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WHO warns of waterborne diseases in Pakistan

Flood-ravaged Pakistan faces major public health threats from waterborne and infectious diseases, the World Health Organization cautioned.

Tractors are the main way of getting around some flooded areas of Pakistan
Tractors are the main way of getting around some flooded areas of Pakistan (AN/Arooj Kamran/IRC)

Flood-ravaged Pakistan faces major public health threats from waterborne and infectious diseases, the World Health Organization cautioned on Wednesday.

Massive monsoon rainfall and unprecedented levels of flooding is aggravating pre-existing disease outbreaks. Those include acute watery diarrhea, COVID-19, dengue fever, malaria and polio.

Officials says it's especially bad in relief camps and places with damaged water and sanitation facilities even as the waters from unusually strong monsoon rains that many blame on climate change start to recede around the country.

"The current level of devastation is much more severe than that caused by floods in Pakistan in previous years, including those that devastated the country in 2010,” said Dr. Ahmed Al-Mandhari, WHO’s Eastern Mediterranean regional director, citing a preliminary assessment by WHO and humanitarian agencies.

“WHO has initiated an immediate response to treat the injured, provide life-saving supplies to health facilities, support mobile health teams, and prevent the spread of infectious diseases," he said.

At least 1,162 people are dead and 1,300 others injured from the flooding and heavy monsoon rains since mid-June, according to Pakistan's health ministry. More than 161,000 are displaced in relief camps and some 1 million homes have been damaged or destroyed.

In all, 33 million people — about one in seven of Pakistan's 230 million population — are affected. Many in the flood-hit areas complain of diarrhea, skin infections and other waterborne illnesses. More than 20 million people in Pakistan were affected in 2010 when monsoon rains caused extensive flash flooding.

On Tuesday, the United Nations and Pakistan launched an emergency appeal for US$160 million to help the nation cope with what U.N. Secretary-General António Guterres described as yet another "climate catastrophe" that could strike anywhere on the planet. He plans a "solidarity visit" there next week.

"Pakistan is awash in suffering. The Pakistani people are facing a monsoon on steroids — the relentless impact of epochal levels of rain and flooding," Guterres said.

"Millions are homeless, schools and health facilities have been destroyed, livelihoods are shattered, critical infrastructure wiped out, and people’s hopes and dreams have washed away," he said. "Let’s stop sleepwalking towards the destruction of our planet by climate change. Today, it’s Pakistan. Tomorrow, it could be your country."

'Worst in the history of Pakistan'

WHO says 888 health facilities are damaged, including 180 that are destroyed, leaving millions of people without access to any health care and medical treatment. The rains and floods also disrupted a national polio vaccination campaign.

Dr. Palitha Mahipala, WHO's chief representative in Pakistan, said the main priority is to get essential health services to millions of people affected by the flood, improve disease surveillance, and prevent more disease outbreaks. The U.N. health agency is sending mobile medical camps to affected places and handing out sample collection kits to ensure clinical testing for infectious diseases.

Pakistan's government is in charge of the response and has declared a state of emergency in some areas. It has set up control rooms and medical camps at the provincial and district levels, organized air evacuation operations, and spread information about the risks of waterborne and infectious diseases.

With a third of his nation underwater, Pakistan's Prime Minister Shehbaz Sharif called the flooding "the worst in the history of Pakistan" and estimated it has cost US$10 billion in damage to the economy.

WHO and other agencies also have been vaccinating people for cholera and expanding surveillance for polio and other diseases, since Pakistan and Afghanistan are the world's only two remaining polio-endemic countries — the ones that never interrupted the transmission of wild poliovirus.

WHO's Director-General Tedros Adhanom Ghebreyesus told reporters that damage to health infrastructure, shortages of health workers, and limited health supplies are disrupting health services, leaving children and pregnant and lactating women at increased risk.

"Pakistan was already facing health threats including COVID-19, cholera, typhoid, measles, leishmaniasis, HIV and polio. Now, the flooding has led to new outbreaks of diarrheal diseases, skin infections, respiratory tract infections, malaria, dengue, and more," he said.

Loss of crops and livestock will have a significant impact on the nutrition and health of many communities, Tedros said, and more rain is expected. Geneva-based WHO classified Pakistan's flooding as a grade 3 emergency, the highest level, he said, which means  all three levels of the global organization are involved: the country and regional offices, and headquarters. WHO also is releasing US$10 million from an emergency fund to support its work there.

"Floods in Pakistan, drought and famine in the Greater Horn of Africa, and more frequent and intense cyclones in the Pacific and Caribbean," Tedros said, "all point to the urgent need for action against the existential threat of climate change."