Floods and aftermath
The writer is an Adjunct Professor of Epidemiology at the University of Nebraska and has worked for the US Centers for Disease Control and Prevention. He can be reached at jasghar@gmail.com
Floods are not a new phenomenon in Pakistan. We do witness a major flood in a decade or two. Floods 2010 were historic in nature until then, and now floods 2022 have broken all previous records. Floods are a natural calamity and even insurance companies in the US were not insuring a house against floods. Where we can’t predict and limit floods to a great extent, we could still minimise the human and property losses which happen periodically in our country.
In the 2010 floods, I went out to Sindh which was the most affected province then too. I saw all the scenes we are seeing these days. I saw a kid stranded alone in waters for some 72 hours until he was rescued and now was suffering through severe mental health issues. I saw families using thin bed sheets to have some shade for their kids in makeshift tents; relief aid was pouring in and alongside political opportunists and sketchy relief organisations to mint political and material profits out of a health crisis. In a relief camp I saw four or five medical camps working independently and all of them were showing a number of patients which could be more than the total number of people living in the camp. Everyone was just inflating its number but for me what was more worrisome was that I could not figure out if cases of diseases were going up or the same patient was visiting all five medical camps and everyone was registering him as a new patient. Without this vital information, health planners are working in the dark and result is a complete waste of resources.
The relief work to be meaningful should be divided into short term and long-term steps. In short term steps, we need to have a reliable and representative health intelligence system. We need to have very clear and early information if cases of dengue, malaria, typhoid, hepatitis or other infectious diseases are starting to go up. If we have that information only then our interventions could be effective, and we would be able to save lives. Hiding cases these days is criminal and will create much bigger problems which will be difficult to manage later.
Ensuring clean and safe drinking water to flood victims will decrease the chances of water-borne disease to minimum. Larvae control and proper insecticide sprays will help control dengue, malaria and chikungunya. So, health departments and relief organisations should prioritise investing in safe water systems (chlorine tablets, filters, small solar water filter systems, etc). Similarly, mosquito repellents, insecticide sprays and coils will help reduce the chances of mosquito bites. Focusing in these two areas could reduce chances of infectious diseases outbreaks by 70%. Providing waterproof tents or other temporary living will save them from extreme weather which we are still witnessing. Mental health is another most needed area which is always neglected as the need is not seen by superficial visits or consultations.
Alongside the other critical need is providing gynecological and obstetric support to millions of females living in the open.
In the long-term we need to start thinking about better protected houses and areas in lands of historic floods. In many older cities close to rivers or seas, houses were built on logs to stay overwater even in high tides. New village planning needs to be done to factor in climate change and increasing risks of bigger floods. Disaster relief organisations need to be more robust and flexible.
Many have asked me to guide them about relief work in affected areas. My advice is to find a local trustworthy organisation or person from the area and channel your support through them. They can better tell you what people actually need, and it may be very different to what you have perceived living in your houses.
A global effort is needed to change the course of climate change and it may take decades. But until then it’s our responsibility to safeguard our vulnerable population and property. We are already a poor country, and we can’t afford inaction.
Published in The Express Tribune, September 17th, 2022.
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