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hen the flash floods tore through Swat Valley, they didn’t just wash away bridges, roads and houses, they also swept away livelihoods and years of painstaking community health work.
For Shabnum Bibi, a 45-year-old lady health worker from Union Council Lundi Kas, it was a nightmare she will never forget. “The water came roaring down the mountains,” she recalls. “Within minutes, everything was gone: our homes, our health centre, even the registers we used for work.”
Shabnum’s area, along with Amankot and Rahimabad, was among the three worst-affected union councils of Swat. For over six weeks after the flood, she and dozens of other LHWs were unable to perform their duties—not out of choice, but because the floods had wiped out everything, including transportation and basic infrastructure needed to carry out their work.
“I used to visit at least ten households every day,” Shabnum says. “I would talk to mothers, check on pregnant women and update vaccination records. But after the floods, there was nothing left to record or report.”
The floods hit certain districts of Khyber Pakhtunkhwa particularly hard—Swat, Buner, Bajaur, Shangla, Mansehra and Swabi—leaving behind a trail of destruction. In Swat alone, dozens of health facilities were damaged and hundreds of families displaced. Among them were at least 24 lady health workers and lady health supervisors whose houses and offices were damaged or destroyed.
For these women, the floods didn’t just take away infrastructure: roofs and walls. Their working kits containing medicines, registers, thermometers and health education materials were also washed away. These items are the backbone of the Lady Health Worker Programme, a network that connects the government’s primary healthcare services to some of the most remote households in the district.
“There is no regular supply of these registers from the district office,” Shabnum explains. “Most of us print and bind them with our own money. It costs around Rs 3,000, which is a lot of money for us, especially now that many of us haven’t been paid for months.”
“In Swat, the service providers themselves became people in need of assistance,” Rizwana Bibi, another lady health worker says with a faint smile. “We had no shelter, no resources, no equipment to continue our work. We were as helpless as the families we usually support.”
The loss had a ripple effect on the wider health system. In the aftermath of the disaster, several health campaigns, including the anti-polio drive, were postponed in the three worst-hit union councils. Without LHWs on the ground, it was nearly impossible to track families or reach children for vaccination.
In many areas, local health officials and partner organisations tried to fill the gap by distributing temporary kits and arranging emergency supplies. But the recovery took time. Roads were blocked, communication networks were down and many health facilities were either under water or cut off by damaged bridges.
As floodwaters receded and the roads reopened, rehabilitation work began gradually. The Health Department, supported by national and international partners, started assessing damage and restoring basic services.
For LHWs, it meant returning to the field, one household at a time. Many of them resumed their work without waiting for proper registers or kits, relying on handwritten notes and personal memory to recall which families needed follow-ups or which children had missed vaccines.
“It was very hard to start from zero,” says Rizwana. “We had to rebuild our lists, revisit every home and regain people’s trust. We did it because the community depends on us.”
Over time, normalcy began to return. The postponed vaccination campaigns resumed; the health centres that were once under water reopened after minor repairs. Lady health supervisors began receiving replacement materials. In some areas, NGOs helped provide temporary shelters for those who had lost their homes.
Though challenges persist, particularly delayed salaries and the need for proper equipment, the sense of resilience is visible everywhere.
“Now, things are much better,” says Shagufta. “We have resumed our duties and families are again receiving visits and support. The fear and chaos of the floods are fading. Life is returning to normal.”
The revival of community level health services plays a crucial role in restoring both physical and emotional stability.
People like Shagufta are more than healthcare workers—they are confidants, educators and a trusted link between the government and the people. In rural areas, their visits often mark the only form of organised healthcare many families receive.
“When our LHWs couldn’t come, people felt cut off,” says a mother in Cheena Street. “They guide us on everything from child vaccination to safe water practices. Without them, we were in the dark.”
The Health Department acknowledges the critical role of these workers in post-disaster rehabilitation. “The lady health workers are the heroes of community health,” an official from the Expanded Programme on Immunisation Khyber Pakhtunkhwa had stated. “Their dedication ensures that even in the toughest times, essential health services continue reaching families.”
Today, months after the flood, Swat’s valleys have regained their green beauty. Markets are open, schools are functioning and health workers have returned to their routines. Yet, the memories of destruction remain fresh.
The experience has also taught valuable lessons particularly about the importance of emergency preparedness and ensuring consistent support for frontline health workers.
“There should be a way to provide us new kits and registers immediately after such disasters,” suggests Shagufta. “We are ready to serve in all sorts of conditions, but we need basic tools to do our job properly.”
For now, Shagufta and her colleagues are focusing on rebuilding what they had lost—not just tools and records, but trust and stability. Each home visit, each conversation and each vaccination card represents a step toward healing.
The writer is a freelance journalist based in Peshawar.