The sheer scale of destruction from the recent floods in Pakistan can be gauged from the fact that Angeline Jolie came back to comfort the distressed un-homed masses. Jokes aside, tens of millions of people have been displaced and there seems to be no real end in sight for the plight of the displaced.
Pakistan was already in an incredibly sensitive state before the floods hit half the country: the economy was in shambles and we were left on the generosity of the IMF and our other foreign benefactors to save the country from default. Inflation and wage stagnation had left most of the country’s people unable to support themselves and their families and now those unaffected by the floods have to do more just to ensure that the affectees do not starve to death.
Thankfully, Pakistanis are known to be resilient in the face of these mass disasters and calamities and we have seen great responses in the past: earthquakes, floods, terrorism, we have always banded together to support each other. At least the public has. And they have to: the Pakistani political leadership is completely ineffectual and of no help, looking towards the army to handle problems that were their responsibility.
Immediate problems like housing the IDPs and providing them with basic rations to survive and clean water to drink is on everyone’s mind and NGOs and other institutions are trying to fill the gap left by the government.
However, there is one systemic problem that was already difficult to manage before the floods and is now amplified beyond the means available to fill the gap without urgent and massive help-healthcare. The monsoon season is enough for a spike in water-borne illnesses in the subcontinent, but the size and scale of the flood in Pakistan are so big that we can expect the problem to be scales of magnitude worse than what we are used to.
The Rise in Illnesses Post-monsoon
Floods increase the chances of infectious diseases wreaking havoc on a population. In this article, we will be discussing the matter of various post-flood illnesses that we can expect to deal with over the next weeks and months as the immediate needs of the IDPs and flood affectees are met.
Thankfully, researchers and health professionals like Maryam Baqir had analyzed and prepared an article in 2012, Infectious diseases in the aftermath of monsoon flooding in Pakistan, in the Asian Pacific Journal of Biomedicine: this will serve as the main resource for this article as we can face a similar situation after the current floods.
Direct Effects
The initial problem lies in the matter of over-flowing sewers and contaminated water mixing up with rainwater to create the perfect conditions for illnesses to spread. Apart from Diarrhea and skin diseases that occur during the floods, there are illnesses that we need to be prepared for after the flooding is over.
Some common diseases that occur during and after these kinds of floods are typhoid, cholera, hepatitis A, conjunctivitis, leptospirosis, dengue, and jaundice. These are just to start with. All of these illnesses are very difficult to treat and almost always prove debilitating or even fatal when they are left untreated. These illnesses are a direct result of the floodwater itself as animal and human excrement mix and are dispersed in the community-people have no way of escaping the diseases these waters carry.
Mosquito/Insect as Vectors
Malaria and Dengue are borne from mosquitoes that breed in standing water and this is always in great supply during and after flooding. The only way to prevent people from getting these two diseases is to prevent mosquito bites in the first place. Considering that these people no longer have a roof over their heads, it is incredibly difficult for them to get any protection from them. Treatment for both these diseases is expensive and difficult to provide as well.
In January 2009, suspected malaria was reported as the primary diagnosis in almost twenty percent of total medical consultations in flood-affected districts of Balochistan. This made the disease the second leading cause of consultations from healthcare professionals among the affectees. The delay between floods and spikes in these mosquito-caused diseases is usually around seven weeks.
This stands true for both malaria and dengue. Another lesser-known disease carried by insect vectors is Leishmaniasis. This disease is caused by Leishmania, transmitted by the sand fly. It can lead to disfiguring sores at the site of the bite, which is more likely on the exposed parts of the body. Systemic or visceral leishmaniasis which is rarer in Pakistan affects the internal body organs, particularly the spleen and liver.
The situation is further complicated by the fact that very few local physicians can differentiate between leishmaniasis and other skin diseases. Floods can potentially increase the transmission of leishmaniasis. Bihar, an often flooded region, has seen a surge in the disease since the 1970s. As the relief efforts in flood-hit Pakistan intensify, officials should brace themselves for an outbreak of leishmaniasis among the millions affected by the floods. Residual insecticide spray and impregnated bed nets are effective.
Even more important, however, is improving environmental and sanitation living conditions.
In the aftermath of floods, infections of the respiratory tract are usually amongst the most common causes of morbidity and mortality in survivors. When devastating floods affected millions of people in Bangladesh in 1988, it was found that respiratory tract infections accounted for about eighteen of all illnesses and 13% of all reported deaths. Illnesses like Tuberculosis, the current Covid pandemic, flu viruses, and the common cold, all of these can hurt the population that has been left vulnerable to the elements.
Apart from the illnesses mentioned, the current state of flood-hit areas provides fertile breeding ground for new kinds of diseases to wreak absolute havoc on an already destitute population.
In Conclusion
There needs to be coordinated awareness campaigns and resource mobilization to prevent and treat these illnesses and the only real way to do so is through government institutions-including the military and other institutions. The only way to do so is for the pertinent individuals to be notified and pressured by the public and those in authority so that public, government, and military resources can be mobilized to tackle this ticking time-bomb of a problem.
