Healthcare in Pakistan
In a study that The Lancet conducted, healthcare in Pakistan currently ranks 154th out of 195 countries in terms of overall system performance. As a developing country with a mere 2% of its GDP allocated for total health expenditures, Pakistan struggles to maintain a proper healthcare system with regard to quality and accessibility.

Pakistan’s numerous cases of communicable and vaccine-preventable diseases highlight its struggling healthcare system. Viral hepatitis, dengue, tuberculosis, malaria, typhoid, HIV and cholera have long been leading causes of death. They are the result of overpopulated cities, poor sanitation, unsafe drinking water and inadequate socioeconomic conditions.

Pakistan has one of the lowest amounts of immunized children, with overall vaccination coverage of just 60%. The result is a high newborn mortality rate: 69.3 deaths per 1,000 live births. Moreover, while the rest of the world is free from polio, experts still consider the disease as an endemic in Pakistan. Documentations determined that there were nearly 150 polio cases in 2019. With these alarming statistics in mind, here are six facts about healthcare in Pakistan.

6 Facts About Healthcare in Pakistan

  1. Healthcare in Pakistan includes both private and public sectors. The private sector serves approximately 70% of the population. Private hospitals and healthcare institutions consistently outperform their public counterparts, as measured by the overall quality of healthcare and patient satisfaction.
  2. A common misconception is that healthcare services in the public sector are free of charge to Pakistani citizens. This is not the case, as 78% of the population continues to pay for healthcare out of their own pockets.
  3. Healthcare in Pakistan has been a focal point after the country signed the U.N. Millennium Development Goals (MDGs). Pakistan began to initiate healthcare programs, establishing both Basic Health Units as well as Rural Health Units. Basic Health Units are assigned to NGOs, who manage the day-to-day operations, administer medicine and overlook the facilities.
  4. Reports estimate that there are roughly 175,000 doctors registered to serve the population. However, many Pakistani doctors choose to practice abroad due to poor service structure, increased workload, lack of funding and a rise in hostility by some. Moreover, many female doctors have stopped practicing due to family and social compulsions. Taking into account all these factors,  the doctor to population ratio stands at one doctor for every 1,764 persons. For adequate population coverage, Pakistan needs at least two doctors for every 1,000 persons.
  5. Healthcare in Pakistan has gradually improved over time. Currently, 92% of the rural population and 100% of the urban population have access to health services. Such improvement has been a direct result of Pakistan meeting the MDGs. Despite measures to increase the quality of healthcare facilities, most of the population prefers to consult private doctors and practitioners.
  6. Pakistan continues to commit to the MDGs in order to eradicate a multitude of preventable diseases. The introduction of immunization programs, such as the Expanded Program on Immunization (EPI), has increased vaccination coverage in Pakistan from 5% to 84%. EPI partnered with the Global Alliance for Vaccines and Immunization (GAVI), a global health organization dedicated to increasing immunization in low- and middle-income countries. With this partnership, countless people are working to eradicate vaccine-preventable diseases, such as measles, polio and neonatal tetanus.

With the arrival of COVID-19, Pakistan’s healthcare system is under immense pressure and is struggling to deal with the thousands of cases arriving each day. Frontline workers are taking the brunt of the virus. An estimated 3% of the total cases in the country consist of healthcare workers. Medical professionals are resorting to strikes and protests over the lack of protective gear necessary to safely treat patients.

In light of the unrest, Prime Minister Imran Khan announced new healthcare reforms to fix the faults of the health sector. The reforms allocate $300 million to pay for additional ventilators and other medical equipment. Additionally, major cities are setting up isolation centers to increase hospital capacity for infected patients.

These six facts about healthcare in Pakistan determine that the country will need to radically transform its health system performance in the following years in order to confront outbreaks that continue to threaten the population. The World Health Organization has recommended that Pakistan’s Ministry of Health increase healthcare expenditures to 5% of its GDP. Doing so would not only put an end to controllable diseases, but it will also ensure that the healthcare system will be able to deal with dangerous outbreaks in the future.

–  Abbas Raza
Photo: Flickr

 

Poverty in Pakistan
Founded during the partition of India and located in South Asia, the Islamic Republic of Pakistan is the fifth most populous country in the world, with a population of more than 210 million. Cornerstones of Pakistani culture include incredible cuisine, iconic architecture and the popular game of cricket. However, like so many nations across the globe, Pakistani citizens are forced to confront the harsh reality of extreme poverty. Here are ten facts about poverty in Pakistan.

10 Facts About Poverty in Pakistan

  1. As of 2015, approximately 24% of Pakistani citizens lived below the national poverty line. This is more than twice the global percentage of people living in extreme poverty and amounts to more than 50 million people in Pakistan living in poverty.
  2. Nearly 4% of Pakistan lives below $1.90 a day. As a result, nearly 9 million Pakistani citizens live in extreme poverty. This puts them below the Purchasing Power Parity (PPP) outlined in the U.N.’s Sustainable Development Goals.
  3. As of 2018, almost 7% of babies died before their fifth birthday. Life in poverty makes it extremely difficult to have access to proper housing, nutrition and medication.
  4. The adult illiteracy rate in Pakistan is around 35%. Unequal access to proper and requisite education is inseparable from the reality of poverty.
  5. Pakistan also faces a severe overpopulation problem. While the nation has the fifth-highest population in the world, it takes up less than a percent of this planet’s surface. Overpopulation and unequal access to education amplify problems caused by poverty.
  6. Pakistan has a Human Development Index (HDI) of 0.560. The nation ranks 152nd out of 189 countries and territories. In the last three decades, Pakistan’s HDI has increased by nearly 40%.
  7. Appproximately 38% of Pakistani citizens are living in multidimensional poverty. Another 13% are vulnerable to this status. From 2004 to 2015, the multidimensional poverty rate has dropped from 55% to its current rate at 38%.
  8. Poverty levels in Pakistan fluctuate throughout regions. In urban areas, poverty rates are around 9%, while in rural areas poverty rates rise all the way to 55%. This disparity can be seen among provinces in the Republic as well.
  9. About 25 million Pakistani families rely on wage workers. They have unfortunately become vulnerable due to the current COVID-19 pandemic. The Prime Minister has said that the pandemic is harder to deal with in countries facing the challenges of poverty.
  10. The Pakistani government hopes to receive $5 billion in financial aid. This would come from outside sources and countries, along with the $1.3 billion they have already received from the IMF.

With continued efforts, poverty in Pakistan will hopefully decrease. The Citizens Foundation is one of many non-profits that have been working to improve the quality of life for underprivileged Pakistani citizens. In 25 years, the Citizens Foundation has created 1,652 schools, providing a proper education to over 266,000 children who would not have had it otherwise. These schools also combat gender inequality in Pakistan, as they have all-female faculty and a 50% student gender ratio.

However, there is still work to be done. In Pakistan, gender disparities compound the unjust realities of poverty. Poverty rates in rural areas are more than five times higher than those in urban areas. Yet, similar to global trends, the amount of people living in poverty in Pakistan has clearly been decreasing in recent years. This is in large part due to individuals and organizations dedicating themselves to the cause of ending poverty. These continued efforts will help fight and eventually end poverty in Pakistan, and in turn will make the Republic a more just and equal country for all those who call it home.

Ehran Hodes
Photo: Flickr

Tuberculosis in PakistanPakistan is ranked as the fifth-highest nation contracting Tuberculosis (TB) daily in the world. It has an “estimated 510,000 new TB cases emerging each year,” accounting for 61% of TB in the eastern Mediterranean region. According to the Stop TB Partnership, there are 1,540 developing cases and 121 deaths from tuberculosis in Pakistan every day. Pakistan also experiences the fourth-highest rate of multidrug-resistant TB (MDR-TB) globally. The abundance of MDR-TB cases largely results from delays in diagnosis, inadequate drug treatment and non-compliance of some patients.

Economic Background and Effects

The average monthly cost to treat Tuberculosis in Pakistan is between 1,500 and 1,800 Pakistani rupees, which equals around $9 to $11 per month. In Pakistan, this is a huge financial burden considering the average monthly income of less than $35, with many TB patients earning even less than that. One study reported 96.7% of Pakastani TB patients were already struggling financially prior to their diagnosis.

After diagnosis, changes in employment status are common for many patients. Roughly 75% of TB patients are unemployed after diagnosis. Those who do not lose their jobs often face cuts in work hours. These economic constraints inadvertently encourage non-compliance and refusal of treatment, which ultimately contributes to the spread of TB in Pakistan.

Stigmatization of Tuberculosis

Beyond employment consequences, tuberculosis in Pakistan is heavily stigmatized by the public. More than three-quarters of Pakistanis believe TB patients should be kept in hospitals or sanitariums during treatment. Some even admit that they would not marry an individual who has had TB. Out of a fear of being ostracized, most TB patients in Pakistan hide their disease and refuse treatment—behavior that contributes to the high rates of MDR-TB in the country.

The stigmatization of TB in Pakistan is mainly a result of a lack of public knowledge and misconceptions about the disease. Recent studies point toward insufficient TB awareness among the public and even patients in Pakistan. One study found that 88.7% of patients questioned did not know the risk factors of TB or the protective measures people with the disease should take. Moreover, less than half of the respondents could accurately identify TB symptoms.

The National TB Control Program (NTP)

Despite the high rates of tuberculosis in Pakistan, the country has made strides in decreasing its numbers. Organizations such as the National TB Control Program (NTP) are actively working to achieve a TB-free Pakistan. NTP re-launched in 2001 after TB became a national emergency in Pakistan. Since then, the organization has worked alongside the National Institute of Health to fight TB in the country. The main objective of NTP is to cut the number of TB cases present in 2012 in half by the year 2025.

The organization has brought more attention to the issue and improved its detection of cases from 11,050 cases in 2000 to 248,115 in 2008. The NTP hopes to increase that number to 420,000 by the end of 2020. Furthermore, the organization was able to bring the treatment success rate up to 91% by 2007 and has been working to maintain that level since.

COVID-19 Impact

The recent outbreak of COVID-19 across the globe has posed a major threat to the state of tuberculosis in Pakistan. With social distancing regulations, it has become difficult for individuals to be diagnosed and treated for the disease. Despite these new challenges, Pakistan and the NTP have remained committed to controlling the TB situation. The National Manager of NTP, for example, announced that follow-up appointments following treatment are to be conducted over the phone. Furthermore, the NTP outlined plans to use methods like the Pakistan Postal Service and Uber to deliver ongoing treatment to patients across the country.

The NTP has also started an online TB case notification pilot program where patients can register and receive treatment notifications and additional assistance from healthcare workers via text. This program will provide the NTP with greater information on TB cases in Pakistan as well as encourage patient compliance with treatment plans.

– Mary Kate Langan
Photo: Flickr

Jobs in PakistanDue to the coronavirus pandemic, many people around the world lost have their jobs and are now facing financial hardship. The economic impact is projected to increase global poverty. This will be the first time since 1998 that the world sees an increase. Luckily, countries have been creating new job markets to aid the unemployed and fight poverty levels. A new market of jobs in Pakistan has been created for those laid off because of the coronavirus: tree planting.

“10 Billion Trees Tsunami”

In 2018, Pakistan started a campaign called the “10 Billion Trees Tsunami” program. The project goal: to plant more trees and fight against deforestation. Additionally, this program will help the environment. Jobs in Pakistan have already been affected by the pandemic, and it is projected that as many as 19 million people will be laid off due to COVID-19. To combat this, Pakistan started employing those who lost their jobs because of the virus to plant trees as a part of their “10 Billion Trees Tsunami” program. Though this program was not specifically created for those who lost their jobs due to the pandemic, it is greatly helping those who did. These new laborers have been dubbed “jungle workers.” This program aims at creating more than 60,000 jobs as a way to help citizens and the economy and fight against climate change. In order to help as many citizens as possible during this devastating time, the program has tripled the number of workers hired.

These jungle workers are mostly seen in rural areas. Hiring is aimed primarily at women, unemployed daily workers and those who are from cities in lockdown. A large portion of the workforce is also made up of young people. As tree planting does not require much past experience, many unskilled workers are still able to be employed during this harsh economic period. There are still strict precautions in place for those working, such as having to wear a mask and continuing to keep a social distance of 6 feet while working.

Relief for the Unemployed

The program’s creation of new jobs in Pakistan allows its citizens to continue making enough money in order to provide for their families. A construction worker named Abdul Rahman lost his job when the coronavirus struck and began to face financial instability. Once employed as a jungle worker for the “10 Billion Trees Tsunami,” he was able to start providing for his family again. In an interview with the Thomson Reuters Foundation, Rahman said “Due to coronavirus, all the cities have shut down and there is no work. Most of us daily wagers couldn’t earn a living.” Rahman is now earning around ₹500 a day, which translates to about $3. Though this payment is about half of what he would have made on a good day as a construction worker, he says it is enough “to feed our families.”

Pakistan’s Positive Example

Through this program and its employment of more citizens, Pakistan is taking a step towards rebuilding its economy and aiding poor citizens. The project aims at having planted 50 million trees by the end of this year and, with the addition of more workers, this goal is achievable. The presence of such jobs in Pakistan is an example of hope during this time and, as the economy improves, Pakistani citizens can earn living wages and the environment reaps the benefits.

– Erin Henderson

Photo: Flickr

India vs Pakistan: Not Just Common Enemies
A man from India and a man from Pakistan stood proudly together representing their nations at a T-20 Cricket World Cup game in 2012. This is significant, as, in the year 1947, after India became independent from the British Empire, the Muslim minorities in the nation felt that they were experiencing underrepresentation and demanded partition. As a result of their religious divisions, India and Pakistan divided into two sovereign nations. About 70 years later, their harsh differences continue to exist. It is important to note that despite their religious and lingual difference, their poverty rates are both high. In India, about 21.9% of people lived below the poverty line as of 2011. Meanwhile, in Pakistan, about 24.3% of people lived below the poverty line as of 2015.

Religious Divisions

The main reason behind India’s partition was its religious divisions. Due to the Hindu majority within the government, the Muslim minorities felt that the government policies would only benefit the Hindus. Moreover, they also felt that the government would misrepresent them. Muhammed Ali Jinnah, a Pakistani politician, led Pakistan and developed a Muslim majority nation, while Jawaharlal Nehru, India’s first prime minister, developed a Hindu majority of India. Religion became the foundation of the partition movement. Many still view it as the basis of the conflict between the two nations.

Consequently, about 15 million people suffered displacement, as the Muslims in India migrated towards the newly established Pakistan. Along with this, about 1 million and more people died due to religious conflicts. The political conflicts between the two nations had led many other citizens to suffer the consequences. As a result, many families lost important members, and some became homeless.

Poverty in India

While the two nations have often been enemies, they have a common issue of high poverty rates, with India at 21.9% in 2011 and 29.5% in 2015. The causes of the high rates of poverty are similar in both nations as well.

A common cause of poverty in both nations is hunger, unemployment and lack of education. In India, about 200 million people do not have access to decent food. In addition, the lack of employment with proper wages is difficult to access, since many Indian people live in small rural villages. UNICEF revealed that about 25% of children in India do not have access to education in India. In fact, often girls in India have to learn household jobs. Due to this unequal treatment of women, it is difficult for them to find jobs with a good wage.

Poverty in Pakistan

Pakistan has seen a similar trend to India. Typically, women and children find it really difficult to find access to food. Due to inflation, many resources are simply unaffordable.

In terms of employment, many Pakistani citizens live in rural areas. Consequently, they do not have access to proper jobs. Many who have jobs do not have proper wages. Moreover, about 90 million people lived on less than $2 a day in 2011. This makes poverty harder to overcome.

Inequality amongst women and young girls also increases poverty levels. Like India, women have to learn household tasks so that they have experience when they marry. Additionally, people often look down on women who work outside the house. Efforts to educate women have made a significant impact on this. Other influences on poverty include violence, ongoing conflicts with terrorist groups, malnutrition, infant mortality rates and child labor.

Solutions to Poverty in India

In India, the government is working to combat poverty in a variety of different ways. An initiative the government has launched to help decrease poverty is Pradhan Mantri Awas Yojana or Housing For All. It focuses on providing the poor with affordable housing. Additionally, the program tries to empower the women by mandatorily making them the owner or co-owner of the house. Another program that the government launched is the Atal Mission For Urban Rejuvenation and Transformation. This program focuses on improving infrastructure and developing a proper sewage network, along with better water supplies for urbanization. In addition, the nation gets support from international organizations such as the U.N.

Solutions to Poverty in Pakistan

Pakistan’s government is also working effectively to decrease poverty levels. A program that the Pakistani government launched to help combat poverty is known as the Benazir Income Support Program. It focuses on assisting the poor financially. The program is essentially a cash transfer program that forces on reducing poverty and elevating the status of marginalized and underprivileged communities. Additionally, Pakistan receives plenty of support from international organizations such as USAID and the World Bank.

India and Pakistan continue to have political conflicts between each other. Similar to the relationship between the United States and Russia, the two nations have competitive views towards each other. Despite their differences, they have similar issues internally, such as poverty. However, although the new nations have significantly high levels of poverty, they have decreased the rates. Within a period of 10 years, 2006 to 2016, India lifted about 271 million people out of poverty. Pakistan significantly lowered its poverty rates as well and now has the second-lowest headcount poverty rate in South Asia. As urbanization continues in both countries, reductions in poverty are occurring, although at a slow rate.

Krishna Panchal
Photo: Flickr

Disaster Risk in Pakistan
Locust swarms ravaged Pakistan in early 2020, overwhelming the agricultural industry. Like many less developed countries, agriculture composes a large portion of Pakistan’s economy. Agriculture alone creates 24.4 percent of GDP and 42.3 percent of the total labor force. Pakistan’s exports also rely on agro-based industries, such as cotton textile processing. As the fourth largest cotton producer in the world, cotton related products in Pakistan provided $11.7 billion of $24.7 billion in total exports last year. Improving preparedness and reducing disaster risk in Pakistan is crucial for national poverty eradication.infrastructure.

Disaster Risk Reduction in Less Developed Countries

Less developed countries (LDCs) are particularly vulnerable to disasters. One study suggested that the efforts aimed at reducing poverty and mitigating disaster risks are interconnected. Removing the loss from natural disasters would remove 26 million people from living in extreme poverty (defined as those who live on $1.9 per day). Poor people and poorer countries are highly vulnerable during natural disasters as they cannot regain societal norms back as effectively as more affluent nations.

Another report from the U.N. OHRLLS summarizes the measures of disaster risk reduction in LCDs and deduces that aims should minimize vulnerabilities and strengthen resilience in LDCs. The initial step taken by most LDCs to reduce the devastating impact of natural disasters is integrating the institutional infrastructure.assessment.

Disaster Risk Reduction in Pakistan

Before the recent locust swarms, natural disasters, including floods, earthquakes, landslides, drought and monsoons have already been an issue in Pakistan’s development. Monsoon season in 2018 alone caused 134 deaths and 1,663 houses to be damaged. Earthquakes in 2005 caused over 80,000 deaths in Pakistan. This staggering number was largely attributed to the low capabilities of emergency services after the earthquakes.

In 2007, Pakistan established the national disaster emergency system. The National Disaster Management Authority (NDMA) was placed in charge of general operations for disaster response.

Five years after the foundation, NDMA’s investment in disaster assessment reached $1.4 billion. That large amount of funds generates plenty of room for reducing disaster risk in Pakistan. Specifically, it allows the development of a monitoring and forecast system across the nation, which collects and consolidates data for disaster assessment.

International Efforts

International organizations developed projects for reducing disaster risk in Pakistan based on the Sendai Framework of Disaster Risk Reduction. This framework sets four priorities to embrace an improved disaster response: a better understanding of disaster risks, wider governance in risk management, improved ability in ex-post disaster recovery and greater investment in resilience development.

Based on these principles and priorities, the projects for disaster risk reduction in Pakistan cover varied issues. The World Bank offered $4 million to establish early forecast systems, ensuring Pakistan would have access to crucial disaster assessment information. Further international aid (£1.5 million) was offered from the U.K. to promote local safety and resilience culture through education and innovation. The U.N. provided the largest investment of $46 million to ensure disaster preparedness and other measures are the priority in policy implementation at every level.

Moving Forward

These efforts by the Pakistani government and other international organizations have improved the nation’s ability to prepare for and respond to natural disasters. This work has reduced the significant impact disasters generally have on the impoverished. Moving forward, it is essential that disaster risk reduction projects continue to grow, as new methods and technologies become available.

– Dingnan Zhang
Photo: Flickr

childrens health in Pakistan
Pakistan is a country that has had many years of strife regarding affordable and accessible health care, particularly for families. Many organizations seek to change this so that the country can improve the well-being of its children, the most vulnerable group. Below are seven facts about children’s health in Pakistan.

7 Facts About Children’s Health in Pakistan

  1. Immunizations: UNICEF has been supporting the Pakistani government in ensuring that children have access to routine immunizations. The Expanded Programme on Immunization (EPI) in Pakistan works to provide vaccinations to children in both urban and rural communities. In 2018, 75 percent of infants received a third dose of the Diptheria-Tetanus-Pertussis (DTaP) vaccine, compared to only 59 percent in 2000. Similarly, in 2018, 67 percent of children received a second dose of the measles vaccine, compared to only 30 percent in 2009.
  2. Pneumonia: Pneumonia is the number one cause of death among children in the world as well as in Pakistan. About 91,000 Pakistani children die from pneumonia each year. However, in 2012, Pakistan was the first nation in South Asia to introduce a pneumonia vaccine to children. Though the vaccine is expensive, international organizations such as the World Health Organization (WHO), Global Alliance for Vaccines Initiative (GAVI) and the Bill and Melinda Gates Foundation have begun to include this vaccine in the free immunization program for children.
  3. Child Health and Sanitation Week: Twice a year, Pakistan holds Child Health and Sanitation Week. UNICEF and the Government of Pakistan hold events and marches to raise awareness about children’s health. They provide free immunizations and deworming, and hold information sessions on breastfeeding and hydration. Children and families also learn about the importance of good hygiene and how to prevent certain diseases.
  4. Diarrhea: About 53,000 children die from diarrhea in Pakistan every year. Though diarrhea is another leading cause of death, UNICEF Pakistan supports the Global Action Plan for Pneumonia and Diarrhea (GAPPD). The GAPPD trains health care workers, researches causes of illness and provides supplies to help treat and prevent both conditions.
  5. Neonatal Deaths: The government of Pakistan Provides programs on EPI, family planning, maternal/neonatal and child health and primary health care and nutrition for women and children living in rural and remote areas of Pakistan. According to the National Institute of Health, these sorts of programs have the potential to prevent 20 percent of neonatal deaths, between 29 to 40 percent of deaths in children below the age of 5.
  6. Government Projects: The Government of Pakistan has initiated a wide variety of programs aimed specifically towards protecting the health of children and their mothers including the Maternal and Child Health Programme, National Program for Family Planning and Primary Health Care, National EPI Programme, Nutrition Project, Acute Respiratory Infections Control Project and the Integrated Management of Childhood Illnesses Strategy. These projects are able to assist areas of Pakistan that need treatment and prevention supplies for various illnesses in children.
  7. HIV: UNICEF is assisting the Government of Pakistan in preventing HIV cases in children. Though the amount of pediatric HIV cases has increased in Pakistan throughout the last few years, the Prevention of Parent to Child Transmission has been researching ways to change this and strengthen the care that infected children receive. The initiative is also working to educate adolescents on HIV prevention.

Pakistan has struggled with providing its families with accessible and affordable health care. However, with many new initiatives, specifically with immunizations, its children will be able to thrive. As the Government of Pakistan has shown, children’s health in Pakistan will continue to be among its priorities.

Alyson Kaufman
Photo: Wikimedia

Sanitation in Pakistan
Pakistan had a population of 210 million people as of 2017 and is the world’s fifth-most populous country. Further, it is surprising that Pakistan’s GDP has grown 3.3 percent in a single year considering that 24 percent of its population lives below the national poverty line. Poverty has contributed to citizens’ ongoing struggle with inadequate sanitation. Here are 10 facts about sanitation in Pakistan.

10 Facts About Sanitation in Pakistan

  1. Pakistan is among the top 10 countries in the world that lack access to clean water. The nonprofit organization WaterAid conducted a study revealing that 21 million people out of the country’s total population lack access to clean water. Out of Pakistan’s total population, 79.2 percent of the rural poor have access to clean water. On the other hand, 98 percent of Pakistan’s rich have access to clean water. 
  2. Seventy-nine million people in Pakistan do not have access to a proper toilet. According to WaterAid.org, every two out of five people, or the majority of people living in poor rural areas, do not have access to a toilet. The lack of adequate facilities can create additional problems for citizens, such as bacterial infection or diarrhea. In fact, 16,800 children under the age of 5 die from diarrhea each year. WaterAid is currently working to combat the sanitation issue in Pakistan by working with government and local officials to provide proper toilet facilities throughout disadvantaged communities.
  3. Pakistan’s women and young girls often stay at home rather than partaking in normal activities, due to a lack of menstruation supplies and proper facilities. According to the United Nations International Children’s Emergency Fund (UNICEF), 75 percent of women stay at home during menstruation. Due to a lack of resources and cleaning facilities, many girls have no choice but to use unsanitary methods for managing menstruation, such as homemade sanitary pads. Further, these methods are prone to cause vaginal infections as a result of reuse. 
  4. Improper sanitation and food storage are some of the major sanitation issues in Pakistan. The National Center for Biotechnology Information (NCBI) reveals the prevalence of illness from improper food care. Contamination of food due to washing it in unsanitary water sources can cause bacteria like E. Coli, salmonella and other pathogens to enter the human body, causing severe illness.
  5. Waterborne diseases are prevalent as a result of untreated drinking water. According to the Pakistan Council of Research in Water Resources (PCRWR), 62 percent of the urban population and 84 percent of the rural population of Pakistan do not treat their drinking water to prevent waterborne diseases. The United Nations Educational, Scientific and Cultural Organization (UNESCO) estimates that 40 percent of all diseases in Pakistan are due to unsanitary drinking water.
  6. Stunted growth due to unsanitary conditions affects 38 percent of children in Pakistan. The United Nations International Children’s Emergency Fund (UNICEF) found that unsanitary conditions like drinking and bathing in unsanitary water stunt growth. In the state of Sindh, stunted growth affects 50 percent of children, which can also cause cognitive development stunting. The consequences of stunting are irreversible, causing lifelong implications for the child into adulthood. Working with these communities, the United States Agency for International Development (USAID) has begun a stunting reduction program to work with families to provide children with clean water and facilities to fight against poor sanitation in Pakistan.
  7. The misuse of pesticides in Pakistan’s agricultural fields results in an annual death rate of 10,000 people per year from agrochemical poisoning. Around 500,000 people fall ill annually as a result, although most are fortunate to recover. When people do not properly use pesticides, they can persist through rain and flooding, eventually entering water sources. People drink these water sources, in turn causing illness. Training is crucial for agricultural workers to properly prevent water contamination.
  8. The population growth rate has been climbing since the late 1900s. According to the United Nations, the total population of the country will reach 220 million people by mid-2020. A researcher with the Sustainable Development Policy Institute (SDPI) stresses that millions of people still live without access to clean drinking water, which includes large metropolitan cities where drinking water is scarce. The Sustainable Development Policy Institute (SDPI) recommendation for government intervention to bring clean water to overpopulated areas should help improve sanitation in Pakistan.
  9. The lack of proper toilet facilities is a part of 41 million people’s lives in Pakistan. According to The United Nations International Emergency Children’s Fund (UNICEF), the lack of toilets leaves people with no choice but to practice open defecation, which can lead to the spread of diseases among communities. Pakistan is the third-largest country where people practice open defecation. UNICEF is working with the government to help build toilet facilities for communities that need them to ultimately improve sanitation in Pakistan. These facilities are especially important for girls to protect them against assault, which happens often during open defecation.
  10. Only two cities in Pakistan — Islamabad and Karachi — have biological waste facilities. These facilities clean only about 8 percent of wastewater due to limited functioning, even with the already limited number of facilities to filter wastewater. Industrial waste also pollutes water in Pakistan. Out of 6,000 of the country’s registered businesses, 1,228 have “highly polluted” water sources. Government officials are working towards improving water treatment centers. Pakistan established the National Water Policy (NWP) to ensure that the country applies 10 percent of national funding to the development and repair of water infrastructure.

Pakistan’s impoverished citizens experience sanitation issues the most. The solutions are fairly simple but Pakistan’s acceptance of outside support will be a substantial step. If one considers the progress that Pakistan is already making to change the lives of people facing sanitation challenges in Pakistan, it is clear that the country should be able to implement real change and help communities thrive for years to come.

– Amelia Sharma
Photo: Flickr

Disaster Risk Reduction in Pakistan
Locust swarms struck Pakistan in early 2020, causing challenges to Pakistan’s agriculture. Agriculture factors into a large portion of Pakistan’s economy, similar to other developing countries around the world. Agriculture alone is 24.4 percent of Pakistan’s GDP and employs 42.3 percent of the total labor force. Pakistan’s exports rely on agro-based industries, such as cotton processing and textile industries. As the fourth-leading cotton producer in the world, cotton related products in Pakistan provided $11.7 billion out of $24.7 billion total export value in 2019. Therefore, a pivotal part of disaster risk reduction in Pakistan is for it to increase its preparedness in dealing with emergencies like locust swarms and other natural disasters.

Disaster Risk Reduction in Less Developed Countries

Less developed countries (LDCs) are particularly vulnerable to disasters. A study suggested that the “effort to reduce poverty and disaster risks are complementary.” The loss from natural disasters makes the life of 26 million people return below the extreme poverty line of $1.90 per day. Hence, poor people or countries are more often in close proximity to natural disasters and gain less protection than the non-poor.

Another report from the U.N. Office of the High Representative for the Least Developed Countries, Landlocked Developing Countries and Small Island Developing States (UN-OHRLLS) summarized the measures of disaster risk reduction in LDCs should aim at “reducing vulnerabilities and strengthening resilience in LDCs.” It entails three aspects: recovering from disasters, preventing future disasters and withstanding possible future disasters. Laying down the institutional arrangement is the initial step that most LDCs take.

Disaster Risk Reduction in Pakistan

Before the recent locust swarms, natural disasters, including floods, earthquakes, landslides, droughts and monsoons, were already an outstanding problem in Pakistan’s development. Monsoon season in 2018 caused 134 deaths and damage to 1,663 houses alone. Meanwhile, earthquakes in 2005 caused over 80,000 deaths in Pakistan. The country’s low capability to provide rescue after the earthquakes might have been one major reason for such a high death toll. Therefore, Pakistan established a national disaster emergency system in 2007 called the National Disaster Management Authority (NDMA). It works to identify natural disaster risks and action plans to provide warnings about them.

Five years after NDMA emerged, its investment in disaster assessment reached $1.4 billion. The ambitious amount of funds is creating room for higher performance of disaster risk reduction in Pakistan. It is also allowing for the building of a monitoring and forecast system across the nation to collect and consolidate hazard data for the assessment of disasters.

International Participation in Disaster Risk Reduction

Several international institutions are developing projects aimed at disaster risk reduction in Pakistan based on the Sendai Framework of Disaster Risk Reduction. The framework sets four priorities to embrace more countries and institutions in disaster response including a better understanding of disaster risks, more professional governance in risk management, improved ability in ex-post disaster recovery and more investment in resilience development.

Based on the principles and priorities, the projects for disaster risk reduction in Pakistan cover varied issues. The World Bank offered $4 million of funding to the ERRA DRM program to ensure that Pakistan will be able to establish an early forecast system in order to efficiently respond to disasters. DFID from the U.K. offered $1.5 million U.K. pounds to fund projects to promote the local culture of safety and resilience through education and innovation. The U.N. provided $46 million to ensure that disaster preparedness and other DRR measures are the priority in all-level policy implementation. So far, disaster risk reduction in Pakistan covered most of the disasters. Despite the locust strike being a shock to numbers of farmers, Pakistan NDMA has responded by building up a system to plan against locusts and other natural disasters.

– Dingnan Zhang
Photo: Flickr