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Lady Health Workers travel by boat across the Indus River to remote Shah Nawaz Village in Shikarpur District in Sindh Province. They are on their way to vaccinate children under age five in the flood-affected village. One of the women carries an insulated ‘cold box’, to keep vaccines at a constant low temperature to maintain their potency. They are vaccinating all children under age five in the village, part of the September 2012 polio National Immunization Days (NIDs). The NIDs are part of a multi-partner effort by the Government and the Global Polio Eradication Initiative (led by the World Health Organization, UNICEF, the (US) Centers for Disease Control and Prevention and Rotary International) to eradicate the disease globally. Pakistan is one of just three polio-endemic countries, with Afghanistan and Nigeria, remaining in the world and presently has the world’s highest number of new polio cases.

By mid-October 2012 in Pakistan, monsoon rains and torrential flooding that began in early September had affected more than 5 million people – primarily in the provinces of Sindh, Punjab and Balochistan. Over 459,000 homes as well as roads and schools have been damaged or destroyed; some 265,000 people remain displaced in relief camps, with many others living in roadside and other informal settlements; over 1.1 million acres of land and an estimated 54 per cent of health facilities have been affected; and numerous water sources have been contaminated. More than 80 per cent of the affected are women and children under age 14 in need of shelter, food, safe drinking water, sanitation, maternal and child health care and malaria prevention. Malnutrition rates in the hardest hit districts are well above the emergency threshold, and 74 per cent of children in affected communities are out of school. Logistical constraints are hampering relief efforts in many areas, and continuing insecurity is placing United Nations staff and other humanitarian workers at increased risk. In response to the crisis, UNICEF is working with the Government (which has pledged US $91 million to the monsoon floods response), as well as with other UN agencies and partner NGOs. Support includes the provision of: essential child and maternal health services; therapeutic and supplementary feeding programmes; safe drinking water, sanitation facilities and hygiene kits; ongoing immunization services, including to eradicate polio; temporary learning centres and child-friendly spaces; and protective services for children, including for family reunification and psychosocial support. UNICEF is requesting US $15.4 million to fund its part of the response over the next three months.