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Current Situation and Impact on Health
The recent devastating floods that hit Pakistan have severely impacted the lives of 33 million people and considerably elevated the risk of a public health disaster.
As of 30 September, the floods have killed over 1,500 people and injured over 12,000 people. More than 116 districts have been affected, with 84 declared as ‘calamity hit’. A million homes have been damaged or destroyed, over 600,000 persons displaced, and 700,000 livestock destroyed.
According to the National Disaster Management Authority (NDMA), 2,000 health facilities, representing 10% of all health facilities in the country have been either damaged or destroyed. As a result, over eight million people in flood-affected districts are in urgent need of health assistance. WHO is concerned about the risks of increased illnesses and deaths, particularly since water has still not receded in many areas of Sindh – the most affected province – and stagnant water here as well as in other provinces continues to pose a significant health threat.
According to the assessment conducted jointly by WHO and UN Office for the Coordination of Humanitarian Affairs (UN-OCHA) in mid-September 2022, less than 50% of all people needing health services are currently able to access health facilities. This is alarming given the already fragile context that displaced populations find themselves in – without adequate shelter, food and in crowded, unsanitary surroundings. In addition, pregnant women and lactating mothers in these settings are at increased risk of life-threatening complications.
The risks of disease outbreaks is particularly high. Recent surveillance data from district and provincial authorities indicates spikes in the number of cases of malaria (with numbers almost doubling in some areas), dengue, and acute watery diarrhoea, particularly in Sindh and Balochistan provinces.
Cases of Severe Acute Malnutrition (SAM) with complications are also on the rise. Given that the percentage of children with SAM rates above emergency thresholds was already high in flood-affected areas of Sindh and Balochistan, these increases are extremely concerning.
Floods have also disrupted immunisation campaigns, expanded programme on immunization (EPI) surveillance efforts, the cold chain as well as the treatment of chronic disease, such as tuberculosis (TB) and human immunodeficiency viruses (HIV). The nationwide polio vaccination campaign has also been disrupted, which is concerning as Pakistan is one of the two remaining polio-endemic countries in the world. The transmission of COVID-19 also represents an important health risk, especially for those who have been displaced into camps.
Stocks of essential medicines and medical supplies have been washed away or are critically low, and transport infrastructure has been severally damaged, making access to essential health services extremely challenging. According to the NDMA Monsoon Situation Report of 23 September 2022, 13,074 kms of roads and 392 bridges have been washed away.
Disease surveillance activities have also been compromised. The Integrated Disease Surveillance and Reporting System (IDSR), only functional in 45 of the country’s 160 districts, is not currently implemented in many of the calamity-hit districts and does not have an early warning component linked to response. It is therefore urgent to ensure active disease outbreak detection and rapid response.