Climate change has disturbed virtually every aspect of life. In Pakistan, it poses the dual challenge of being a direct threat to human health on one hand and straining the country’s healthcare infrastructure on the other, further exacerbating existing healthcare disparities and vulnerabilities.

The increasing frequency and intensity of a wide range of climate-related events, including floods, droughts, heatwaves, etc are directly impacting the healthcare system in Pakistan.

According to the World Climatological Database, the average temperature recorded in Pakistan between 1980 and 2021 increased by about 0.9 degrees Centigrade. While Pakistan produces less than 1 percent of the world’s carbon footprint, the Global Climate Risk Index ranks Pakistan as the fifth most climate-vulnerable country. The ND-Gain Index ranks it as 27th least ready country in the world to address the impacts of climate change.

Having lost nearly 10,000 lives due to climate change from 1999 to 2018, Pakistan faced loss of life, infrastructure and economy during the floods of 2022, affecting 33 million people in 94 districts in the country. “The floods not only result in immediate injuries and fatalities but also lead to long-term health consequences such as waterborne/ mosquito-borne diseases, malnutrition and mental health issues,” medical experts tell The News on Sunday.

The Pakistan Medical Association, in its Annual Health Report 2024, indicated that several environmental challenges including water pollution and water shortage, soil erosion, land pollution, deforestation, global warming, air pollution, noise pollution and natural disasters pose serious threats to human health and life. According to the latest global Environment Performance Index ranking, Pakistan is on the list of countries with poor air quality.

The PMA points out another environmental issue of waste management. “Factories, hospitals and municipalities dispose thousands of tonnes of their waste into our oceans, lakes and rivers, which are life-threatening for aquatic and human life dependent on these water resources,” says Dr Abdul Ghafoor Shoro, PMA Centre’s secretary general while quoting the report.

Prof Zulfiqar Ali, an environmental expert, says that the weather forecast suggests a sizzling hot weather with temperatures soaring to 45 degree Celsius, feeling like 50 degree Celsius, from mid-May; minimum temperatures will be more than 30 degree Celsius. The el niño effect on regional weather pattern, which triggers extreme heat waves, is likely to persist till 2027.

“This kind of weather is too hot to bear as children, elderly and the patients and even healthy individuals accustomed to staying indoors will be susceptible to dehydration and other medical complications,” he warns. He advises people to keep themselves hydrated; to stay indoors during the day time and to cover their heads with wet cloth when outdoors.

Prof Ali says that this extremely hot weather is dangerous for human, livestock and plant health alike. “We must assess these rapid changes in weather patterns and take action lest we have to pay a heavy price.”

Empirical research has conclusively demonstrated a direct link between exposure to extreme heat and kidney damage, as well as the aggravation of underlying cardiovascular and respiratory diseases, mental health disorders and unfavourable pregnancy outcomes.

Dr Ali Mir, a population and health expert, says soaring temperatures and heatwaves pose a significant threat to public health in Pakistan, particularly increasing the risk of heatstroke, dehydration, and cardiovascular problems, especially among vulnerable populations such as the elderly, children and outdoor workers. Empirical research has conclusively demonstrated a direct link between exposure to extreme heat and kidney damage, as well as the aggravation of underlying cardiovascular and respiratory diseases, mental health disorders and unfavourable pregnancy outcomes.

“There is a higher incidence of pre-term deliveries, low birth weight, stillbirths and neonatal stress in hot temperature exposures,” he says. After India, Pakistan has the highest number of stillbirths in the region.

In cities like Karachi and Lahore, where heatwaves have become more frequent and severe in recent years, regular electricity breakdowns further aggravate the situation, putting people’s health at risk.

In addition to direct health impacts, climate change also has indirect effects on healthcare in Pakistan. “It disrupts agricultural productivity, leading to food insecurity and malnutrition, which in turn affects the overall health and well-being of the population, especially women and children. Likewise, it enhances the salinity of water reservoirs, making them more brackish and conducive to propagating pathogens that cause gastrointestinal disorders,” says Dr Ali Mir.

The impact of climate change on healthcare in Pakistan is further compounded by socio-economic disparities and inadequate healthcare infrastructure. Public health experts believe that the rural communities entangled in a web of poverty, illiteracy and lack of awareness about climate change despite being hit the hardest, face limited access to healthcare facilities, trained medical personnel and essential medicines. This makes them more susceptible to its health impacts.

“The health system resilience needs to be strengthened at the community level through lady health workers, community midwives and mobile outreach,” says Dr Shahid Shaukat, a public health expert.

While the poor are more vulnerable to extreme weather conditions than those who are more resourceful, Dr Ali Mir emphasises the need to produce accurate epidemiological data and in-depth research to develop targeted interventions to protect the groups most at risk for heat-related illnesses.

Medical experts believe that investing in healthcare infrastructure, access to clean water and sanitation, disease surveillance and response systems will strengthen climate resilience, among other initiatives, as bulwark to climate-induced threat to health and healthcare systems in Pakistan.

While international cooperation and support through knowledge sharing and technology transfer is crucial, Pakistan requires a more coordinated multi-sectoral approach, involving government and community, to ensure a healthier and more sustainable future for its citizens.

The writer is an investigative journalist associated with The News International, Pakistan. He is an EWC and GIJN fellow. His X handle: @AmerMalik3