Floods in Pakistan: Six Ways Floods Affect Health

The floods that have engulfed large parts of Pakistan in recent weeks have killed around 1,500 people and left tens of millions homeless, but the final death toll is likely to be significantly higher. Floods, from disease to health care disruption, affect people’s health in a variety of direct and indirect ways. Such events are also expected to become more frequent due to climate change and rising sea levels. So what makes flooding so deadly, and is there anything countries can do to reduce the toll?

Floods can cause widespread damage to crops and livestock, affecting both the quantity and quality of food available.

1. Drowning and Acute Injury

Floods are responsible for 40% of all natural disasters worldwide and are responsible for about half of related deaths. Most of these deaths are the result of drowning, especially as a result of people getting stuck in their vehicles while trying to drive through the streams. Deaths can also occur when people are knocked over by fast-flowing water, as a result of overexertion, hypothermia, or electrocution, or as a result of being struck by objects that similarly enter the floodwater, including falling trees. Some of these injuries may not be fatal immediately, but in the days or weeks after the event, such as from wounds infected by bacteria in the floodwater.

Carbon monoxide poisoning is also surprisingly common, as people use pumps, generators and pressure washers to clear or dry buildings without adequate ventilation.

2. Disease

Access to clean water is often a major problem in the aftermath of severe flooding. Floods can flood sewers, contaminate drinking water and increase the risk of gastrointestinal disease, while poor hygiene and overcrowded shelters can exacerbate the situation.

Recent floods in Bangladesh have led to major outbreaks of bacterial gastroenteritis, particularly cholera and pathogenic E. coli – with cholera outbreaks tended to hit about eight days after the initial flood. Rapid distribution of oral cholera vaccine may help reduce this risk, although delivering it to flood-affected communities is challenging.

Other diseases linked to flooding include typhoid fever, hepatitis A and E, rotavirus and norovirus. Immersion in or breathing floodwaters can also lead to lower respiratory infections such as pneumonia, as well as skin or eye diseases, or leptospirosis (Weil’s disease), which spreads through contact with rodent urine.

As floodwaters recede, pools of standing water can become breeding grounds for mosquitoes, increasing the risk of mosquito-borne diseases such as dengue fever and malaria. There has already been an increase in dengue cases in Pakistan, with at least 3,830 cases and 9 deaths reported by health officials in Sindh province as of September 15, 2022. Health officials have also reported an increase in malaria, diarrhea and skin disease following the floods.

3. Poisonous Creatures

Not only people are made homeless by flooding. Wild animals, including snakes and spiders, can take refuge in houses, storage sheds and other buildings, especially if they are damaged. Prompt treatment with antivenin is necessary for those bitten by venomous snakes, but flooding can also hinder access to treatment.

As of August 30, 134 people in Pakistan were reported to have suffered snakebites as a result of the flooding, including a woman in northwestern Khyber Pakhtunkhwa province who died after being denied access to prompt medical care. In addition to deaths, bites from venomous snakes and spider bites can cause permanent disabilities.

4. Disrupted healthcare

When Cyclone Ana hit Malawi in late January 2022, it caused widespread flooding in some areas. This resulted in extensive damage to health infrastructure, including clinics, medical records, cold chain equipment, medicines and medical supplies. Many people also lost regular medicines in the floods.

One consequence of such disruption is a deterioration in the health of people with chronic diseases such as diabetes or cardiovascular disease, with a corresponding increase in mortality. For example, after flooding in Florida during the 2004 hurricane season, there was an increase in heart attacks, and doctors reported a deterioration in patients’ blood pressure control.

Floods can also hinder the delivery of vaccines, especially in rural areas where people have to travel to access clinics.

5. Malnutrition

Floods can cause widespread damage to crops and livestock, affecting both the quantity and quality of food available. In parts of South Sudan, for example, the floods of the past three years have left many people unable to work on their land. Some have also lost livestock to diseases caused by the animals grazing on flooded fields and many have resorted to foraging wild foods such as water lilies. Malnutrition or malnutrition remain major threats to health.

6. Psychological Trauma

While it may not be that deadly, the emotional impact of losing your home, possessions, or livelihood remains long after the floods have subsided. There’s also the economic stress that comes with rebuilding, which adds to this psychological toll. Mental health problems in the aftermath of floods are often overlooked and not as well studied as the immediate health effects of floods.

According to research conducted in the UK in the wake of widespread flooding in the winter of 2013/14, the prevalence of depression, anxiety and post-traumatic stress disorder (PTSD) remained elevated for at least two years after flood exposure. “Our research suggests that support to address the extensive damage to homes, sanitation and utilities caused by flooding may be needed to reduce mental health risks,” the authors wrote.

In Bangladesh, interviews with flood survivors suggested that about 57.5% of them had suicidal thoughts, while 6% and 2% had planned or attempted suicide, respectively. Suffering from depression, anxiety and PTSD, and experiencing financial hardship or economic hardship were among the main risk factors identified.

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