A Gender-Sensitive Emergency Response to Flood-Affected Areas in Pakistan

According to the World Health Organization (WHO), climate change stands as the single most significant health threat facing humanity in the modern world. Intriguingly, climate change is not solely a geographical phenomenon; it profoundly impacts society, exacerbating inequalities for already marginalised groups, particularly women and children. Hence, climate change is far from being ‘gender-neutral’. As per UN Women, as the climate crisis unravels, women and girls face various forms of Gender-Based Violence (GBV) and are less likely to overcome healthcare challenges, such as maternal issues, due to limited access to information, mobility, and decision-making abilities. These challenges are amplified in developing countries like Pakistan, which has been identified as one of the top 10 climate-vulnerable nations in the world.

In 2022, the devastating flood in Pakistan shook the entire nation, posing the greatest humanitarian crisis of the decade. The monsoon season brought with it disastrous floods that swept away not only homes and livestock, but also the livelihoods of millions of people, submerging 30 percent of the country under water. The UN estimated that over 33 million people were affected, with more than 2,100 lives lost and around 12,000 injured. Pakistan also faced massive economic losses, which amounted to over $30 billion. According to WHO, approximately 1,500 health facilities were damaged, significantly decimating the overall healthcare infrastructure in the affected areas.

These harrowing statistics are insufficient to capture the magnitude of devastation and challenges faced by marginalised segments of society, especially women and children. With the destruction of crops, inaccessible healthcare, water-borne and vector-borne diseases, 3.4 million children were at risk of malnutrition, 650,000 pregnant women and young girls in immediate need of assistance and vulnerable to escalating GBV. The crisis was further exacerbated by pre-existing structural gender inequities, aggravating issues like forced marriages, unintended pregnancies, unsafe abortions, and sexually transmitted diseases.

Such a pressing predicament necessitated the need for innovative impactful solutions to aid in mitigating the healthcare crisis precipitated by the floods. Indus Hospital & Health Network (IHHN), with its extensive network of free-of-cost tertiary and secondary care hospitals, along with its expansive primary care and public health initiatives, was duly equipped to address the crisis. Characterised by its multi-sectoral approach, diverse interventions, and gender-sensitive initiatives, IHHN’s transformative Primary Care Programme, marked by innovative preventive and curative interventions, has made a profound impact, benefiting over 9.2 million lives. This solid foundation equipped IHHN to be one the first organisations to launch its multi-sectoral, multi-layered, and gender-sensitive climate-resistant flood-relief programme in Sindh and Punjab in collaboration with UNFPA to facilitate sexual and reproductive health facilities, curb GBV, and empower women.

IHHN’s extensive flood relief programme comprised 2 Mobile Medical Buses (MMBs), 3 specialised Basic Emergency Obstetric & Newborn Care (BEmONC) facilities and 327 medical camps. The program was pivotal in ensuring access to vital healthcare services to the most vulnerable. The MMBs, equipped to provide comprehensive reproductive health services and safe delivery assistance, including antenatal care, postnatal care, family planning counselling, and skilled deliveries, addressed urgent needs of 120,332 women requiring critical care. Meanwhile, the BEmONC facilities emerged as vital sanctuaries, delivering emergency obstetric care and conducting over 1,434 skilled deliveries, significantly reducing maternal and neonatal mortality rates. Moreover, the medical camps, through specialised consultations, catered to the essential healthcare requirements of 27,172 patients, with a significant focus on women’s health needs. Thereby playing a pivotal role in alleviating the suffering of women from these disaster-stricken communities.

Optimising Telehealth, IHHN bridged healthcare gaps, offering remote consultations in fixed sites along with five HumWell health clinics. These telehealth services facilitated access to healthcare professionals for consultations on SRH issues and provided reproductive health services to women and girls in remote areas. Over 5,320 patients benefited from fixed Sites and HumWell mobile units, including Gynae patients, general OPD patients, and telehealth deliveries.

In light of surging GBV, IHHN created 18 Women & Girls Friendly Spaces (WGFS), provided psychosocial support, distributed dignity kits, and created awareness about GBV and SRH. Staffed with trained personnel, WGFS were used as central hubs for the provision of Psychosocial Support (PSS), GBV, and SRH awareness, GBV referrals and case management, and various recreational and vocational activities such as performance art, story-telling and sewing; this benefitted 142,925 women and girls. Moreover, through PSS, trained officers were deployed at each WGFS to address mental health concerns through awareness programmes, consultations, therapy, mediation sessions, and first aid. The GBV and SRH awareness sessions spanned a wide range of topics, including menstrual hygiene, family planning, women’s rights, child rights, forced and early marriages, mental health, HIV and STIs. These sessions laid the groundwork for further discourse and potential attitude shift, especially among men, benefitting 144,448 people in total. Finally, for economic empowerment of women, IHHN organised certified 8-week long training courses, led by professionals in sewing, and beautician skills. These initiatives profoundly impacted the lives of women as one of them shares, “WGFS has been my foundation during the toughest times. It is where I rediscovered hope and resilience.”

In poverty-stricken communities tormented by floods, IHHN emerged as a beacon of hope with its climate-resilient healthcare infrastructure and gender-sensitive emergency responses. It offered critical psychosocial support, and empowerment opportunities for women and girls in flood-affected areas, highlighting the necessity for inclusive climate resilience strategies.

• Supplements