Not much has changed since the 2010 floods that affected the poorest of the poor in Pakistan, according to a comment published in The Lancet.
"Despite ample warnings by the country’s meteorological department this year, federal and provincial disaster management authorities did not take rapid enough measures to strengthen embankments, clear major drains, or stockpile commodities for potential mass displacement," it added.
There was little coordination, and the response was haphazard and inadequate, the published comment said.
The global recognition and response to the crisis were initially also slow and uncoordinated, observed authors including Professor Zulfiqar A Bhutta, founding director of the Institute for Global Health and Development at the Aga Khan University, and Co-Director of the SickKids Centre for Global Child Health.
Read more: Almost 30% of flood victims gone home in Hyderabad: Memon
Notwithstanding the floods, Pakistan remains one of the most water-stressed countries globally.
The authors stressed that comprehensive climate adaptation and mitigation strategies are needed to implement actions in three areas: strengthening capacity to ensure that the water infrastructure and resources are sufficient in urban and rural settings; adopt climate-smart construction standards for reconstruction and development of infrastructure; and resource and empower local governments to provide municipal and environmental services.
The authors said that high-income countries have a major responsibility to help address the climate emergency that is affecting Pakistan. "For a country that contributes less than 0·5% to global carbon emissions annually, it is entirely reasonable to seek climate retribution to rebuild Pakistan’s infrastructure and flood control systems."
This is not external assistance or charity, it is climate justice, the authors said.
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