HEAVY rains have left Pakistan awash not just with floodwater but also disease. Across Punjab and Sindh, hospitals are overrun with patients suffering from mosquito-borne illnesses and waterborne infections. Entire neighbourhoods have turned into stagnant ponds, ideal breeding grounds for Aedes aegypti. The result is a surge in dengue cases, with malaria close behind. Dirty water is also taking its toll. Reports from relief camps describe children doubled over with diarrhoea, families struggling with gastric pain and vomiting, and doctors battling suspected cholera clusters. In makeshift shelters, skin rashes, eye infections and coughs are spreading fast. These maladies are hardly new. They return each monsoon, exposing the same underlying weakness: Pakistan’s creaking sanitation and drainage systems, and its chronic underinvestment in public health. The Met Office has issued a high-risk dengue alert from Sept 20 through early December, citing waterlogging, humidity above 60pc, and continuing rainfall as near-perfect conditions for the mosquito’s spread. Forecasts also point to further rainfall, raising fears of fresh flooding and prolonging the public health crisis.

Yet the response remains reactive. Provincial authorities issue warnings; local councils scramble to fog neighbourhoods against mosquitoes; hospitals plead for more medicines. International agencies deliver purification tablets and rehydration salts. But little is done to prepare before the rains fall. The result is an annual cycle of avoidable suffering, disproportionately borne by the poor who lack access to clean water or private healthcare. Breaking this cycle requires more than temporary relief. The government must invest in drainage and sewerage systems in its cities, where unplanned sprawl has outpaced infrastructure. Disease-surveillance networks must be strengthened so outbreaks can be tracked and contained swiftly. Relief camps need reliable supplies of safe drinking water and sanitation facilities. And vector control should be year-round, not merely after floodwaters rise. Unless preparedness replaces firefighting, each monsoon will continue to unleash misery.

Published in Dawn, September 17th, 2025