Pakistan SDGS, Catastrophic Floods are a Public Health Crisis 

Over 33 million people have been affected by the monsoon rains and the consequent flooding since mid-June 2022, causing unprecedented destruction in Pakistan, particularly in Sindh, Balochistan, and Southern Punjab.

Muhammad in Lahore, Pakistan
Muhammad in Lahore, Pakistan

Natural disasters in the region account for 40% of the world's disasters and have resulted in the deaths of many people. Along with it, the brunt of the health crisis has haunted flood-hit Pakistan. However, the Sustainable Development Goals (SDGs) provide a comprehensive strategy to address issues like poverty, inadequate food supply, poor health care, bad climatic conditions, and more for developed and developing countries. In particular, SDGs seek to end all hunger caused by extreme global climatic conditions. Admittedly, 2022 was a tumultuous year in the context of environmental,  social and governance issues for humanity. This summer, there was a significant disruption in the environmental balance leading to natural disasters. With that being stated, Pakistan floods were reported as the sixth costliest climate disaster of 2022. At the core of flooding negotiations is the conundrum of how to prevent disasters while preserving the environment. 

Pakistan has successfully met SDG goal 13, as SDG index manager at SDSN, Guillaume Lafortune, said, “In our methodology, Pakistan has achieved the climate action goal, as its energy-related emissions are below two tons per capita.” It still needs to pursue efforts to fight climate change. Furthermore, Pakistan is lagging in achieving SDG 3, which is related to the health and well-being of all. Although efforts are being made to improve the healthcare system, its chances of meeting this goal in the next seven years are bleak. 

In this article, we’ll be looking at:

●        Overview of 2022 Floods

●        Impacts of the Flood on Health 

●        What Lies Ahead?

●        Preventive Measures for Disaster Management 

Overview of 2022 Pakistan Floods

Heavy rains and a heatwave set off the floods caused by glaciers melting in the mountains. Floods are extreme events that cause massive destruction of land and infrastructures. The damage of the 2010 flood still needed to be amended, and unfortunately the country had to face another mega event last year. Due to improper planning and safety measures, a considerable portion of the provinces of Sindh and Punjab drowned under the powerful water flow. The country was amidst the vilest economic and political crisis, and the flood came as an additional calamity. Due to the political turmoil, the governance delivery was below par amid the crisis. The affected people were not helped adequately. Political instability undermined the necessary policymaking which resulted in hyper-inflation and food shortage.

Nevertheless, flooding continues to ravage Pakistan, worsening the humanitarian crisis. According to Dr. Brennan, WHO Regional Emergency Director, humanitarian organizations fought a tough battle against this crisis. He further added, ‘’the catastrophe has pushed the country to the brink and diseases are rampant.’’

The flood killed many people, and many people lost their homes and agricultural land. The country faced over $15.2 billion of economic losses, including the shortage of food and water as an after-effect. With the skies clearing in Pakistan, the extent of the flood damage becomes more apparent. 

Impacts of the Flood on Health

Women Health Issues

The situation of 2022 was worse than the 2010 floods, and the aftermath of the health crisis is terrifying. Around 650,000 pregnant women were dislocated and were necessitated to give birth in hazardous conditions and face maternal malnourishment and improper care. Lack of menstruation supplies and inadequate maternal services have put many menstruating and pregnant women in a dreadful situation. Since women cannot get proper sanitary care during their menses, it can be a severe health issue causing infections that can be spread to others. 

Amid the flood, due to poor hygiene and contaminated water, the crippled health infrastructure had worsened the battle against pre-existing illnesses, such as COVID-19, dengue fever, and polio. The birth of babies in flood camps with no health care workers or proper medication is resulting in infant deaths, postpartum deficiencies, and a colossal health crisis in the country. Moreover, the damage to infrastructure in the flood-affected areas has made it difficult for women to access clinics and hospitals since they can't travel through damaged roads. In addition, the lack of connection with authorities has disrupted immunization programs, resulting in an increase in polio and other viral diseases.

Malnutrition 

According to UNICEF, ten million children are malnourished in Pakistan. Besides having one of the highest maternal mortality rates in the world, more than 40% of Pakistani mothers were already anaemic before the floods. Now there is a surge in malnourished babies. Malnutrition, however, emerges as a real threat as water keeps wiping out crops and the roads transporting food. Children are not getting the right food and care, affecting their growth and brain development. Even mothers cannot feed their infants due to lack of energy and food. Yet, this catastrophe doesn't just affect the flood-affected areas, but the food shortage and damaged crops will lead to a country-level crisis whose glimpses we have started to see in the rising prices of flour, rice, and other necessities. 

Snake Bites 

Floods have had an impact on both humans and wild animals, depriving them of refuge. This led to many lethal diseases caused by poisonous creatures such as snakes. People who have been bitten by dangerous snakes need to receive antivenom therapy at once, but floods can also make it difficult to get help. 134 individuals in Pakistan were said to have been bitten by snakes due to the floods as of August 30, including a woman in the northwest's Khyber Pakhtunkhwa province who expired after not receiving appropriate and quick medical attention.

Infectious Diseases

The authorities are still not able to channel the flood water to the sea. The stagnant water is a hub of waterborne infections and diseases, such as cholera, dysentery, dengue, malaria, and many more. And with no immunization and medical help, these conditions can be fatal. Since flooding has given rise to many water and vector-borne diseases, it was not wrong to categorize illnesses into acute and subacute care settings. Diseases, like diarrhoea, leptospirosis and skin infections, were reported in acute care settings, whereas in subacute environments, respiratory infections, leishmaniasis, hepatitis and malaria were reported. 

After severe flooding, access to clean water is frequently a significant issue. Overcrowded shelters and poor sanitation exacerbate the spread of diseases in flood-prone areas when sewers overflow, contaminating drinking water and increasing the likelihood of gastrointestinal disorders. Humidity and prolonged contact with contaminated water contribute to common skin infections. Moreover, mosquito breeding is common in flood-affected areas that have turned into breeding grounds, contributing to mosquito-related illnesses like malaria and dengue fever.

Psychological Trauma 

Due to the devastation of the flood, a large number of children are also affected, disrupting their vaccinations, proper food supply and education. With the country already running behind on its educational targets, this can directly affect its development in years to come. These children will not only be physically weak but also mentally traumatized by the conditions they are surviving in. The monsoon rains leading to catastrophic floods have also left many cases of mental trauma. 

In flood-hit areas, more than 50% of the affected children were reported with signs of mental distress. During disasters, children's psychosocial well-being is affected by several factors, including homelessness, loss of access to education and loss of loved ones. The lack of education and living under the sky with deaths, diseases and stagnant water around them will leave a profound mark on their souls and minds that will take decades to fade away.

What Lies Ahead?

Director General of the World Health Organization, Tedros Adhanom Ghebreyesus, said, “The water has stopped rising, but the danger has not, we are on the verge of a public health disaster.” It's a situation of crisis, and the people of Pakistan, living within the country and abroad, have come forward to provide immediate help to the affected. Still, the disaster is so huge that the whole world needs to extend its hand to help these people living in extremely harsh conditions and are prone to disease, starvation and death.

With the winters going on, the situation is getting more aggravating, and the food, shelter, clothing and health crisis is peaking up in the whole county. Health conditions are the biggest hurdle, and if not given the attention they need, it might affect the whole country later. Spread of powerful viruses and infections can flow through the water to other parts of the country. Limiting polio or measles cases would require a lot of work for the authorities once the virus spreads.

Preventive Measures for Disaster Management 

Knowledge about common health-related challenges helps to plan an efficient healthcare program during floods. More than 4210 medical camps have been set up by authorities to manage flood-related victims. Digital media should provide early warnings about the effects of flood disasters and flood forecasting so that people can evacuate safely and quickly before significant damage. 

Early Warning Systems:

Prevention of outbreaks of waterborne illnesses is a step that needs to be taken. One significant preventive measure includes strengthening Early Warning Systems (EWSs) that can prevent epidemic diseases. To develop policies and establish plans for limiting infectious outbreaks, it is imperative to evaluate risk factors, such as water pollution and sanitation, scarcity of health facilities and liveable shelters, and exposure to disease vectors. Heavy rains are strongly linked to mosquito-borne illnesses, like malaria and dengue; thus, to prevent outbreaks, it is essential to ensure that health facilities in high-risk regions are stocked with medications, such as antimalarials and rehydration fluids. Chlorination to disinfect water and immediate actions targeting disposal of polluted water and other waste should be taken to protect public health. 

Psychological First Aid

Since mental disorders are common, mitigating psychological trauma risks is also essential. Public health interventions such as Psychological First Aid (PFA) are both practical and cost-effective in Pakistan to facilitate the healing of psychological trauma in flood victims. Efforts should be made to develop mental health policies.

State’s priorities

Investing in children's education, providing permanent safe homes and pediatric mental health services should be the government's main focus beyond the immediate flood aftermath.

Conclusion 

To conclude, Pakistan’s weak healthcare system is facing dire consequences of flood and finding it difficult to cope with. One-third of the country was drowned in water and some areas are still watered. Pakistan is facing environmental challenges that are not of its own creation. The country contributes less than 0.5% to global emissions but faces acute climate challenges. In such circumstances, it needs climate justice in the form of international cooperation to mitigate these threats that affect a considerable population in many ways. The authorities must act swiftly to achieve SDG goals to minimize environmental patterns' effects and save the lives of people affected by natural disasters. Pakistan needs to leverage its efforts and align its budget with SDGs to achieve the majority of SDG goals that can help to mitigate many risk factors that can disrupt the economy and health of this country.