Unprecedented monsoon rains, which started in June, caused extensive destruction across the country, leaving more than one-third of it under water. In one of the worst flooding disasters in Pakistan’s history, millions of people were forced to leave their villages and spend months living in camps, often without shelter or access to basic needs such as clean drinking water.  

People lost their livestock, food stores were destroyed and land was damaged, making it unfit for the next planting season. All this has had an impact on food security, and our teams reported very concerning numbers of malnutrition and malaria cases in east Balochistan and Sindh.  

In Sindh, our emergency teams ran six mobile clinics which visited over 24 different locations per week in Dadu, Sanghar, Jacobabad, Sukkur and Shahdadkot districts. Most patients presented with skin diseases, malaria, respiratory tract infections, malnutrition and diarrhoea. In the makeshift ‘tent city’ set up in Keamari district, Karachi, to accommodate people displaced by floods, MSF teams provided more than 800 tents, as well as shower points and latrines. 

In eastern Balochistan, our teams ran outpatient general health services for people affected by the floods in Naseerabad, Sohbatpur, Jaffarabad, Usta Muhammad and Jhal Magsi districts, treating more than 1,000 patients a day.

Areas of stagnant water were a major contributor to the rise in the number of people with water- and vector-borne diseases. In October, our water and sanitation teams installed a water filtration plant, with a capacity of 270,000 litres per day, in Jaffarabad district. The clean drinking water was delivered by trucks to flood-affected villages and displaced-person camps in eastern Balochistan and in Dadu, Sindh, helping to mitigate the risk of waterborne disease caused by contaminated water.

In Khyber Pakhtunkhwa province, MSF installed water filtration systems, and cleaned and decontaminated 800 wells in flood-affected villages in Charsadda district. The aim was to rehabilitate 1,500 wells by March 2023.

MSF also conducted outpatient general healthcare consultations in the province in the early stage of the emergency, and distributed essential items, such as hygiene and cooking kits, to thousands of families in Charsadda and Nowshera, and in DI Khan district.

Overall, our teams in Balochistan, Sindh and Khyber Pakhtunkhwa provided millions of litres of clean drinking water, and distributed tens of thousands of relief packages, including tents, cooking kits, hygiene items and mosquito nets, to people affected by the floods. 

Regular activities 

Despite some interruption caused by the flooding, we managed to maintain most of our activities throughout the year, including our reproductive, neonatal and paediatric care services at five different locations in Balochistan and Khyber Pakhtunkhwa provinces.  

We strengthened our support to DHQ hospital in Dera Murad Jamali, Balochistan, by sending additional medical and non-medical experts, and increasing bed capacity from 40 to 69 to address increased needs linked to the floods.  

In addition, we assisted local communities, Afghan refugees and people in border areas by running emergency obstetric services and nutrition programmes, and ensuring the management and referral of critical trauma patients. We also continued to operate our cutaneous leishmaniasis programme in Balochistan and Khyber Pakhtunkhwa provinces, and started a project to address cutaneous leishmaniasis in Dadu, Sindh province.  

In Karachi, Sindh province, we continued to run a hepatitis C project in the informal settlement of Machar Colony and support COVID-19 vaccination activities, focusing particularly on undocumented people.  

In Gujranwala, Punjab province, we diagnosed and treated people with multidrug-resistant tuberculosis, implementing a decentralised approach that enabled patients to receive care nearer their homes.  

In November, we ran training sessions for key female medical officers, health workers and community midwives from Khyber Pakhtunkhwa on the correct use of oxytocin and other labour-inducing drugs.  

At the end of 2022, after 11 years, MSF’s comprehensive emergency obstetric and neonatal care hospital in Peshawar closed. The project was opened to address the needs of neglected communities in the area, such as Afghan refugees and internally displaced people, and provided free-of-charge care. During the life of the project, we assisted over 54,400 deliveries.