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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 July 14; 335(7610): 66.
PMCID: PMC1914477

Waterborne diseases pose threat in Pakistan as floods strike

Hundreds of thousands of people are living in the open as large tracts of India, Pakistan, and China have been struck by lethal floods after weeks of torrential monsoon weather and a direct hit from a tropical cyclone on Pakistan's southern coast.

Hardest hit is Pakistan. Cyclone Yemyin narrowly missed Karachi on 26 June, just three days after the city was struck by another storm that caused widespread damage and killed 228 people. The cyclone instead hit land in the province of Balochistan, one of Pakistan's most deprived areas.

The Balochistan relief commissioner, Khuda Bakhsh Baloch, says that roughly 200 000 houses in the province have been destroyed by flooding, and confirmed 130 people were dead. Estimates of the number of people affected by the floods in the province swiftly grew to more than 800 000, of whom more than 100 000 lack shelter. Hundreds of thousands more people are affected in Sindh province.

Some remote areas of Balochistan have not yet been reached except by air, as flood waters have still not fully subsided. Health kits and mobile clinics stored by the World Health Organization in the town of Lasbella were inspected from the air and found to be flooded. The townspeople were seen taking refuge on rooftops.

Aid agencies and Pakistani authorities are primarily concerned about the risk from waterborne diseases, said Antonia Paradela of Unicef Pakistan. “In some of the districts worst affected by the floods, when we had previous assessments, we had found that half of the children had had diarrhoea in the prior two weeks,” she said. “In the current conditions, with the water system being damaged, we are very worried about the children's nutritional situation.”

Water purification and nutrition are Unicef's top priorities, she said, with greatest importance given to unaccompanied children and mothers with families.

There have already been reports of “a large number of diarrhoea cases” in the medical camp in Hashim Goath, which is housing people displaced by the earlier storm at Karachi, according to a WHO briefing.

The flooding in Balochistan threatened to sabotage a long planned measles immunisation drive that was to begin there on 2 July. More than 1.5 million children in the province were to be immunised as part of a Pakistani government campaign to vaccinate 63 million children by March 2008.

Although deaths from measles have fallen globally by 60% since 1999, Pakistan's toll from the disease remains high, at about 21 000 deaths a year. Vaccination drives in Balochistan have stumbled after rumours that the campaigns were aimed at sterilisation. But after a large public education campaign, the first phase of the Balochistan vaccination drive earlier this year achieved 96% coverage in four districts.

Eight more districts were to be targeted in the current phase, but two have been postponed until August because of the flooding. Nearly 3000 health workers in 600 teams left for the other six districts last week, accompanying emergency relief teams. Initial field reports suggest “good community acceptance” and high uptake of the vaccine.

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