Subgroup: Volume 12, Issue 6
Date: November 2010
Start Page: 606
End Page: 607
- KB Lankarani Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
City, Province: Shiraz, Fars
Mansoon rains, floods and other disaster, all of these started in July 26, 2010. Pakistan was affected by the worse flood in the recent decade.1,2 Nearly, one fifth of the entire landmass and more than 20 millions of the population were directly affected in this flood. More than 1.9 millions houses and many infrastructures including transportation system, health facilities and schools were damaged or destroyed.1,2 About a quarter of the country’s harvest has been destroyed and the next year’s harvest seems to be threatened too. Estimated Sindh’s agricultural loss is at least US$1 billion which is quite high for a country with low GDP. Much of the cotton crop as one of the major Pakistan’s export has been wiped out. The social and economic effect of this tragedy seems to be already more than all the three recent major natural disasters namely Indian Ocean Tsunami in 2004, Southeast Asian earthquake in 2005 and Haiti earthquake in 2010.
Fortunately, the death toll has been far less than previous natural disasters in Pakistan. For instance in Pakistan earthquake in 2005, more than 76,000 people died but in this flood the direct death toll was near 1700 at the beginning which means that the acute rescue efforts of the Pakistani government especially the deployment activities ran mostly by the Pakistani army and civic society organizations were effective in avoiding acute deaths. But unfortunately the tragedic effects of this natural disaster are just beginning. Providing sanitary food, water and shelter for those affected seems to be impossible as epidemics of infectious diseases.3-5 World Health Organization has reported that more than ten millions have forced to drink unsafe water. Cases of cholera and malaria are sky rising. Field observation of rescue teams indicates increasing number of patients with hepatitis A and E. United Nation has warned that up to 3.5 millions of children are now at increased risk of potentially fatal water-born infections in Pakistan. In a country with already high maternal and infant mortality, a further dramatic increase in both indices seems unavoidable. Malnutrition especially in far remote areas is also increasing. No body can realize the psychological effects of this disaster and how it affects the mental health of affected population.
The flood has widened the gaps in Pakistan between the wealthy and the poor. As in many other natural disasters, the health impact of this flood could be directly related to poverty level. Wealthy people were far less affected by the flood.
The health impact of flood is acutely tremendous and there is a great need for international help and cooperation to avoid acute detrimental effects of this disaster on population health. But much more is needed for reconstruction of the lost infrastructures and to avoid the chronic detrimental effects.
Many countries have at least announced their commitment to donate to Pakistan. But in reality, only two third of the $460 million UN flash appeal for Pakistan have been funded. Pakistan already owes more than 50 billion USD to the creditors.6 Some of these creditors have donated much less than what they receive from debt repayment even in short term. For instance the French Government, which receives about $62 million per year from Pakistan in debt repayment, has only committed $2·45 million to the UN appeal.6 No major plan for funding of reconstruction of the lost infrastructures have been announced so far by any international authority.
Several international organizations have established local camps for relief operations. Iranian Red Crescent Society for instance has established 13 camps and several clinics in the field. The need for treatment of the timely donations and relief programs are of extreme importance if these relief efforts are going to be effective. Unfortunately, there are few organizations worldwide that have the capacity for urgent proactive structured mobilization of resources including material and team. We need more international initiatives for effective mobilization of resources and cooperation in disasters.
Conflict of interest: None declared.
- UN Office for the Coordination of Humanitarian Affairs. Pakistan. Sep 17, 2010. http://ochaonline.un.org/OCHA Home/WhereWeWork/Pakistan/PakistanFloods/tabid/6844/language/en-US/Default.aspx (accessed Sep 20, 2010).
- Solberg K. Worst floods in living memory leave Pakistan in paralysis. Lancet 2010;376:1039-40. [208790 89] [doi:10.1016/S0140-6736(10) 61469-9]
- Siva N. Malaria is on the rise in Pakistan, health workers warn. BMJ 2010;341:c4752.  [doi: 10.1136/bmj.c4752]
- Siva N. Pakistan sees first suspected cases of cholera. BMJ 2010;341:c4525.  [doi: 10.1136/bmj.c4525]
- Siva N. Health workers fear cholera outbreak in Pakistan. BMJ 2010; 341:c4344. doi: 10.1136/bmj.c4344.  [doi:10.1136/bmj.c4344]
- Burki T. Aid slows to a trickle as Pakistan crisis enters a new phase. Lancet 2010;376:1041-2. [208790 90] [doi:10.1016/S0140-6736(10)61470-5]