BALAKOT, Pakistan, Jan 25 (UNHCR) – The first time a fight broke out in their camp, Major Salman and his men rejoiced. "It was vicious. The woman and her daughter-in-law were slapping each other," says the major, smiling nostalgically. "But we were very happy, because it showed that they were overcoming their trauma and going back to normal life."

The solution? "We told the women to respect each other, and warned the man to control the situation," says the major, who runs Bassian camp for more than 2,800 earthquake survivors in Balakot, northern Pakistan. But a firm male hand isn't always the best approach when a large part of the camp population consists of women and children.

And unlike the squabbling in-laws, few women in Pakistan's quake-hit areas are as vocal about what bothers them. For cultural reasons, many of them prefer to stay behind the curtains. Too embarrassed to walk openly to latrines in the camps, some relieve themselves in their tents despite the health hazards. Others would rather suffer in silence than face a male doctor.

"Pregnant women don't like to come out of their tents, and there were no male doctors around. So we brought female doctors to them," says Noreen, a community mobiliser with UNHCR's implementing partner, Best.

Today, the Best team has brought some Cuban doctors to Balakot's Lighthouse camp. A surprising number of women turn up for the check-up. Old women get their blood pressure measured and girls are treated for scabies. Pregnant women are referred to the Cuban mobile hospital at Bassian, which has an operating theatre and facilities for ultrasound diagnosis, X-ray, paediatrics, orthopaedics, gynaecology and internal medicine.

The doctors and nurses, who speak little English and no Urdu, have somehow found a way to communicate with their patients. "Sometimes we speak Spanish, sometimes English, sometimes Urdu, mostly sign language," shrugs a Cuban doctor. "We understand each other perfectly."

Some topics are harder to broach. "Sometimes I ask if they'd like more children," says Nadira Mehrnwaz, a community services officer with UNHCR. "They say, 'No, God forbid! But we don't know how to stop it.' They ask about prevention and I refer them to the hospital for birth control."

As head of the camp management cluster, UNHCR sends out community services teams to identify and meet the needs of vulnerable people like widows, unaccompanied children and disabled people in camps.

"We went to Ghazikot camp and saw this boy with no legs, walking on his hands. We asked around for a wheelchair and got one from the army. The boy's face lit up when he saw it," says Mehrnwaz, whose team has also distributed crutches to handicapped girls in Balakot's camps.

Able-bodied kids also need protection. In Batagram, where Maidan camp is located beside a busy road with heavy aid convoys, community services officer Elin Kjorholt lobbied for a speed bump. "It was an accident waiting to happen. Kids would dash across the road in front of zooming trucks. Thanks to the speed bump, cars now have to slow down as they pass the camp."

Meanwhile, at Mundihar camp near Mansehra, UNHCR and Best staff are talking to a group of women about personal hygiene. "You should wash your hands before eating, wash your utensils in one place and throw the water away," says a Best worker. "It's good to shower every day and cut your nails. When you have to relieve yourself, you should go to the latrine, not do it in your tent. And you should clean the tent regularly."

One woman from the sea of multi-coloured shawls agrees: "Yes, we follow your instructions every day!"

This outburst unleashes a wave of mumblings through the crowd. Everyone has an opinion and the crowd gets increasingly animated, even agitated. Arms flail and bangles jangle. After playing along with the aid workers, they reveal their real concerns.

"I didn't get the compensation in my hometown because I was here in the camp. How can I claim it?" asks an old woman.

"My home fell away in a landslide," says another woman. "Now the land is no more and my house is somewhere at the bottom of the mountain. Can you talk to the government to give me new land?"

The community services team doesn't have enough information to help them immediately, but takes down their details to pass on to the relevant authorities. The only consolation for these women who have lost their homes is that they have found a voice. It remains the job of people in organisations like UNHCR and Best to make sure they are heard – loud and clear.

By Vivian Tan
In Balakot, northern Pakistan