Health officials have warned of large-scale disease outbreaks in Pakistan after severe flooding that displaced millions of people.
An increase in cases of diarrhea and malaria has been reported after months of heavy rains that left people stranded and without access to clean water.
Authorities say they are concerned that the spread of waterborne diseases after the floods, which have killed almost 1,200 people, will put more pressure on health facilities. More than 880 clinics have been damaged, according to the World Health Organization, which has allocated $10 million (£8.6 million) to emergency health relief efforts.
Tedros Adhanom Ghebreyesus, director-general of the WHO, said on Wednesday that the agency had classified the flooding as the highest level of emergency. He said the threat of waterborne diseases meant access to health services and disease monitoring and control were a “key priority”.
Arif Jabbar Khan, director of WaterAid Pakistan, has visited Sindh province, the province most affected by the rains, which started in June. He said there was a serious risk of diarrhea and dysentery due to the lack of clean water.
“Families now live on the banks of overflowing canals and rivers in dilapidated shacks made of bamboo and plastic. They have even been drinking flood water because there is no other option: a recipe for large-scale disease outbreaks. We are doing everything we can to reach them,” Khan said.
At least 33 million people have been affected by the floods, which have contaminated water sources and rendered latrines unusable.
Sindh Health Minister Dr. Azra Fazal Pechuho said the government had set up 4,210 medical camps for people suffering from skin conditions and waterborne diseases.
In the northwestern province of Khyber Pakhtunkhwa, a doctor, Farhad Khan, told the Associated Press that patients initially came with flood injuries, but now diarrhea was common.
A provincial government spokesman, Kamran Bangash, said hundreds of people had contracted waterborne illnesses. With evacuation operations nearly complete, authorities will focus on providing clean water and food, he added.
“In recent weeks, the floods seriously affected hundreds of thousands of people. We do not want them to suffer again, this time due to the lack of availability of clean water. It can be prevented,” Bangash said.
The UN and Pakistan have asked for $160 million to provide emergency support to 5 million people, including food, water, sanitation and shelter.
the The WHO said it was working with the Pakistan government to respond to outbreaks of diarrhoea, cholera and other diseases. He said the flooding had exacerbated existing problems with malaria and dengue fever.
He also warned about the impact of the floods in dealing with other diseases, such as measles and polio. Pakistan and Afghanistan are the only countries where polio remains endemic.
Mustafa Khan, a British-Pakistani who was on holiday in Karachi when the rains hit, said people living in Khokhrapar, an informal settlement on the outskirts of the port city, had no access to toilets. Khan, who is volunteering with a charity to help with relief efforts, added that hygiene conditions were clearly deteriorating and many children were suffering from eye infections.
“Everyone’s clothes were pretty dirty because there was no water, so they’re not going to prioritize getting clean over drinking. Any fresh water they have, they are going to use for cooking,” she said.
“It was pretty gloomy, but because this [settlement] it was closer to Karachi, there are road connections and people are supplying them with supplies. It’s not as terrible a condition as those villages completely surrounded by water where it’s obviously very, very bad.”
Sadiqa Salahuddin, who runs a girls’ education group, Indus Resource Centre, said many of the schools she helped run in Sindh province were now housing displaced people but were running out of space.
She said her team was trying to build temporary toilets, but construction materials were hard to find.
Ashfaque Soomro, who runs the Research and Development Foundation, a Sindhi charity, said the many makeshift roadside camps that had sprung up had non-existent or inadequate sanitation.
“The NGO response is not well organized. So this aspect remains intact. In government-designated camps, like schools and technical institutions, toilets are available, but we don’t know how functional they are. The influx of internally displaced [internally displaced people] it’s huge, so even if they worked on normal days, this may not be the case now.”
Aid agencies also warned that pregnant and menstruating women and girls faced greater challenges. The UN reproductive health agency UNFPA estimates that there are 650,000 pregnant women in the flood-affected areas, with as many as 73,000 expected to give birth in the next month.
Salahuddin said he was struggling to provide women with sanitary pads because the village where he used to buy them had been flooded.
“Women sitting on the side of the road are the worst off. They wait until sunset before relieving themselves. And those who have the period usually wear dark colored clothes. shalwars [loose pleated trousers] so that you don’t notice that they are bleeding,” he said.