loods across Pakistan have once again devastated millions of lives, destroying homes, livelihoods and infrastructure. Relief efforts are under way, with government agencies, humanitarian organisationsand community volunteers working tirelessly to provide food, shelter and medical support. Amidst the commendable ork, a sobering reality persists: not everyone gets reached out.

In times of chaos and displacement, those who are the most vulnerable - such as women, children, persons with disabilities, the elderly and the marginalised groups - are often left behind. The stronger, more vocal and better-connected manage to access relief first, while those in desperate need struggle silently. If humanitarian response is to be meaningful, it must move beyond numbers and logistics and ensure inclusion as a core principle.

Disasters do not impact everyone equally. For women and girls, displacement brings heightened risks of harassment, abuse and trafficking. When families are forced into crowded shelters or camps, privacy and safety get compromised.

Reports from previous emergencies have shown that the absence of gender-sensitive planning leads to women suffering in silence. Women require more than food and shelter — they also need safe spaces, dignity kits and access to hygiene supplies to manage their basic needs. For pregnant women, disasters can turn into life-threatening emergencies.

Without maternal care facilities, many face unsafe deliveries or lose access to essential medication. Mothers require support to care for their infants in fragile environments. Protecting women’s dignity is not a secondary issue — it is central to protecting life.

Children are among the first to feel the psychological weight of displacement. Losing homes, schools and the security of routine can trigger deep anxiety, stress and depression. Too often, children’s mental health is overlooked in favour of immediate survival needs. In the absence of psycho-social support, these wounds may shape their entire future. Safe play spaces, temporary learning centers and child-friendly corners are critical. These allow children to regain a sense of normalcy while keeping them safe from exploitation, child labour or trafficking.

Following every flood or earthquake, persons with disabilities are consistently left behind. Relief camps are rarely accessible and distribution points are often located far from affected neighbourhoods. While able-bodied individuals can rush to access aid, persons with disabilities particularly those with mobility impairments, remain at home, waiting for help that might never arrive.

This exclusion is not due to lack of need, but because relief efforts are rarely designed with accessibility in mind. Rations, tentsand medical kits must reach people where they live. Mapping their locations before and during emergencies is critical. Community volunteers can play a key role in ensuring that no one is overlooked. Providing mobility aids, building ramps in shelters and training relief workers on disability inclusion are steps that can transform the response.

One of the persistent challenges in flood-hit areas is the unequal distribution of aid. Those with influence or connections often manage to secure most of the relief packages; the poorest and the most marginalised risk going empty-handed. 

Another group often neglected is the elderly, especially those living with chronic conditions such as diabetes, hypertension or heart disease. For them, disruption of medical supplies and lack of specialised care can be fatal. Relief distribution must prioritise regular medication, accessible sheltersand medical monitoring for older people. Their voices may not always be loud in chaotic camps, but their needs are urgent.

One of the persistent challenges in flood-hit areas is the unequal distribution of aid. Those with greater influence or better connections often manage to secure most of the relief packages, while the poorest and the most marginalised risk going empty-handed. This imbalance undermines the very purpose of humanitarian assistance. Relief must not be captured by the powerful. Mechanisms for transparent and equitable distribution — such as community-led monitoring and fair registration processes — are essential.

Beyond food and shelter, disasters leave behind a heavy psychological toll. Families who have lost loved ones, livelihoods or homes carry deep trauma. Yet, when health centres are overwhelmed, psycho-social support is often the first service to be ignored. In South Asian cultures, discussing mental health carries stigma, making it even harder for people to ask for help. Humanitarian actors must integrate counselors, social workers and trained volunteers into their response. Group sessions, safe listening spaces and community activities can help individuals process grief and anxiety. Healing minds is just as urgent as healing bodies.

Disaster response is not best measured by how many trucks of aid are dispatched or how many shelters are set up. One must also ask whether the most marginalised are protected, supported and included.

For that, several steps are critical such as inclusion mapping to identify and track women-headed households, persons with disabilities, children, elderly and marginalised families; door-to-door surveys to ensure that those who cannot reach distribution points are served where they are; gender-sensitive planning to provide safe spaces, dignity kitsand maternal health services; child protection measures through psycho-social support, safe play and learning opportunities; disability accessibility in camps, centres and services; integration of mental health services into every relief effort; and community oversight to involve local leaders in ensuring transparency and fairness.

Pakistan’s floods test not just the infrastructure and resources, but also social values. Relief work that overlooks women, children, persons with disabilities and the elderly is not truly humanitarian, it is selective survival. Inclusion is not an optional add-on, it is the foundation of justice in crisis. As we rebuild from devastating floods, let us remember that every life matters equally and no one should be left behind.

The writer is a communications and advocacy expert leading grassroots awareness and development initiatives. She is currently the projects director at Digital Time Communications.