5 Traders, 8 Days - Closing Thoughts (Days 1 - 8)

Sajjad Rashid

A group of CDS and fixed income traders led by Iftikhar Ali from hedge fund Millennium Capital, recently returned from Pakistan to help raise funds for the victims of the country's recent floods.

The team was rounded-out by Shaz Amir (Nomura), Ivor O'Toole (Tullett Prebon), Sajjad Rashid (Bank of America Merrill Lynch) and Abid Hussain (Citi), and travelled with the charity Midland Doctors Association UK (MDAUK). 

To date, this group of traders have raised an amazing £850,000 in online donations, pledges and bank matching.

The traders each kept a record of their experiences in Pakistan, and here we reproduce Days 1 - 4 from the diary of Sajjad Rashid, who is a Managing Director in the Global Funding Group at Bank of America Merrill Lynch.

Day 1 - Outward Bound

'Busy morning, packing the essentials for the trip. Spent the time also fielding calls/texts from family and friends. All wishing me well. I sit at the kitchen table ready to go... I take a moment to have a cup of tea and take malaria tablets. 

Leave home for the airport feeling slightly apprehensive. Have been to Pakistan before, though only visiting family in the major towns or cities. Going out to the villages would be a new experience at the best of times but what will it be like after this devastation ? Wondering whether I am doing the right thing: Do I know what I am doing ? Have I ever done anything like this before ? The answer to both is no, but that is not enough of a reason to stop me going.

Nazia and my daughter Hana, see me off at Departures. My travelling doubts are erased when I meet my fellow travellers at the check in, Iftikhar Ali, Shahzad Amir and Ivor O'Toole. Everyone feels this journey is something we need to do, anything to try and help even a few people. All our donors over the last 5 weeks have also put great trust in us. We are not sure of what to expect but are determined to take our time and absorb what we see in Pakistan.

Get a text from Dr Iftikhar, Chairman of Midland Doctors Association UK, he has already landed ahead of us in Pakistan. It is also reassuring that Dr Iftikhar is there to help guide us on the ground, we hope not to be a burden to him and the MDAUK team.

We board the plane, it looks like we will leave on time for Pakistan. Need to make sure I get some sleep on this flight. We will be on the go once we land. Just got the announcement to shut off the mobiles....doors are closing.

Day 2 - First Day In Pakistan

We land in Karachi. The flight was uneventful, unfortunately I did not sleep. I watch the in-flight movie to try and relax. I contemplate whether watching the 'Robin Hood' movie was ironic given the purpose of our trip, ".... getting from the rich to give to the poor."

We land an hour late but customs and baggage collection is pretty smooth. Ivor is the first one through! Dr Iftikhar meets the 4 of us at the exit and directs us to a minibus, while he awaits the arrival of the 5th member of the team, Abid Hussain, via another flight.

We arrive at our accommodation and I get 2 hours sleep and then change into local plain shalwar kameez attire. Ifti and Ivor do likewise. Shahzad has gone to visit a local Karachi school that Nomura has setup and sponsored. It is a school for 300 pupils (aged 11-16) and costs £30,000 annually to run! Shahzad shares the photos of a well run and well resourced school. I am impressed by the efforts of Nomura. This gets me thinking about sustainability and what can we and our donors do along that same theme ?

The team is complete as Dr Iftikhar and Abid join the 4 of us on the start of a long day. Dr Iftikhar takes us via minibus firstly to the Pakistan Medical Association (PMA) offices. I sense that my other team members would have preferred to go direct to the relief camp asap.... but MDAUK & the PMA wanted to ensure we were briefed and prepared for what we were about to embark on. We also get a tour of the compound where MDAUK are storing the goods and also a view of the paperwork/admin of all the funds that come through MDAUK in Pakistan.

We drive an hour out of the city to the relief camp which houses 150+ families. We arrive at the heat of the day with 2 MDAUK relief lorries containing shelter packs (sheets, blankets, pillows and duvets).

The crowd gathers as the lorries start to get unloaded by the team. Ivor and Ifti jump up to the top of the lorry to take the lead on the unloading.

The rest of us are on "client facing duties". The key part of our briefing was not to give any of the shelter packs to those without ration cards. This is easier said than done!

When an elderly lady stands in front of you with her hands together in hope but has no ration card.... what do you do? Risk the wrath of the crowd that has ration cards and is queuing? Or does this lady have the look that only our mothers could have so you melt and give to her ? Iftikhar and I stare at each other trying (and failing) to answer the dilemma in the midst of an ever encroaching crowd.

We completely unload one lorry and work on a different part of the camp. Abid and Shahzad now take the lead with the unloading of the second lorry. As the number of remaining packs starts to diminish we are ushered away by the MDAUK team, as part of their security protocol, from a disappointed crowd that has not received packs. The silence in our team minibus suggests that we are as disappointed as the crowd.

On the journey out of the camp and through the chaotic city centre it dawns on me, we cannot physically or financially help everyone.... we need to start by helping one more person than was helped yesterday.

Late afternoon, sees the team visit a charity hospital setup to help women suffering from fistulae. An obstetric fistula develops when blood supply to the tissues of the vagina and the bladder is cut off during a prolonged obstructed labour. The tissues die and a hole forms through which urine and/or faeces pass uncontrollably. Women who develop fistulae are often abandoned by their husbands, rejected by their communities, and forced to live an isolated existence. This disease currently affects 25,000 Pakistani women annually.

This charity hospital is supported by MDAUK and has excellent facilities to give women the very basic but very necessary surgery to repair the fistula. As we walk around we see patients from all over the country in the wards (and their relatives living close by outside on the grass verges). The hospital has also focused on the teaching and qualifying of nurses and midwifes. Both professions are in great need within Pakistan. UK NHS staff also donates their time to fly over and provide the teaching required for nurses and midwives. Mental note: This is another topic to add to the sustainable project category that we are looking to support.

As we close the day, I am glad for the loose clothing that I wore today, as we return tired, sweaty and dirty from the day's efforts. I don't recall getting this sweaty after a day in the office!

A lot for us to think about today... but need to rest before tomorrow's efforts at a relief camp further afield.

Day 3 - Suffer The Little Children

Had a deep sleep. I have not slept this deep for weeks. I get woken by Ifti Ali's call to check I was ready. Unfortunately, my phone alarm was set to UK time so it would have made me late as it would not have gone off for another 4 hours!

Once again we dress in shalwar kameez. Dr Iftikhar takes us to meet Professor Arif at the Shan Hospital in the City centre. Professor Arif is the lead for the Pakistani Paediatric Association (PPA). He gives us background on the work of the PPA.

Professor Arif takes the lead to take us to a Hospital further out of the City, called Baqai Hospital. It is a very old hospital but is kept very clean and it goes against my preconceptions. We see many people milling in the corridors, they look like they are relatives of patients. From their demeanour it is easy to see that they have been there for weeks. We visit a ward with children suffering from malaria, typhoid and dengue fever. This is the quietest children's ward that I have ever been to. It is very quiet as most of the children lie there listless. Most had their mothers there with them. The Doctor in charge tells us that this is the start of the next phase of the flood impact as more and more disease starts to spread. He fully expects to be out of resources as the impact deepens.

I guess this is the difference between an earthquake and a flood disaster. Earthquake zones tend to see patients immediately and the way of life generally does not worsen (maybe weeks later even improve) post devastation. Flood zones worsen as poor sanitation and contaminated waters permeate into outbreaks of several diseases. We saw it with the Katrina devastation and subsequent flooding and we see it here. Excess water has no borders.

As we depart the hospital, the team is keen not to leave without leaving something for the children. We turn back to the ward. Whatever is in each of our pockets we proceed to individually provide to each child in the ward. I can see the team silently impacted by what we have seen. This is the quietest that I have seen a group of traders.....

Next stop is to a large roadside camp on a major highway. There are rows of tent shelters which the dispossessed rural families have been residing in for weeks. The PPA and MDAUK have setup a clinic on the edge of the camp with a team of male and female doctors. The intention is to vaccinate the children today with typhoid vaccine injections.

The MDAUK team have been through the camps earlier to gather groups of children. They log every name, age and home town of every child. This is to avoid children receiving duplicate vaccines while at the camp. However, these records are redundant as soon as these children depart the camps and return to their remote towns and villages.

We enter the ramshackle shelter where the MDAUK team are conducting the vaccination clinic. The shelter is just packed out with children clambering to get in line for the vaccines. Most children are aged from 3 to 11. I see the children's faces with huge smiles ready with a sleeve rolled up and ready. When my 6 year old son got his swine flu injection last year, I don't recall him being so cheery! These children are desperate to get vaccinated....most children or their mothers don't know what the vaccination is. Speaking to one mother, she says that all she was told that injections are good for the children, but she had no idea what the injections are or will do. This is the devastating impact of the floods, an already poverty stricken working class which has no means or no education to be able to react to any change of circumstance let alone a flood.

The team proceed to help the MDAUK support staff prepare the injections for the doctors. Abid Hussain and Shahzad Amir are particularly adept at preparing the needles and swabs!

I was keen to talk to the local doctors who have been volunteering their services since the disaster unfolded. Their concerns echo what we have seen in the hospital earlier, with malaria and diarrhoea rampant in the camps. We can see for ourselves the lack of sanitation and the close proximity of the tents to each other in the camps as the prime cause of the diseases.

Most children leave the clinic happily, with a black marker stamp on their hand to confirm their vaccination is done (and to avoid repeat doses). As the word spreads of the MDAUK clinic taking place, we see many more mothers turning up with children and babies in tow.

I see the pile of used needles growing as the doctors try and succeed in getting each child vaccinated. As the clinic runs out of vaccines the Doctors need to wind down today's activities, before an unmanageable crowd forms.

We request that MDAUK allow us to take a tour of the camp for a closer inspection. They reluctantly comply but insist we keep it short. I find out later that this reluctance is due to a relief worker having been kidnapped from this camp the day before.

We see rows and rows of tents that contain very little home comforts. The size of the tent is so small that barely 2 adults could fit into them.....these "house" a family of 8+ members. As we walk round, we see so many children milling around and their mothers. I do wonder why I don't see that many men? We are told that the men from the camps try to find labouring work in the City.

I stop to talk a young girl of 6. She has a weather beaten face but eyes that are so warm. I wonder how far she and her family have travelled to get to the camp. I ask her and fully expect her to say hundreds of miles. Innocently, she tells me that she came from the tent 20 yards away!

Embarrassed, I proceed with Ifti to her tent. We meet her middle aged father. He has travelled from Kharpur, 350km away. Nine children and his wife travelled with him. Somehow, I doubt if he flew with Pakistan International Airways, which will be our mode of transport to Khairpur tomorrow. We ask when he will return home. He said that the landowner he worked for is demanding his loans to be repaid before he will allow him to return. The landowner is suffering losses and looking to recover loans from those under him. In an ideal world we would need the government to compensate the landowners instead of punishing the lowly workers with no ability to pay.

We find what I can only describe as a "tuck shop" in one of the tents where one enterprising soul is selling basic essentials and confectionery. Shahzad buys a number of crisps for the children who have now gathered around. As he is poised to handout, our host's security pull us all out, feeling that we are now drawing too much attention. At no stage did we feel threatened but defer to our hosts and retreat to the cars. As Shahzad and I turn to look back the children are receiving the purchased crisps from one of the camp volunteers. The joy on their faces is palpable and I can see a smile of contentment emerge on Shahzad's face.

The evening sees us swap our shalwar kameez for smarter apparel. Dr Iftikhar's local Karachi contacts, particularly Dr Sher Shah (aka "Daddy" because he has taught so many doctors and is a keen humanitarian activist in Karachi) setup a meeting with a senior politician. Nafeesa is an MNA (MP equivalent) in the province of Sindh and her father is the Chief Minister for the whole province of Sindh. Iftikhar and I realise this meeting is important to MDAUK's efforts to support the rebuilding of villages. We have our personal views on the governance of the country, but we ensure we pay homage and engage in active discussion with Nafeesa. She has a unique perspective as an active politician in the flood devastated areas.

We ensure she is aware that the 5 of us are representing several hundred donors, many of whom are of non-Pakistani heritage. She is impressed by the MDAUK efforts and commits to support the rebuilding efforts. She also ensures that we have guides and security for our travels tomorrow to the heart of Sindh's flooded areas in Sukkur.

It is late to bed for us all due to the meetings. Let's see how tomorrow plays out with our early rise to visit Sukkur.

Day 4 - The Heart Of The Devastation

Today is the key day of our whole trip. We are going to the heart of the devastation. We will see first hand the affected fields, villages and relief camps. This day is also important to the team as we make our assessment of a possible village to adopt for rebuilding. This will decide where our donors' funds will go, so the team need to ensure we are ready to absorb all we see today.

We have a very early start. Four hours sleep and a quick cup of tea and we are all in the bus to the airport. Given our tight schedule we take an internal flight from the provincial capital of Sindh, Karachi, to the other part of the province.

Sindh is the size of England and Wales, with a population of over 50 million, so you can only imagine what such an area looks like when hit by such devastation. Sindh is essentially the southernmost province of Pakistan and from what I could see from the airplane the terrain is very flat. This is later confirmed by our car journey, where you can see land for miles with a few houses and trees interspersed.

Our destination was Sukkur airport, where we arrived 40 minutes late and were met by cars to pick us up. We were led by an armed police escort and this continued for the whole day. Our first destination was the Khairpur, District Co-ordinators Office (DCO). This was the office that the MP, Nafeesa, from the Dinner the night before insisted we visit. Initially, I think it may be overkill but seeing a dozen burnt out NATO oil tankers (which the Taliban hit the previous week) reminds me not to be complacent.

All relief work and rebuilding efforts in each district needs to be co-ordinated through the DCO. This bureaucratic structure remains from the days of the British ruling India. The DCO is connected with the district and provisional governments and his support is essential in overcoming legal and bureaucratic hurdles that MDAUK may encounter in rebuilding a village.

The team reside in the DCO's large office from which he co-ordinates the district. Behind the DCO's desk, we see a large map of his district. He recounts how the flood waters engulfed his district. He shows us on the map how thousands of villagers on the flatlands were displaced to relief camps. Many NGO's were slow to react in Sindh as many international relief agencies have historically resided in the north of the country, due to the earthquake zones and the proximity to Afghanistan. He says the camps are now overflowing particularly with children suffering from malaria and diarrhoea. Many of these villages housing these camps did not have pharmacies or schools before, so their capacity to absorb the devastation is zero.

I am keen to know how the impact and relief requirements have changed from the initial acute phase. He said water has started to recede from many areas, but there remains contaminated silt in many villages. This makes returning the (Internal Displaced Persons) IDPs to their villages difficult.

Many NGO's are now starting to wind down their camps and "encourage" the people to return to their broken homes. The DCO mentioned that shelter and food packs are being provided to people as they exit the camps. Knowing that the UK offices of Bank of America Merrill Lynch in conjunction with MDAUK, are looking at starting a collection effort for blankets, clothes and tents, I ask what types of items do the people need ? Essentially, the DCO said that the current weather maybe 35C but as the winter arrives the best donations are of tents, blankets and winter clothing.

The DCO's office is now full of his staff coming in and out as he requests a variety of information to share with us. It is important to get the governmental perspective and tally that with our own hands on views later that day. I decide to interpret for Ivor so that he gets the DCO's perspective. However, once again as a team we are eager to proceed to the camps and villages. The DCO is very hospitable and after providing tea, he is keen to give us a historical view of Sindh as well as provide scarves to each of us in the colour of the Sindh.

Eventually, we depart as Dr Iftikhar leads us to a relief camp that MDAUK had adopted 6 weeks ago as the flood waters flooded across the country. This relief camp has about 40 families, and when I say family I mean 8+ members on average in each tent made for 2 adults!

MDAUK have pre-organised ration cards for each tent. On our arrival the noise and activity of the camp rises measurably. We split the team up. Ivor and Abid Hussain begin to unload the shelter and water packs. Iftikhar Ali, Shahzad Amir and I have a stack of colouring books and crayons for the children.

We only have a few children approach initially but once those children return to their tents and tell their brothers and sisters, you can see them running towards us from afar! Within minutes we are handing out books and crayons to a throng of children. When we run out, I see one girl talking to two of her friends about her box of 6 crayons. I hear her say, "It does not matter that they have run out, these 2 are for you," she says to one of the girls, "these 2 are for you," to another girl..... We have children teaching us to make the best of what we have. Superb.

We also continue to hand out the winter shelter packs and water. For any lady or young child who comes to pick one up, the team of Bankers, are only too happy to carry them to their tent for them!

Our time comes to an end at this camp and we ease ourselves away. On exiting I see a set of 3 cricket stumps in the ground next to the tents. It's a small thing but even that memory of cricket stumps makes me proud of how this camp's inhabitants continue to fight adversity and try and bring normality for the children.

We take a long drive through Shakarpur to visit 2 possible villages for us to adopt and invest our Donors' money. The intention would be a medium term project with MDAUK to rebuild, for example, 100 homes for close to 1000 adults and children.

The first village, Yusuf Bhatia, is approached by a long narrow road which has flood water either side. Two weeks ago this road had been engulfed by the flood waters which are now causing the road to crumble. We walk around the village for 10 minutes and in that time we are engulfed by the men of the village.

They were all pleasant and realised straightaway why we were there. I did worry about what Jo Simpson (DIFID) had warned me about, namely that at times I may feel like a "Disaster Tourist"! I understood this when one villager spoke to Iftikhar and I, to say many had come previously like us and made notes and left. They had been given nothing. I heard the despair in his voice. At that moment, I wanted to grab his hand and say this is different and we will commit to help. However, I was not in a position to talk for the rest of our team or MDAUK. "Be Patient" I told myself.

We saw another village, Remenabad, which was much the same. The key issue was that the old houses were brick built but not with cement. This was not a problem as the fields had not had much excess water for 13 years. Dr Iftikhar was telling us that we needed to rebuild with sustainable houses utilising better foundations and cement to bind the bricks. We were being asked by MDAUK, which village we would choose to rebuild. Wow...what a tough choice to make. We all remind each other that you cannot help everyone. Even as we pass other villages, the inhabitants clamour on the road to beg and point us to visit their village.

It was difficult to drive on but we had to as our escorts were insistent. The decision on village choice was put on hold until MDAUK have further conversations with the provisional government next week.

The sun sets and we make a long journey in the dark back to Sukkur airport. No street lights mean our car journey is a little more hairy as vans and trucks make crazy manoeuvres and additionally pedestrians mingle by the roadside in the dark.

Plenty to absorb today. This trip has been worth it. To see for my own eyes the dirty water, the fallen houses and the beaten faces of the homeless villagers was important.

Tomorrow is another early start as we depart the fair shore of Karachi for a different terrain of the northern territories.

Day 5 - The Hospital Project

Today we leave our base in Karachi and head towards the opposite end of Pakistan. The plan is for us to travel via plane to Rawalpindi and onwards via car to Muzzafrabad. There we will see the MDAUK project to build a UK NHS style hospital that will treat the poor for free.

This was a result of the 2005 earthquake that devastated Muzzafrabad. We will be able to see how a major hub like this has recovered 5 years on. Will there also be something for us to learn about the support for the long term recovery of the flood victims?

The day does not start well for me, with the Karachi Runs in the belly. Ordinarily I would not be too concerned about this but our journey will take 7-8 hours, the first leg involving an internal flight from Karachi to Rawalpindi. This will take us from the province of Sindh into the Punjab province. We will see the temperature change from Karachi's sun baked mid 30s to Rawalpindi's cloudy low 20s.

The flight was relatively smooth, but I felt tired and lethargic. However, as we disembark the plane, I suddenly perk up and get a great feeling of excitement. Maybe it is the familiarity of Rawalpindi, where I have been before, or is it that we will be heading to the land of my family, Kashmir?

Our guide, is Imtiaz Raza, the younger brother of Derby based surgeon and executive trustee of MDAUK, Dr Javed Ahmed. Imtiaz drives us through Islamabad (the capital of Pakistan) which I recognise from my previous visits and from there we headed north towards Kashmir.

The total drive was 4 hours up into the mountains along windy narrow roads. The roads are tarmac but are only just wide enough for 2 cars with a rock wall on one side and a sheer drop off a cliff on the other. Think Michael Caine's Italian Job movie where the bus full of people and gold gets stuck at the end of the movie. So the driving needs to be spot on.

Shahzad Amir and I are in the car which Imtiaz was driving. He is an excellent driver however; you need to be conscious of others on the road. At one point a large bus coming towards us around a sharp bend swerves onto our side of the road. Imtiaz slams on the breaks and veers to the right (yes, the right being a sheer cliff drop side). The bus also veers that way and it looks at one point like we are going to hit the bus which is fast approaching the drop! However, all is well as our car slides to a stop and just ends up kissing the bus gently. Apart from a little fright everyone is fine. Imtiaz calmly handles the ensuing negotiations and we are on our way.

The scenery, forests and views are absolutely breathtaking. This continues the closer we get to Azad Kashmir.

The province of Kashmir has its own provincial government and procedures. However, their funding and overall governance is from the Pakistan government. I guess it is similar to the structure of Northern Ireland in the UK.

I mention the governance because to get any projects done in Kashmir, you need to pay homage to the provisional government of Kashmir. Even as you enter Kashmir a sign reads, "You are leaving Pakistan and are entering Azad Kashmir". On entering Kashmir we have a United Nations vehicle take some of the team to help ensure a safe passage.

After the long drive and no sleep in the car we reach our accommodation in Muzzafrabad which is on top of a hill. When I look out on the valley within which Muzzafrabad is located, I am absolutely stunned. The beauty of the scenery was outstanding. Imagine the Alps but much bigger, greener and with a beautiful Himalayan river running through it.

Muzzafrabad is the capital city of Azad Kashmir, with its own Parliament and Supreme Court buildings. From a distance, the city looks like it is recovering well from the earthquake 5 years ago. I am told the Turkish government reconstructed many government buildings and the Chinese are rebuilding major roads, e.g. up to the heavenly setting of the Neelam valley.

The team are keen not to dwell on the picturesque view as we want to get to the MDAUK Hospital construction site which is 10 minutes drive away. I was particularly keen as I had been hearing about this earthquake reconstruction project for the last few years. Also my employer, Bank of America Merrill Lynch, had made a generous donation to the Hospital in August as well as for the flood relief. Again I felt responsible to ensure that I took in all the details of the project's history and future. I want to be able to give my BoAML colleagues a detailed view and report.

On site, Dr Iftikhar and the resident MDAUK project managers begin by showing us the architectural plans and pictures of what the structure will eventually look like. Essentially this will be a two storey facility with wards for 60 patients, labs, x-ray and operating theatre facilities. A further 100 staff are anticipated to be in the hospital. There will also be a separate accommodation block for resident doctors and nurses.

After the background briefing, Dr Iftikhar took us over to the building site. There we saw the foundation of the structure in place. The key item our team were keen to see was the depth of the foundations, the steel binding rods and concrete mix used. The MDAUK team are very keen to ensure that this building has the ability to withstand another very powerful earthquake, if it were to ever happen again.

Iftikhar Ali pretty much walked every inch of the ground floor structure and pulled on every vertical steel rod. This construction was to European standards and is being built to last. Dr Iftikhar mentions that they have pro actively taken the extra time and funds to get the foundation 100% right. He mentioned that the building of the upper floor and completion of the building is on schedule for summer of 2011.

The team then split up and inspected the site separately. We wanted to allow Dr Iftikhar to catch up with his project team. I watch from afar as many items are being analysed, decisions made and observations provided by Dr Iftikhar.

He has also had to deal with some sceptical locals, who think that a hospital being built to support free treatment for all has some "angle". Over time these locals have started to soften as they see the actual delivery and action of MDAUK's promises.

When you look up the word "patience" in the dictionary you would see Dr Iftikhar's picture next to it. He is a top Consultant surgeon in his field in the UK, but to have the capacity and capability to run a major Hospital and now flood relief initiative is impressive. His MDAUK management team in the UK provide a great deal of support I am told, which allows Dr Ifitikhar and Dr Javed to focus on the Pakistan side of the projects. They are both born in Pakistan and are well respected in the provinces of Sindh and Kashmir. They are able to utilise their family and friends network here to help make some positive change. We have witnessed this for ourselves.

This hospital will be a state of the art facility providing treatment to anyone according to their medical need. Medical treatment in this part of the world costs money, there is no government UK National Health Service here! However, this hospital will be the first of its kind in Pakistan. MDAUK will be sending volunteer UK qualified doctors (400+ volunteers already signed up) over to Muzzafrabad on a regular basis to treat the poor. These doctors will also train the local Pakistani doctors and nurses. After seeing the School of Midwifery in Karachi on Day 2, I can see why MDAUK will setup a similar school in Muzzafrabad.

Previously on our trip I had been so focused on the floods impact and destruction that I had not had much time to think about the earthquake devastation in Muzzafrabad or the MDAUK Hospital project. Therefore, I had no expectations for today. I had previously written that the Day 4 visit to Sukkur was our key day on this trip. In hindsight, after the visit to the MDAUK Hospital construction site, today's trip was just as important and impactful.

I went back to our accommodation and sat down to absorb the efforts that I had seen. I felt truly humbled by the efforts of the MDAUK team. I sent the management team a message sharing my instant heartfelt reaction.

MDAUK, thank you for what you do.

Day 6 - Land Of Our Fathers

Today our short stay in Muzzafrabad is over. We have a long journey to another part of Azad Kashmir, to the city of Mirpur. The land of our fathers,....well at least the fathers of Iftikhar Ali and I.

Before we set off, Dr Iftikhar needed to catch up with the MDAUK Hospital Project manager. Iftikhar, Shahzad and I took the opportunity to take a walk. The fresh air in the valley and the view of the river flowing through the city is tremendous. I wonder when I will return to this place that has just surprised all of us.

Our drive to Mirpur from Muzzafrabad will take 6 hours, half of which will be back along those twisty mountainous roads I mentioned yesterday. I take the opportunity to learn more about the impact of the 2005 earthquake from our guide Imtiaz Raza, while he takes the opportunity to learn about the Equity stock markets from us!

Imtiaz mentions that a large portion of the City's infrastructure was destroyed in 2005. However, 5 years on, the reconstruction efforts have gone reasonable well due to the support of international partners/donors from the US, Europe, Middle East and the UK. I saw a whole section of public buildings (coloured red) that the Turkish government had rebuilt. That was a great effort in a short space of time.

Imtiaz says that the memories of the earthquake linger on. Only 6 months ago (almost 5 years after the earthquake) a road was being rebuilt that had suffered in the destruction. A road digger that was removing debris and soil, that had slide down the mountain during the earthquake, hit a metallic object. Larger equipment was brought in to excavate the object and found a large minibus that had fallen into the road when it had cracked open during the quake. The van was then buried by a landslide of soil and rocks and the passengers were buried alive. The bodies had decomposed so much over the intervening 5 years that the only way to identify the bodies now was through the identification documents they had with them.

This story brought home to me the scale of the earthquake that hit the City.

The windy road back from Muzzafrabad has parts which have just fallen away down the cliff. At these points only cars in single file can pass. I asked Imtiaz why the road has fallen away in certain sections and not others. As well as landslides, he says, at the bottom of the cliff, approx 300feet down, you see the river flowing.

When the monsoon rains came a few weeks ago and the water gushed down from the mountains this river was running much faster and higher. It was as high as the road I was on. Wow! 300 feet higher than what I saw flowing today. The river waters damaged the roads and caused parts of it to collapse. It was this surge that fed all the way through Pakistan to the flatlands of Sindh. For someone, like me, who does not swim I love the beauty and peaceful flow of water but I have now seen the uncompromising nature of water.

As we continue through the winding roads, we also see goat herders heading south with their goats. Imtiaz says they are from the mountains that we have just seen around Muzzafrabad. They migrate south to the Punjab for the winter as the mountains are virtually uninhabitable for them. They have done this for centuries. That trek with his herd is hundreds of miles and then he returns 6 months later. It makes me stop complaining about my long arduous journey.

Once we start to descend from the winding mountainous roads, I know Islamabad is not far away. There we will have a brief pit stop and part ways with our MDAUK host, Dr Iftikhar. He has looked after us the whole time we have been here and did not miss any detail in our preparation or planning. Dr Iftikhar was flying back to Karachi, as he was due to meet the Chief Minister of Sindh to discuss our Model Village rebuilding project. However, before he boarded his flight, we are told by Imtiaz that he had been asked to help perform a serious operation at a hospital in Rawalpindi. His time and skills are always in demand.....he humbly gives both for free.

After a further 2 hours drive we get closer to Mirpur and drive through a district called District Jhelum. My mother's family reside here and I recognise the surroundings immediately. That positive feeling I had landing in Rawalpindi airport, the previous day just magnified.

We head back into the province of Kashmir and arrive late in the day at the bustling City of Mirpur. Given, Dr Iftikhar is now in Karachi and Imtiaz heads of to his Mirpur house to freshen up, Iftikhar and I are now the lead guides. Iftikhar has relatives here as do I but I don't really know their exact locations.....plus they don't know I am in the country!

One notable aspect of Mirpur is that it is located next to Mangla Dam. This was a huge dam constructed in the 1960s, and many families were displaced from their villages at the time. It was this dam that most likely ensured that members of my close family in the districts of Mirpur and Jhelum were saved from the flood waters last month. It makes me wonder whether further dams across the north of Pakistan would have helped save the destruction that we have recently witnessed.

Our evening is spent with the family of Dr Javed Ahmed (MDAUK executive trustee and consultant surgeon in the UK). His brother Ajaz, who is the Manager of Mirpur Royal Bank Scotland branch, has actively been supporting the MDAUK work in Pakistan. He provides some good history of the MDAUK Hospital construction efforts to date. Particularly the history of the legal and administrative logistical efforts with respect to the district and provisional governments. That perspective was important to hear as it gave me even more confidence that this project would have sufficient support to overcome any bureaucratic hurdles that may come MDAUK's way. The summer of 2011 looks bright for MDAUK's hospital.

Tomorrow, before heading back to Rawalpindi for our return flights, I plan to take the morning to really see the land of my father and visit his village.

Day 7 - Beginnings

Today I aim to take the opportunity to visit the village, Jarol Klan, where my father was born and grew up. We only have a few hours before we head of to Rawalpindi for a brief overnight stop and then the flight home.

Iftikhar's cousin who knows the surrounding area drops me close to my father's village. I surprise my one remaining uncle in the village with a visit to his house. I am unsure of where my father's house is, so he kindly takes me there.

We do break down on the way. After a little bit of fiddling under the bonnet by Ifti, we get going again!

We pass through several fields, with small homes dotted around before coming to the centre of the village where I am shown a metal gate. As I pass through the gate I see a yellow decrepit house.

When I say house, I mean 2 rooms with a total size of about 2x8 metres. The roof is leaking and water has run down the walls. It looks like this has been vacant for many years and is now just being used to store firewood by the neighbours.

Many people from the villages closely surrounding Mirpur, including Jarol Klan, emigrated to the UK in the 1950s and 60s to find work. My Father was one of those. He only planned to go to the UK for a couple of years and return to farm the land. My Mother came over soon after and they started to settle down with their children in the UK. Many Mirpuris worked in the UK textile mills, steel industry or car industry during those years and my Father was a welder in the car industry. Many of those industries have evaporated from the UK and now those ex-pat Mirpuris have moved into many other fields. However, they still have a close bond to the land of Mirpur.

This morning is probably the only personal part of this journey for me, so why am I telling you all this ? I was born in the UK. I have always lived and worked in the UK. Maybe today's visit was my way of trying to connect with the people I saw in the flooded villages only a few days ago. Iftikhar and I discussed later how, if it had not been for our fathers taking a leap of faith and leaving their homes we could have been one those destitute villagers devastated by the floods....

Given we are short of time, I race back to the centre of Mirpur to meet the rest of the team. Imtiaz refuses to provide a driver for us, insisting on driving us the 2 hours to Rawalpindi himself.

In Rawalpindi, we stay next to the airport as our flight leaves early the next morning. That evening we have been invited to have dinner with Retired General Anwar. He had heard of our team via Dr Javed and was keen to meet us. Iftikhar, Shahzad, Ivor and I are on our best behaviour. I had met the General previously when he attended a function at my house, but did not get a chance to discuss much with him. He is a gently spoken man with perfect English, which was great, as I may embarrass myself with my spoken punjabi/urdu mix! I found it interesting to get his perspective on the issues surrounding Pakistan's rehabilitation post the flood devastation. His knowledge and high level advice to MDAUK again gives me further confidence that they are on the right track with the Model Village and also the Hospital construction.

The night draws to a close. I wish the team goodnight and retreat to my bed for our last night in Pakistan.

Day 8 - Closing Thoughts

The team awakes early and after a quick bite to eat, we head to the airport in Rawalpindi.

I know I will not sleep much on the plane. We have travelled thousands of miles in the space of a week, so while on the plane I am keen to share my closing thoughts.

This trip has been an eye opener.

The aim was to help as many as we could, with SHORT term immediate relief. But also to assess the MEDIUM term support by rebuilding a model village. And then to analyse how a LONG term programme like the hospital construction can work.

MDAUK have led us on this humanitarian relief effort and we all thank them for allowing us to be part of that journey.

From a personal perspective, my affection for my parent's homeland has grown, not because of the beautiful scenery but because of the people I have met. I have never met so many such humble and hospitable people on my previous (sheltered) visits to Pakistan.

The other members of the team, Iftikhar Ali, Shahzad Amir, Ivor O'Toole and Abid Hussain have been great company. Whilst we were all together, we have all had different defining moments. However, we have all reached similar conclusions. Watching the millions of farmers squatting in the ruins of their villages, the support for the Pakistani people needs to continue.

MDAUK have taken on the burden of building a model village and a hospital. At this stage, I am not sure what the next step for us as a team is. However, I do know that when I share my experiences with my friends, families and colleagues we will all find a path to help MDAUK carry that burden'.

To lend your support to the work these traders have started, please go to: www.justgiving.com/iftikhar-ali

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