This is Going to Get Worse: Flooding in Pakistan

In August 2022, Pakistan saw some of the worst flooding in its history. Two years prior, Karachi – the largest city in the country – had the highest rainfall in over a century. A decade earlier, Pakistan had floods so devastating that the total number of affected people surpassed the 2004 Indian Ocean tsunami, the 2005 Kashmir earthquake, and the 2010 Haiti earthquake – combined.

The pattern is clear: for Pakistan, and the world at large, catastrophic weather events are becoming increasingly frequent. The latest flooding is not the first, nor the last that the country will see, which is a significant concern for pathologists and other medical professionals as water-borne diseases rise.

One such pathologist is Shahid Pervez, Senior Consultant Histopathologist at Aga Khan University Hospital (AKUH), Pakistan. AKUH is based in Karachi, so Shahid has firsthand experience of how these floods affect the vital healthcare infrastructure of Pakistan’s most populated city. We spoke with him briefly to gain an understanding of how pathologists are dealing with the situation.

Karachi saw massive flooding in 2020. How does this recent event compare?
 

The flooding here has left the infrastructure broken, but most of the major damage has been in rural areas of Sindh Province, Balochistan, South Punjab, and areas of Khyber Pakhtunkhwa province. This kind of massive flooding has not been seen since Pakistan’s creation 75 years ago. Over 30 million people have been directly affected. Hundreds of thousands of livestock have perished and there has been major loss of rice, cotton, and vegetable crops. Wheat sowing time is around the corner, but it is not clear whether it will be possible to cultivate wheat on this wet land, which raises the possibility of wheat shortage in coming months and years. The response to the flooding has been prompt, but those who were stranded in remote areas with no communication have struggled.

There must be a lot on your mind at the moment…
 

Personally, I am focusing on dengue fever testing and rapid blood testing. Overall, as you might imagine, diarrhea, malaria, cholera, dengue, and other waterborne diseases have all increased. To compound the problem, local basic labs have become nonfunctional due to damage and there is a lack of safe, reliable transport for samples from affected areas.

Pakistan’s response to COVID-19 has been impressive. With climate change in mind, what is the future for Pakistan’s ability to respond to changing rates of disease?
 

Our nation has been resilient so far and testing capacity is adequate. In Pakistan, infectious diseases such as COVID-19, dengue, and Crimean-Congo hemorrhagic fever must be reported to the government at the provincial and federal levels by law. This means that monitoring is heavily supported.

If you could change one thing about pathology in Pakistan, what would it be?
 

In Karachi, we need to build capacity and establish mobile basic labs for stat testing such as platelets.