Pakistan's invisible climate casualties

Vulnerable communities are hit hardest by climate-linked disasters and remain exposed long after the headlines fade. In Pakistan, deaths recorded immediately after major disasters receive attention, while the far greater toll in the months that follow goes largely unacknowledged.

Pakistan's healthcare system is chronically underfunded and overstretched, struggling to provide basic care even in ordinary times. Recurrent climate-fueled emergencies, including heat waves, droughts and floods, are pushing this fragile system to the brink. Waterborne diseases, extreme heat and disrupted medical services create a deadly combination for those already most at risk.

A report by Amnesty International and the Indus Hospital and Health Network highlights the hidden toll of climate change using 2022 data from Badin, Muzaffargarh and Rahim Yar Khan. It shows a surge in deaths among the elderly and children under five after extreme weather events. In Badin, floods struck without warning, leaving the most vulnerable unable to escape. In southern Punjab, relentless heatwaves proved deadly for older adults and young children whose developing bodies cannot regulate temperature, making them highly susceptible to dehydration and heat stroke.

Climate stressors also cause slower, less visible harm. A Lancet study linked rising maternal mortality in coastal areas to hypertension caused by increasingly saline drinking water. Urban populations are not immune: prolonged summer power outages turn congested neighborhoods into heat traps.

Tracking climate-related deaths is difficult, especially when pre-existing health conditions increase vulnerability. Scientists often rely on excess deaths, the number of fatalities above expected averages, to estimate the human toll related to crises. Pakistan, however, collects insufficient data on casualty figures related to climate crises. In 2022, after the catastrophic floods which affected 33 million people and displaced 8 million, only 1,739 deaths were recorded. This meager count ignored fatalities from disease, maternal and neonatal complications and delayed health impacts. Researchers note how no heat-related deaths were officially recorded during the same year, despite temperatures having soared above 50 degrees Celsius in many locations. There is no comprehensive data on the health toll of repeated winter smog that recurrently descends on large parts of the Punjab.

Without accurate information on who is most at risk, the government cannot design effective interventions, and international support cannot be targeted to those who need it most. However, responsibility does not rest with Islamabad or provincial governments alone. High-emitting nations must do more to support both the states and the communities which have become hotspots for climate change.

Since wealthy nations showed little willingness to enhance support to the 'Loss and Damage Fund' at the recent climate summit in Brazil, it has become essential to consider other ways of holding major polluters to account. Pakistani farmers who have taken two German companies to court, supported by a German ruling that allows liability for climate harm abroad, offer one such example. Victims of a severe Philippine typhoon seeking compensation from Shell provide another. These cases show how citizens are turning to the courts because political leaders and international institutions have failed them. If such experimental claims succeed, they could pave the way for other vulnerable communities to directly sue multinational companies for climate-related losses.

Now is the moment for a bold legal challenge, in Germany or beyond, on behalf of older adults and young children in Pakistan, who face the greatest climate risks yet remain invisible in official mitigation plans.