Nightmare in Pakistan

By Luis Sánchez Perpiñá

Twitter: @luis_perpi

A bus driving in Kalam, Pakistan. By Umar Farooq on Unsplash.

Imagine that you live in a house in the middle of the countryside, surrounded by hundreds of hectares of cotton that help you sustain your family every month. However, one day after you open your eyes that view is just a memory, and your house is now an island encircled by muddy and putrid water. That was what Muhammad Jaffar lived last summer in Dādu, Pakistan, after record floods devastated Pakistan from June to October, mainly in the regions of Balochistan, Sindh, and Khyber Pakhtunkhwa. 

Even in that dramatic situation, Muhammad was still among the lucky people that kept their house unlike 2.2 million of his fellow citizens who did not have the same luck. According to the National Disaster Management Authority, more than 33 million people were affected by the crisis in the fifth most populous country in the world, killing 1,739 people including 647 children and becoming the deadliest disaster in the history of Pakistan, even worse than the floods of 2010. 

This extraordinary event was caused by unusually high temperatures in April and May that massively melted glaciers and increased the amount of moisture so that the air couldn’t contain it, leading to an early monsoon season. This left more than 10% of the country underwater after having received more rainfall than three times the 30-year national average. 

On August 25th, the Pakistani government declared a national state of emergency due to the high loss of lives, properties, infrastructure, livestock, and livelihoods. As usual in crises, the most vulnerable populations were specially harmed, namely children, women, and refugees, worsening the already alarming situation. It is worth mentioning that Pakistan is a major refugee host country with almost 1.5 million Afghan refugees living there double than in the second country, Iran. 

People were forced to leave their houses due to the threat of drowning, roads and bridges collapsed hindering access to humanitarian aid, while schools and other buildings disappeared as they were dragged by the force of water. However, a second terrible wave was yet to come.  

“Pakistan is among the top 10 countries in the world with a large pool of unvaccinated or undervaccinated children and is home to more than 600,000 children who have not received a single vaccine dose.” 

The second wave 

This disaster did nothing but enlarge the existing health deficit, as the vaccination campaigns were halted due to lack of healthcare professionals, blocked access, and a huge number of spoilt vaccines due to breaks in the cold chain. In fact, poliovirus paralyzed a child in 2022 raising fears of spread. 

With 13% of the national health facilities destroyed or damaged and no access to potable water, health issues did not take a long time to arise with soaring numbers of malaria, dengue, and acute watery diarrhea. Moreover, food shortage deteriorated the already precarious situation, resulting in an increasing number of severe acute malnutrition (SAM), especially among children. 

Women were also suffering the effects of this catastrophe, specifically more than 650,000 women that needed maternity services in the flooded areas, which could cause higher infant mortality rates.  

Picture of the water in Kalam, Pakistan. By Umar Farooq on Unsplash.

As a result, the WHO elaborated a health response with strategic response priorities in close  collaboration with the Pakistani government. Their advice included coordination at a national and sub-national level; disease surveillance, outbreak prevention and control; management of children suffering SAM and support to increase water quality surveillance. Ten Emergency Operations Centers and three Operational Hubs in Sukkur, Nasserbad and Hyderabad were established in order to achieve these goals. 

This public health crisis awakened a wave of solidarity among the international community that  culminated on January 9th 2023 during the session in the United Nations headquarters in Geneva, where more than $9 billion were pledged to assist Pakistan with the reconstruction efforts. 

The situation is far from being solved but it has started to revert, since the last report from the WHO recorded a decrease in the cases of malaria, cholera, dengue and acute watery diarrheal  diseases. The improvement is thanks to the incessant distribution of tents, mosquito nets, ration beds and folding beds for the affected population. 

Health crisis is not only about health 

The case of Pakistan is just another piece of evidence of how closely global health is linked to climate change. As the Federal Councilor for Foreign Affairs of Switzerland said in the International Conference on Climate Resilient Pakistan:  

“Today, it’s you, Pakistan, that needs help. But tomorrow, it could be us, all of us. One thing is certain: none of us is safe. We are all concerned by climate change, a global threat that requires a global response.” 

Climate change is accelerating the appearance of extreme weather phenomena, making them more frequent and devastating, causing enormous consequences in health particularly among low- and middle-income countries, as we have seen in Pakistan. In fact, many countries have been extremely critical about the fact that the largest impact of climate change are being seen in countries with low emissions. Pakistan’s Prime Minister Shehbaz Sharif himself said

“Pakistan has never seen a starker and more devastating example of the impact of global warming… Nature has unleashed her fury on Pakistan without looking at our carbon footprint, which is next to nothing. Our actions did not contribute to this.” 

We need further collaboration if want to make our countries resilient against future health challenges and humanitarian crises, and only then will we be able to avoid tragedies like the one in Pakistan.

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