Floods, poverty, and survival in Pakistan

MSF is supporting women and children in eastern Balochistan, an area battered by floods and chronic poverty.

Nurse checking a patient's history

MSF staff nurse Mussarat checks a patient's history in the pediatric ward. | Pakistan 2025 © Gul Nayab/MSF

Women and children in Pakistan’s eastern Balochistan struggle to access basic health care, often traveling long distances and paying high transport costs just to receive essential services. 

The region experiences seasonal floods and droughts, food insecurity, and chronic poverty, which all worsen a maternal health crisis. Doctors Without Borders/Médecins Sans Frontières (MSF) is providing free maternal and child health care in the eastern Balochistan town of Dera Murad Jamali. MSF is also helping to manage infectious disease outbreaks, such as diphtheria and measles, in other districts across the region. 

Mud houses in eastern Pakistan.
A view of mud houses in Dera Murad Jamali, which experiences a heavy monsoon season that typically spans from July to September. | Pakistan 2025 © Gul Nayab/MSF

A lifeline for care in a region still recovering from floods

In the heart of Dera Murad Jamali, a town frequently battered by seasonal floods, the mother and child health care facility supported by MSF at the District Headquarter Hospital serves as a vital center of support and care. The facility offers a wide range of services including maternity care, neonatal intensive care, pediatric admissions, a therapeutic feeding program for malnourished children—all delivered free of charge in a region where health care is otherwise largely out of reach.

Wazira Begum, a grandmother from the nearby village of Abdul Ghani Solangi, came to visit her newborn grandson in the neonatal intensive care unit (NICU), where he was receiving treatment for a chest infection. “We have lived in a tent since the 2022 floods destroyed our house. It gets very cold in winter, and we couldn’t protect the baby from the cold,” Wazira explained. “We brought him here in very serious condition. Now, thanks to the doctors, he’s doing much better.”
 

We see more than 500 prenatal patients each week. Many come from far-off areas with no health care facilities, walking through the night just to get here.

Fozia Munir, the mother and child care ward supervisor at MSF’s project in Dera Murad Jamali

Wazira lives with her extended family of 40 who have all been displaced by the floods and lack access to clean drinking water, proper shelter, or reliable income. “Before the floods, we had our own mud houses and worked in the landlords’ fields. Now, my sons are laborers, and we are struggling to meet our basic needs.”

Yet amid these challenges, Wazira finds solace in the care provided by MSF. “Eleven of my grandchildren were born here at the MSF facility. My youngest daughter-in-law is pregnant, and we come for prenatal check-ups regularly. We are given food, medicine and everything here. For poor people like us, this place is a blessing.”

MSF staff lead a workshop on breastfeeding technique in Pakistan.
MSF health promotion staff demonstrate breastfeeding techniques to mothers whose children are admitted to the neonatal intensive care unit at the MSF facility in DHQ Hospital in Dera Murad Jamali. | Pakistan 2025 © Gul Nayab/MSF

Mothers walk through the night to reach care

The MSF-supported facility offers 24-hour basic emergency obstetric and newborn care, assisted deliveries, postnatal consultations, family planning, and nutrition support for pregnant and lactating women. Complicated cases are referred to health facilities in Sindh province, including Sukkur and Larkana, with MSF covering transport and ensuring continuity of care. In 2024 alone, over 13,800 prenatal consultations and 3,500 births were assisted here.

“We see more than 500 prenatal patients each week,” said Fozia Munir, the mother and child care ward supervisor at MSF’s project in Dera Murad Jamali, who has worked in the region for more than a decade. “Many come from far-off areas with no health care facilities, walking through the night just to get here,” she said. “This morning, a woman arrived from Gandawah in Jhal Magsi District. There’s no trained birth attendant where she lives. She walked in the dark and reached us at 5 a.m.”

Fozia recalled how during the 2022 floods, a patient’s husband carried her for hours through the water to reach the hospital. “She was in critical condition. We treated her, and both she and the baby survived. The relief on the attendant’s face—that moment stays with you.”

The challenges in Balochistan go beyond health care. Wazira’s family, like many others, faces recurring climate disasters, tribal conflict, and systemic poverty. Access also remains a major hurdle.

“Our house is about 10 miles away,” Wazira shared. “The road is broken, and there is no public transport. We have to pay Rs. 1,500 (about $5) for a rickshaw ride to get here. “And in summer, the heat becomes unbearable. There’s no shade, no clean water. We drink from the same canals as animals.’

A ward supervisor reviews a chart in Pakistan
Fozia Munir, the mother and childcare ward supervisor at MSF's project in Dera Murad Jamali, has worked with MSF since 2003. | Pakistan 2025 © Gul Nayab/MSF

Education and outreach are creating change and saving lives

In a region where health services are stretched thin and disasters strike frequently, MSF’s continued presence fills a critical gap. The 2024 figures—nearly 10,000 children receiving nutritional support, over 20,000 malaria tests conducted, and thousands treated—represent not only statistics, but lives saved.

Fozia and her team also work on broader issues like family planning and maternal education. “Awareness around the importance of birth spacing and hygiene has increased,” she explained. “Our health promotion and mental health teams hold regular sessions, and people are beginning to see the benefits.”

Despite the many challenges faced by patients who seek care from MSF, Fozia believes some change is visible. “We used to give birth at home. I lost five children,” Wazira recalled. “Now, we come here. Our babies are born safely, and we are treated with dignity.”

For families like Wazira’s and health care workers like Fozia, this facility is more than a medical center. It is a place of hope, protection, and care—proof that compassionate, quality health care can still reach those who need it most.