said.

Dr. Mutahir Ahmed, an international relations professor at the University of Karachi, suggested that instead of establishing tent villages in Kashmir, these should be made in Punjab to save the survivors from harsh climate.

Economic Options

Dr. Shahid Hasan Siddiqui, chairman of the Research Institute of Islamic Banking and Finance, dilated on the economic scenario.

"According to preliminary estimates a sum of 7-10 billion dollars will be required for carrying out reconstruction and rehabilitation.

"For this, the government is receiving contributions and donations from resident and overseas Pakistanis, international agencies, friendly countries, international financial institutions and the Islamic Development Bank."

He stressed that the balance amount will have to be raised by the government from its own resources.

The expert said the government can seek domestic and foreign debt, accelerate the pace of privatization of public sector enterprises or relocate development expenditure.

"The other option, however, is to enhance the sources by combating corruption and tax evasion and reducing non-development expenditure. The government can also allow the budget deficit to go up to 5 per cent of the GDP as against the target of 3.8 per cent for the current financial year."