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 structures. People had to leave their unsafe 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.
Emergency flood response in Dadu
One of the worst-hit areas was Sindh, where Dadu district is located. Over six months, the MSF team carried out 27,726 primary healthcare consultations in Dadu, Johi, KN Shah and Mehar districts, along with distributing 27,000 non-food items, including hygiene kits and 82,480 tents, blankets and kitchen kits. It also distributed five million litres of water and installed 50 hand pumps between September 2022 and February 2023. In Johi, MSF installed a reverse osmosis plant to purify the saline water to ensure safe drinking water was available.
“Our house and crops were destroyed by the flooding. 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,” says Nazima, a resident of Khudarish Jamil village in Dadu.
Post-flood medical activities
As the flood waters receded, MSF medical teams registered a rise in severe acute malnutrition cases, particularly among children, with the numbers tripling in the areas where MSF was present. MSF set up a nutrition programme where it treated 2,034 children under five years, and 299 pregnant and lactating women between March and September 2023.
Also, there was a sharp increase in the number of patients with malaria in the facility in Dadu. “Stagnant water attracts mosquitoes that carry malaria, so it was a major factor contributing to an increase in cases. However, to our surprise, we also found many cases of malaria in dry areas as well,” says Shaheen, a nurse who has worked with MSF for 16 years in Pakistan. Between September 2022 and September 2023, MSF treated 12,108 people with malaria.
Continuing treatment of cutaneous leishmaniasis during the emergency response
Before the floods, at the request of the Ministry of Health, MSF had just started to set up a project in the hospital 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.
In June 2022, when the floods hit Dadu, MSF kept the cutaneous leishmaniasis programme going but expanded its activities to include an emergency response. Over a period of a year from September 2022 to September 2023, MSF was able to treat 89 patients suffering from 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 on how to diagnose and clinically manage patients with the infection. MSF also donated meglumine injections, laboratory items, medication and dressing materials.
Current MSF medical activities
MSF has been working in Pakistan since 1986. In Dadu district, MSF has responded to three consecutive flooding emergencies in 2010, 2020 and 2022. It has an Emergency Preparedness Plan in place in the event of another emergency. MSF also provides obstetric and gynaecological care to mothers, and paediatric, newborn and malnutrition care to children in Balochistan. MSF provides free medical care to cutaneous leishmaniasis patients in five diagnostic and treatment centres in Balochistan and Khyber Pakhtunkhwa.
In Karachi, MSF offers free hepatitis C screening, diagnostics and treatment in Machar Colony. In Khyber Tribal District MSF supports a primary health centre 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.
Médecins Sans Frontières is an international medical humanitarian organisation that delivers emergency aid to people affected by armed conflict, epidemics, natural disasters and exclusion from healthcare. MSF first started working in Pakistan in 1986, and now provides urgently needed free, quality medical care to people in Balochistan, Punjab, Khyber Pakhtunkhwa and Sindh provinces. MSF works in collaboration with the health authorities in the country. MSF activities in Pakistan are funded solely by private donations, with no institutional or government contributions.