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s floodwaters sweep through the Punjab, aid workers, doctors and hospitals are scrambling to contain a growing health crisis.
Floods pose risks to human and animal health in three phases: the first and immediate phase causes gastroenteritis, skin and eye diseases; the second phase threatens outbreaks like malaria and dengue fever after mosquito breeding due to stagnant waters; and the third phase threatens malnutrition, especially among the elderly and children.
Teams from major medical teaching institutions, including Lahore’s Mayo Hospital, have been formed to be dispatched to surrounding areas to provide medical aid. Field camps and basic health units are active. In Lahore, most patients are turning to Government Teaching Hospital, Shahdara, where several localities have been submerged by floodwaters.
Dr Salman Kazmi from Mayo Hospital says that so far, the public health crisis is unfolding mostly in peripheral areas rather than in major hospitals. The basic health units (BHUs), rural health centres (RHCs) and tehsil headquarters hospitals (THHs) are extending primary and secondary healthcare, respectively. “We have formed teams from every ward to go out and help,” he says. “So far, we have seen no influx of flood-related emergencies in Mayo itself. A majority of cases are gastroenteritis, dengue fever, malaria and skin and eye diseases.”
Doctors across the province confirm a troubling pattern. Contaminated drinking water is fueling diarrhoea, dysentery and gastroenteritis. Dermatological diseases, including scabies, fungal infections, skin/ soft tissue infections, cutaneous larva migrans and eye diseases like conjunctivitis are spreading in relief shelters. Upper respiratory infections are also increasingly common.
“Most people are suffering from waterborne diseases,” says Dr Shahid Malik, a public health expert. “We are seeing infective diarrhoea, dysentery, skin and eye inflammations, even protozoal and bacterial infections,” he says. “Dehydration is a huge issue because clean water simply isn’t available.”
The government, alongside the WHO and the UNICEF, has set up medical camps where primary and secondary care are provided. Non-governmental organisations such as Akhuwat and Alkhidmat Foundation have also established medical camps. But coordination remains a major concern.
“There is no unity of command,” Dr Malik cautions. “Tasks overlap; some are left undone. Several departments are working in isolation. We need a clear multi-disciplinary approach with vaccination drives for children under five, who are most at risk.”
Doctors also warn the crisis will unfold in multiple stages.
“In the first phase, diarrhoea, typhoid and hepatitis are the main threats because drinking water is contaminated,” explains Dr Masood Sheikh, a paediatrician. “The second phase comes with stagnant water—malaria, dengue and skin diseases will rise. The third phase is the most dangerous, because nutritional deficiencies set in. Children under one year and those above sixty face the highest risk of mortality.”
Doctors say that anti-venom treatment must be available in all flood-affected areas as snake bites risk rising sharply. The anti-venom vaccines must also be given where needed.
Imran Nazir, the Punjab health minister, says the government has scaled up efforts. “So far, more than 100,000 patients in flood-hit areas have been treated in field hospitals,” he says. The Maryam Nawaz Clinic on Wheels have been deployed in calamity-stricken districts. The Health and Population Department has established over 850 relief camps. These facilities provide treatment for malaria, fever, rabies, snake bites, diarrhoea and skin diseases.
“In Lahore alone, 9,000 patients have been treated,” he adds. “Special facilities are in place for pregnant women. We are prepared for any epidemics that may break out. All kinds of medicines have been stocked in district, tehsil and field hospitals.”
The minister says that clinics on wheels, field hospitals and relief camps are now operating round the clock, staffed with medical and paramedical teams.
Rescue agencies such as the NDMA, the PDMAs and Rescue 1122 have been tasked with evacuations, but coordination gaps remain. Rescue and evacuations are critical beforehand following forecast of more floods due to continuous rains and water releases from India threaten the safety of people.
Dr Sheikh stresses that stronger communication systems are needed. “The NDMA and the PDMAs should be issuing timely alerts, cordoning off areas and coordinating evacuation orders. The PTA should also send messages in Urdu to every mobile phone to warn people and guide them.”
Khawaja Salman Rafique, the minister for specialised healthcare and medical education, says that teaching hospitals remain on high alert.
“Doctors are on their toes. Medicines are fully stocked and beds have been allocated for the flood affected,” he says.
The absence of mobile health units and the overwhelming demand continue to stretch resources thin.
Beyond human health, the floods have devastated Punjab’s livestock, a lifeline for rural families in peripheral areas. Tens of thousands of cattle, buffaloes, goats and poultry have drowned or fallen ill after prolonged exposure to contaminated floodwaters. For many small farmers, the death of their animals means the loss of both food and income.
“In rural Punjab, a cow or buffalo is not just an animal, it is a family’s savings account,” says Dr Ayesha Javed, a veterinary officer. “When livestock die, families lose their milk, food and economy. The human health crisis is deeply tied to the animal health crisis.”
Veterinary teams deployed by the Livestock and Dairy Development Department are struggling to vaccinate and treat surviving animals. Foot-and-mouth disease, haemorrhagic septicemia and parasitic infections are spreading rapidly in submerged villages. Many animals suffer from starvation as fodder supplies have been washed away.
“Stagnant water is a breeding ground not just for mosquitoes but also for bacteria that cause deadly diseases in livestock,” Dr Javed explains. “We are already seeing outbreaks of haemorrhagic septicemia in cattle and enterotoxemia in sheep and goats. If we don’t intervene quickly, these outbreaks could wipe out what little livestock farmers have managed to save.”
For survivors, the dual blow of illness and livestock loss is overwhelming. Muhammad Iqbal, a livestock farmer in Chung area in the outskirts of Lahore, stood outside a relief camp with his two young children.
“We lost three buffaloes in one night,” he says, his voice breaking. “Those animals were everything. Without them, I cannot feed my family or send my children to school. Now my youngest has diarrhoea and there is no clean water to give her.”
Shazia Bibi, a mother of four sheltering in a school-turned-relief camp across the River Ravi in Lahore, describes her daily struggle. “My children have rashes all over their bodies. We had to wade through waist-deep water to reach safety. We left behind our goats. The camp gives us food but the children keep falling sick. I don’t know how long we can survive like this.”
Animal deaths also increase risks for human populations. The carcasses floating in water sources contaminate drinking supplies, heightening the spread of cholera, typhoid and hepatitis.
Moreover, zoonotic diseases—those that pass from animals to humans—are an emerging concern.
“Leptospirosis, rabies are all risks in post-flood conditions,” Dr Javed warns. “We cannot look at human and animal health separately. If we don’t secure livestock health, we will see a secondary wave of diseases spreading to people.”
Relief organisations say they have requested urgent fodder supplies, vaccines and mobile veterinary clinics to accompany human medical teams. But like the human health response, the animal health system is fragmented, with NGOs, government departments and private charities working in silos.
For families in flood-hit regions, survival is now a two-fold struggle—escaping the waters and fighting the diseases spreading in their wake. Doctors on the ground stress that the coming weeks will determine whether the crisis will remain under control or spirals into widespread epidemics.
“Epidemics can quickly become pandemics. Timely response, efficient treatment, awareness and precautionary steps are the key at both government and community levels,” says Dr Shahid Malik.
The writer is an investigative journalist associated with The News International, Pakistan. An EWC and GIJN fellow, he contributes to various international media outlets. His X handle: AmerMalik3.