<span id="docs-internal-guid-4644ccc7-7fff-eaba-5273-a477bd69bb61"><p dir="ltr" style="line-height: 1.4; text-align: justify; margin-top: 0pt; margin-bottom: 0pt;"><span style="font-size: 14pt; font-family: Helvetica;">﻿</span><font face="Arial"><span style="font-size: 14pt; white-space: pre-wrap; font-family: Helvetica;">Climate change is happening faster than we can imagine. Humans can not even keep up with the rapid natural events that are occurring. There are natural disasters that can occur at any day or at any time such as Hurricanes, Tsunami, rising scorching temperatures, flooding, and glaciers melting on mountains, which leads to sea level rise. These natural disasters are not just detrimental to the environment but also causes a fast spread of infections and the short-term and long-term goals must be taken into account. The research taken by Lama and Tatu have taken Pakistan’s recent flooding as a case study to view the outbreaks caused by climate change.</span></font></p></span><p dir="ltr" style="line-height: 1.4; text-align: justify; margin-top: 0pt; margin-bottom: 0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;"><br></span></font></p><h2 style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;" class=""><font face="Arial"><span style="font-size: 18px; white-space: pre-wrap; font-family: Helvetica;">The Pakistan floods</span></font></h2><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;"><br></span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;"><span style="font-size: 14px; font-family: Helvetica;">In early June, Pakistan experienced heavy monsoon rains which caused massive flooding and worsened in the months down the line. According to several reports there have been more than 1700 deaths and 33 million people have been affected by the floods. The provinces that have been affected the most are Balochistan and Sindh. The water after the floods has come down but there were still many deaths due to infectious outbreaks caused by the floods. The infectious outbreaks were made up of several diseases s</span><span style="font-size: 14px; font-family: Helvetica;">uch as COVID-19, malaria, scabies, cholera, diphtheria, diarrhoea, and mostly water-borne diseases. During mid-September, 20,064 skin disease and 215,000 diarrhoea cases were reported (Lama &amp; Tatu, 2022).</span></span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;"><br></span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 14px; white-space: pre-wrap; font-family: Helvetica;">There was also a large amount of malaria cases reported through January and August 2022 in Pakistan. The two provinces that had most of the cases were in Sindh and Balochistan after the mid-June floods. Further confirmed statistics in the article mentioned, “More than 170,000 cases were laboratory confirmed, out of which 77% were due to Plasmodium vivax, and 23% were due to Plasmodium falciparum. P. falciparum was the causative organism for the more severe and fatal cases. Many challenges to response measures were highlighted when some flood-affected districts reported a two-fold increase in incidence rates, a high P. falciparum ratio, and limited stocks of emergency medicines, insecticides and supplies accompanied with a long lead time for procurement. Vector control is a vital component of prevention of vector borne diseases and elimination strategies as it is highly effective in preventing infection and reducing disease transmission.”</span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;"><br></span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 14px; white-space: pre-wrap; font-family: Helvetica;">September showed the most severe cases and deaths in Pakistan with 62 deaths and 25,932 confirmed dengue cases. In September alone, 74% of the cases were reported in Pakistan. Further, the other provinces were reported as follows, “83% of the total cases, of which 32% were reported from Sindh, 29% from Punjab (including the Islamabad Capital Territory), 25% from Khyber Pakhtunkhwa, and 14% from Balochistan as reported till 22 September, 2022”. Moreover, it is stated that hospitals were not sharing their data with the health departments properly.&nbsp; This shows that the results may not be accurate and are assumptions.</span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;"><br></span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 14px; white-space: pre-wrap; font-family: Helvetica;">The need for health services during a flooding event is a priority as UNICEF mentions that 82% of the people require health services. The World Health Organization mentions that 8 million people require basic health care and essential medical supplies during a flood. The report stated, “the floods being a major health emergency, it is estimated that Pakistan will require upwards of $81.5 million in relief funds to ensure coordinated delivery of essential healthcare services, stronger outbreak detection /control and severe acute malnutrition management.” The World Health organisation has strengthened disease surveillance by providing medical supplies and enforcing vaccination campaigns to combat the disease outbreaks and to treat malaria and most importantly to gain access to clean water.</span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 14px; white-space: pre-wrap; font-family: Helvetica;"><br></span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18px; white-space: pre-wrap; font-family: Helvetica;">The diseases that the flooding spreads</span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;"><br></span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 14px; white-space: pre-wrap; font-family: Helvetica;">Prior to the floods in Pakistan, the country was already experiencing outbreaks of malaria, dengue and COVID-19. Another disease called monkeypox has not been confirmed in Pakistan and research shows that this might have been due to inadequate testing taken by the World Health Organization. The waterborne diseases are prevalent in Pakistan and have increased due to the floods. Lama and Tatu have also sourced other studies to support their research,&nbsp; “Studies suggest that the main causes of diarrhoeal diseases in developing countries like Pakistan are due to organisms like campylobacter jejuni, rotavirus, shigella and E. coli. Other vector-borne neglected infections seen emerging in Pakistan are chikungunya, Japanese encephalitis, Crimean-Congo Hemorrhagic fever (Tick Bite), Leishmaniasis (Sand fly bite)”. Further, zoonotic diseases are on the rise as 33 million people have been displaced from their homes during the floods especially during human- animal interaction.</span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;"><br></span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap; font-family: Helvetica;">Other provinces are being affected by the Floods</span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;"><br></span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 14px; white-space: pre-wrap; font-family: Helvetica;">There is also a high population in Pakistan and its border countries, the article mentions, “particularly in Khyber Pakhtunkhwa province which borders Afghanistan where nearly 800 000 Afghani refugees live in districts officially considered calamity areas hit by floods. At such close proximity to other nations, the risk of international spread of diseases, especially vector borne diseases like malaria cannot be ruled out. It would be advisable for these bordering nations to step up their disease surveillance measures to prevent the spread of such disease outbreaks.”&nbsp;</span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;"><br></span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 14px; white-space: pre-wrap; font-family: Helvetica;">A scientific analysis shows that the floods in Pakistan were caused by climate change. Further, Pakistan is surrounded by 72000 glaciers, however, climate experts mention that the glaciers did not cause the flooding. The flooding was caused by heavy rains. Pakistan is known to be one of the places that is most vulnerable to climate change and yet it only contributes 1% of global greenhouse gas emissions. For changes to be made, the article mentions the following, “There is an urgent need to scale up disease surveillance, replenish health supplies, and restore damaged medical facilities and prepare for emerging infections with a focus on women, children and other vulnerable groups who continue to bear the brunt of this crisis.”</span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;"><br></span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;">A personal viewpoint on natural disasters</span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 18.6667px; white-space: pre-wrap;"><br></span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><font face="Arial"><span style="font-size: 14px; white-space: pre-wrap;">The important topics of COP27 were climate finance and loss and damage as a result of climate change. This is what Pakistan needs, the country needs a climate adaptation and mitigation plan for natural disasters such as flooding.</span></font></p><p dir="ltr" style="line-height:1.38;text-align: justify;margin-top:0pt;margin-bottom:0pt;"><br></p>