Closing out one year of MSF flood response in Pakistan

After responding to devastating floods in Dadu, Pakistan, MSF hands over medical activities to local health providers.

An MSF staff member treats a child carried by their mother in Pakistan after the floods.

Pakistan 2022 © Asim Hafeez

In June 2022, extreme monsoon rains struck Pakistan and submerged more than one-third of the country. The floods caused extensive destruction of crops and buildings, including health facilities. People had to leave their homes and spend months living in camps, often without shelter, access to basic services, or clean drinking water and food. It was one of the worst flooding disasters in Pakistan’s history. 

“Most of Dadu district, especially in Johi, was underwater. Roads were so destroyed that Doctors Without Borders/Médecins Sans Frontières (MSF) teams could not drive to remote areas to reach people in need of medical care, so they had to travel by boat to reach them. MSF set up two mobile clinics and treated respiratory tract infections, diarrhea, and skin diseases,” said Abdullah, the project’s medical referent in Dadu. 

MSF teams travel by boat through flooded Dadu, Pakistan.
An MSF medical team travels by boat to bring medical care to the city of Johi, in Dadu district, Sindh. Pakistan 2022 © Asim Hafeez

Relief for flood-affected people in Pakistan 

One of the worst-hit areas was Sindh province, where Dadu is located. Over a six-month period, the MSF team carried out 27,726 primary health care consultations in Dadu, Johi, KN Shah, and Mehar districts, and distributed 27,000 non-food items, including hygiene kits and 82,480 tents, blankets, and kitchen kits. We also distributed five million liters of water (more than 1.3 million gallons) and installed 50 hand pumps between September 2022 and February 2023. In Johi, MSF installed a reverse osmosis plant to purify saline water and ensure access to safe drinking water. 

"Our house and crops were destroyed by the flooding,” said Nazima, a resident of Khudarish Jamil village in Dadu. “We had to seek refuge in a relief camp. We had no food, so my children became sick. When I took them to MSF’s mobile clinic, I found out they were all malnourished."

A staff member meets with a woman who brought her child to MSF's facility in Dadu for malnutrition treatment.
A staff member meets with a woman who brought her child to MSF's facility in Dadu for malnutrition treatment. Pakistan 2023 © MSF

Post-flood medical activities 

As the floodwaters receded, MSF medical teams registered a spike in severe acute malnutrition cases, particularly among children. The numbers tripled in areas where MSF was present. In response, MSF set up a nutrition program and treated 2,034 children under five years old and 299 pregnant and lactating women between March and September 2023. 

There was also a sharp increase in the number of malaria patients at the facility in Dadu. "Stagnant water attracts mosquitoes that carry malaria, so it was a major factor contributing to an increase in cases,” said Shaheen, a nurse who has worked with MSF for 16 years in Pakistan. “However, to our surprise, we also found many cases of malaria in dry areas as well.” Between September 2022 and September 2023, MSF treated 12,108 people with malaria.  

MSF's health promotion team and environmental team conducting a session with flood-affected people from Dadu, Pakistan.
MSF's health promotion and environmental teams conduct a session for people from Dadu to prepare them in case of another emergency. Here the team works on community mapping to identify issues that need to be addressed to minimize the negative impact of natural disasters. Pakistan 2023 © MSF

Continuing treatment of cutaneous leishmaniasis 

Before the floods, at the request of the Ministry of Health, MSF had just started to set up a project to test and treat people with cutaneous leishmaniasis following an outbreak. Cutaneous leishmaniasis is a neglected tropical disease caused by a parasite transmitted by the bite of an infected sandfly that is considered a public health burden.

When the floods hit Dadu in June 2022, MSF kept the cutaneous leishmaniasis program going but expanded its activities to include emergency response. Over a year-long period from September 2022 to September 2023, MSF treated 89 patients with cutaneous leishmaniasis. 

In October 2023, MSF handed over its cutaneous leishmaniasis activities to the District Hospital in Dadu after training 20 Ministry of Health staff to diagnose and clinically manage patients with the infection. MSF also donated meglumine injections, laboratory items, medication, and dressing materials. 

One year after catastrophic floods in Pakistan, malnutrition soars

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About MSF’s work in Pakistan 

MSF has been working in Pakistan since 1986. In Dadu district, MSF has responded to three consecutive flood emergencies, in 2010, 2020, and 2022To prepare for future emergencies, MSF put together an Emergency Preparedness Plan. MSF also provides obstetric and gynecological care to mothers, and pediatric, newborn, and malnutrition care for children in Balochistan. MSF provides free medical care to cutaneous leishmaniasis patients in five diagnostic and treatment centers in Balochistan and Khyber Pakhtunkhwa. And in Machar Colony, Karachi, MSF offers free hepatitis C screening, diagnostics, and treatment. In the Khyber Tribal District, MSF supports a primary health center in Tirah Valley providing free-of-charge general health services and referrals. 

In Gujranwala, MSF runs a drug-resistant tuberculosis (DR-TB) project at the district headquarters and teaching hospital in collaboration with the Provincial Tuberculosis Control Program (PTP) offering free diagnosis and treatment to DR-TB patients.