Health system crumbling under unprecedented rise in climate-related illnesses, warn officials

ISLAMABAD: Pakistan’s fragile health system is at the verge of collapse as an alarming surge is being witnessed in waterborne ailments, including diarrhoea, extensively-drug resistant typhoid and cholera, as well as vector-borne diseases like malaria and dengue due to extreme weather events as a result of climate change, officials said last week.

“Every week, around 250,000 cases of acute watery diarrhoea (AWD) as well as hundreds of cases of typhoid, bacterial diarrhea, suspected cholera and hepatitis A&E cases are being reported across Pakistan. So far, over 10 million cases of waterborne diseases have been reported in the first eight months of 2023 from entire Pakistan,” an official of the Ministry of National Health Services, Regulations and Coordination (NHS,R&C) told The News.

Blaming climate change for extreme weather events, including devastating floods, unusually heavy rains in different parts of the country and droughts in recent years, for the surge in waterborne diseases, the official said millions of Pakistanis were forced to consume contaminated water as major sources of drinking water had become polluted, the health official added.

Although Pakistan does not officially report and confirm cholera cases fearing a ban on its food exports, the World Health Organisation (WHO) reported this week that over 1000 cholera cases were detected throughout Pakistan in 2022 as climate change is playing an important role in this upsurge. Extreme climate events like floods, droughts and cyclones are triggering new outbreaks and worsening the existing ones.

Citing the data from National Institute of Health (NIH) Islamabad, the health ministry official maintained that the health system in Pakistan was under “tremendous pressure” as acute watery diarrhoea cases were constantly on the rise from different parts of Pakistan, while cases of extensively drug resistant typhoid, which were extremely hard to treat with most of the antibiotic drugs, were also being reported from across Pakistan.

“Hospitals across Pakistan are reporting around 8,000-10,000 typhoid cases every week, of which mostly are of XDR Typhoid. Similarly, we are seeing a surge in the cholera cases in addition to hepatitis A&E. At the moment, most of the health resources are being spent on the management of waterborne diseases across Pakistan,” the official added.

Although no accurate data is available with the authorities due to extremely poor surveillance, it is estimated that around 30,000 to 50,000 people, mostly children, lost their lives in 2022 in Pakistan due to diarrhoea by consuming contaminated water and food.

Commenting on the recent outbreaks or cholera and surge of waterborne diseases, NIH acting head Dr Muhammad Salman said they had been observing “sporadic outbreaks of cholera” in Pakistan for a long time, but there had been an increase in suspected cholera cases and other waterborne diseases due to extreme weather events, especially floods, heavy rains and droughts, in different parts of the country.

“In a country with poor water, sanitation and hygiene conditions, frequent spells of rains, flashfloods and prolonged droughts is resulting in mixing of sewage in clean drinking water, which is resulting in an alarming rise in the number of waterborne diseases in the country,” Dr Salman, who also heads the NIH Labs, observed.

Former federal minister for climate change Sherry Rehman said extreme climate events, such as floods, heavy rains, and droughts, were indeed leading to a surge in waterborne diseases in Pakistan. She added that these events exacerbate the challenges related to water quality and access to safe drinking water.

“When heavy rains and floods occur, they can contaminate water sources with pollutants, including sewage, agricultural chemicals, and debris, leading to a higher risk of waterborne diseases like cholera, dysentery, and typhoid. Moreover, droughts can reduce the availability of clean water, forcing communities to use unsafe water sources, further increasing the likelihood of disease transmission,” she added.

The deterioration of water quality, combined with inadequate sanitation and limited access to healthcare facilities, particularly in vulnerable communities, is creating a perfect storm for the outbreak of waterborne diseases. “The extreme temperatures and heat-waves are intensifying the health risks associated with these diseases, particularly for vulnerable populations like women and children,” Rehman said.

On the other hand, Pakistan has witnessed a 10-times surge in malaria cases, from 370,000 malaria cases in 2021 to over 3 million cases in the first 9 months of the current year, officials associated with the Pakistan’s Malaria Control Program disclosed, saying the 10-times increase in the malaria cases were mainly due to effects of climate change.

“Not only a 10-times surge in malaria cases has been observed in the country but an unprecedented increase in dengue cases has also been seen.

Last year, only 6,000 dengue cases had been reported in the month of January while this year we have seen around 124,000 cases of dengue in Pakistan, which is extremely unusual. Such a large number of dengue cases in usually a cold month indicates how badly we are affected due to climate change,” Dr. Muhammad Mukhtar, director of the National Malaria Control Program, said.

He said floods in Sindh, Balochistan and Khyber Pakhtunkhwa as well as unusually heavy rains due to back-to-back westerly waves in Pakistan provided excellent breeding and thriving conditions to mosquitoes, which resulted in such a large number of malaria and dengue cases. “We have seen a three times increase in dengue cases in the last few years in Pakistan, which is definitely due to extraordinary climate events,” Dr Mukhtar added.