Recently, Pakistan has experienced several natural disasters—such as the earthquake of 2005 in Swat, measuring 7.5 on the Richter scale, and unprecedented flooding that caused havoc from the Himalayas to the shores of the Arabian Sea in 2010. In addition, people are affected by armed conflicts both within Pakistan's borders and in Afghanistan, such as the decade-long conflict in the Northern provinces along the border. Consequently, a large number of refugees and internally displaced people, mostly women and children, are in shelters in internally displaced population camps. These camps lack sufficient supply and storage of daily ration, sanitation, health and educational facilities. Inhuman living conditions add an enormous burden to the level of post-traumatic stress disorder and depression of these internally displaced people. While women are extremely vulnerable to these mental health problems, their children are equally exposed and suffer with mental stresses, as mothers do not have the capacity to supervise and protect their children from the potential physical, psychological and sexual abuse prevalent in marginalised living conditions and an environment of easy exposure to social hazards and the toxic mentality of men. This conceptually based paper addresses some of the challenges and risks identified and faced by children of the camps for displaced persons in Pakistan. The authors propose a psycho-social framework based on public health interventions to decrease the risk of abuse and trauma, to protect these vulnerable children, and to maximise the strength and resilience of the family unit.

Natural disasters affect the health and well-being of mothers with young children. During natural disasters, this population is at risk of discontinuation of their breastfeeding practices. Pakistan is a middle-income country that is susceptible to natural disasters. This study intended to examine sociocultural factors that shape the breastfeeding experiences and practices of internally displaced mothers in Pakistan. This critical ethnographic study was undertaken in disaster-affected villages of Chitral, Pakistan. Data were collected utilizing multiple methods, including in-depth interviews with 18 internally displaced mothers and field observations. Multiple sociocultural factors were identified as either barriers or facilitators to these mothers’ capacities to breastfeed their children. Informal support, formal support, breastfeeding culture, and spiritual practices facilitated displaced mothers to sustain their breastfeeding practices. On the other hand, lack of privacy, cultural beliefs, practices and expectations, covert oppression, and lack of healthcare support served as barriers to the breastfeeding practices of displaced mothers.

Background: During disasters and displacement, affected families often receive humanitarian aid from governmental and nongovernmental organizations and donor agencies. Little information is available on the effects of humanitarian aid on the breastfeeding practices of mothers affected by disaster and displacement. Aims: The aim of this study was to explore the effects of humanitarian aid on the breastfeeding practices of displaced mothers affected by natural disasters in Chitral, Pakistan. Methods: This was qualitative study of residents of four villages of Chitral who had experienced a recent flood and later an earthquake. Data were collected through field observations, analysis of various documents (e.g. aid-agency documents, published reports and newspaper articles) and in-depth interviews with 18 internally displaced mothers living in disaster relief camps in Chitral. Results: Three main themes developed from the data: humanitarian aid as a life saver, insufficient humanitarian aid affecting breastfeeding, and systemic injustices in the distribution of humanitarian aid. Conclusion: Although humanitarian aid facilitated the survival, health and well-being of the displaced mothers and their family members, there were various problems with the humanitarian aid that increased the vulnerability of the displaced mothers and negatively affected their breastfeeding practices. Humanitarian aid must be gender-sensitive, thoughtful, timely, needs-based, equitable and context-specific. A systematic process of aid allocation and restricted donation of formula milk or any other form of breast-milk substitute is recommended during disasters.