By Sardar Khan Niazi

Each year, as monsoon rains roll across Pakistan, they bring not only the threat of overflowing rivers and inundated villages but also an unrelenting strain on the country’s already fragile healthcare system. The floods are not just an environmental disaster–they are a public health emergency that Pakistan is ill-equipped to handle. With climate change intensifying the scale and frequency of floods, the time for piecemeal response has long passed. We must now acknowledge the urgent need for a robust, climate-resilient healthcare infrastructure capable of protecting the most vulnerable during and after climate disasters. Floods wreak havoc across provinces, displacing millions, destroying homes, and cutting off access to clean water and food. In the aftermath, stagnant water becomes a breeding ground for mosquitoes, giving rise to deadly outbreaks of dengue, malaria, and cholera. Last year’s monsoon floods, which affected over 33 million people, triggered a health crisis in Sindh and Baluchistan. Field hospitals were overwhelmed, medicines were scarce, and hundreds of thousands were left without access to even basic care. Pakistan’s healthcare system, already under strain due to underfunding, mismanagement, and unequal distribution of resources, simply cannot cope with disasters of this scale. Rural areas, where most flood damage occurs, often have minimal healthcare infrastructure to begin with. In such regions, one missing doctor or one broken clinic can mean the difference between life and death. Women and children bear the brunt of this collapse. In flood-hit areas, thousands of pregnant women are left without access to maternal care, while children suffer from acute malnutrition and waterborne diseases. The government’s disaster response, while improving in coordination and speed, remains reactive rather than preventive. Mobile medical units, vaccination drives, and emergency tents are welcome but temporary solutions. What we need is a systemic transformation of how healthcare and disaster management are integrated. Climate change is no longer a future threat–it is a current reality. Our policies, budgets, and planning must reflect that. We also cannot ignore the long-term public health implications of flooding. Beyond the immediate disease outbreaks and injuries, there is widespread mental trauma. Displacement, the loss of livelihoods, and prolonged uncertainty have a deep psychological impact, especially on children. Yet mental health remains a grossly neglected aspect of disaster response. It is time to invest in community health workers and training programs that recognize the full spectrum of health needs post-disaster, including psychological support. What is more, climate adaptation must become central to healthcare planning. We need to climate-proof our hospitals, ensure supply chains for essential medicines remain functional during crises, and develop early warning systems that link meteorological data with health preparedness. Provinces should be equipped with climate-resilient healthcare infrastructure–facilities that can operate in extreme weather conditions, with independent power and clean water supplies. Pakistan must also re-evaluate how healthcare funding is distributed. Emergency funding often pours in after a disaster, but little is done to build long-term resilience. A portion of climate financing–whether from international partners or domestic allocations–must be ring-fenced in detail for healthcare adaptation and disaster preparedness. Last of all, public awareness plays a critical role. Communities need to be educated not just about evacuation plans but also about disease prevention, sanitation, and mental health resources. Civil society, NGOs, and local governments must work together to create a culture of preparedness, not just survival. The floods are not going away. However, we can stop turning every flood into a healthcare catastrophe. Doing so requires political will, investment, and a shift in mindset–from reaction to resilience. Pakistan stands at the intersection of two crises–climate and health. Our future depends on how wisely and urgently we respond to both.