It is estimated that over one-fifth of Pakistan went under water during the July 2010 floods. While the floods left only an estimated 1500 dead, they left over 21 million individuals without homes, as a result of what United Nations Secretary General Ban Ki-moon called, “slow moving tsunami”.
The destruction of essential infrastructure created a dangerous atmosphere, where survivors now face potentially epidemic diseases. UNICEF estimates that over 3.5 million children run the risk of contracting a waterborne disease as an aftermath of the flood.
“In general, you have more people crowded, and more people in bad situations. You’re going to have more diarrhea and more repertory track diseases,” said Dorothy Debbie, microbiology and immunology.
“It depends on where you have a flood. In this area the biggest concern … the top one you think of is cholera because cholera is already [an] epidemic in the area,” said Debbie. Cholera was not a concern, for example, after the Haitian earthquake.
“Kids especially would be an issue, and severe cholera is a life threatening disease.” Adults in Pakistan have likely already been exposed, and therefore, they likely have built greater immunity to cholera than children.
The list of bacterial disease continues, with Debbie highlighting diarrheal diseases as another major concern. Dehydration and loss of electrolytes can lead to death. Typhoid, which is also found in South Asia, is also a concern.
“Looking at statistics, more people die of typhoid then cholera,” she said.
Even less deadly diseases pose serious problems during the current crisis. For example, Leptospira affects a victims’ kidneys and liver. Due to flood conditions, it has become a bigger concern.
“[Leptospira] is a bacteria that is spread through urine. It is concentrated in the kidneys, and can even be shed by animals … You see images of people walking around in infected water, and it gets into cuts in their skin,” Debbie described.
“With these kinds of things, things that typically don’t bother us become deadly,” said Dwight Bowman, microbiology and immunology.
Bowman discussed the viruses that are transmittable through water. “Things that we would worry about are Hepatitis A, which is transferred in human waste … and in these kinds of situations you can even have problems with Hepatitis E … It is very deadly for pregnant women,” said Bowman.
While polio is often a concern, previous vaccination campaigns may help keep the number of polio cases under control.
“In these types of situation, what they’ll likely do is go in with high levels of chlorination that they can apply to the water, which makes the water not quite as palatable, but in these type of situations, where infrastructure has collapsed, it’s cheap and doable.”
Other emergency responses include mosquito extermination.
“Mosquitoes numbers go way up. Malaria will get worse, and Dengue will get worse,” said Bowman.
Flooding also causes rodents, flees, ticks and mosquitoes to leave their homes, causing other diseases to become prominent. Transmitting agents are prominent in feces, which is also accelerated by floodwaters.
“When things fall apart and people are cold miserable and dirty, body lice becomes a problem,” said Bowman. Namely, flees and lice carry Typhus. Flees also thrive in layers of clothes brought on by colder weathers and will not be eradicated in the coming months.
In addition to disease, refugees must overcome issues associated with malnourishment and poor access to resources. Without basic resources, like fire to boil water and make it clear, individuals are more susceptible to disease.
“The trouble is, people can’t get away from it. They used to have houses beds, now they’re on streets and camps,” said Bowman. The spread of disease will remain a distinct issue for Pakistan as it recovers from its heavy floods.