To put it simply: we in Pakistan are not prepared for natural disasters. One reason may be the fatalism that afflicts us and that God will be our saviour when calamity strikes. In fact, we leave much undone for God to step in to help when need be. No surprise then that during the few months of the year when our rivers run low, nomads, and sometimes even settled groups, build their homes in riverbeds. The Ravi River outside Lahore1 is a prime example of this occurring year after year.

It is also known that in the summer vacation district of Kalam (Swat), a hotel sitting right on the banks of the Swat River was swept away in the 2010 floods. The following year, the owner rebuilt his property on exactly the same spot. In 2022 it was washed away once more. There is a very slim chance that a lesson was learnt.

Downstream of Attock2, the River Indus creates a wide floodplain through Punjab and Sindh. In Punjab, the river flows virtually straight as an arrow in a south-westerly direction. But in Sindh it is an immense web of oxbows with very shallow banks. The fall of the land stretching up to almost 10 kilometres here is less than a metre. Moreover, unknowing to many, the soil of lower Sindh is virtually impermeable. Here water takes years to percolate into the aquifer.

It was seen that the water left behind by the deluge in 1987, was still sitting in the ditches by the roads five years later. In the districts of Badin and Mirpur Khas, lakes had formed where migratory birds like flamingos and pelicans were wintering in 1992. Likewise, the dry oxbows of the old bed of the Indus in upper Sindh turned into major water bodies that remained for several years.

The flood of 2010-11 was one thing. In 2022, it was simply biblical. Throughout Sindh, men related that once the deluge began in July, it continued for a full forty days with short gaps in between. Whereas mud and wattle huts stood no chance under the cascade, even brick and masonry homes started to collapse after a couple of weeks. These latter are of two types. The one with a proper cement concrete slab lintel for the roof; or the less expensive one with a girder and cross strips inlaid with tiles. In many cases the walls are just one brick thick.

As the skies sent down cascades of water, the Indus too rose from the deluge in its upper reach. Millions of acres of farmland went under as the oxbows overflowed turning the land into a very sea. Date groves with their fruit ready to be picked were flooded killing off the trees at worst and best damaging the fruit. Sindh, famous for its cotton output, lost virtually all of its cotton crop. The vast vegetable patches in the floodplain that had remained dry since 2011 were drowned.

When it is not in spate3, the Indus floodplain is very fertile farmland and all along its course through Punjab and Sindh the loamy soil is used extensively for wheat and vegetables that can be harvested before the summer thaw in the mountains reaches the plains. In 2022, farmers along the river were able only to reap their wheat and collect their vegetables before May. Anything that remained on the stalk was destroyed.

This year, there was no farmer in the Sindh plains along the river who so much as made good their agricultural expenses. And since the practice has long been to make this investment on credit, thousands of farmers went under huge debts.

Loss of agriculture was something that could have been overcome and indeed the milder monsoon of 2023 has ameliorated the agricultural scene to only a little extent because when sowing of wheat commenced in December, the soil was still waterlogged. As a result, the yield was very poor in March. If submerged farmland has to be reclaimed it needs a giant effort by the government to pump out the water. Individual farmers who can afford it have been seen doing such dewatering, but the magnitude of the job is way beyond the capacity of individuals and the civil society.

However, it was the loss of housing that broke the backs of the farming communities across Sindh. With their incomes lost, they were unable to rebuild and a year after the deluge, innumerable families are still living under makeshift shelters.

The cash assistance of PKR 48,000 (Approx. USD 156) in four equal instalments to affected families under one of CWSA’s flood response projects, was some help but as Shams Din a sharecropper of village Ismail Sanjrani (Khairpur) said it was like ‘salt in the flour’, in reference to the pinch of salt added to flour before kneading. His two-room house built many years ago was a heap of bricks and clay after the deluge and the cost of full reconstruction with current inflation was PKR. 300,000. With the little help he had received, he hoped to raise the walls to lintel level. Across it, he said, he would stretch the tarpaulin that currently made his home.

Even holders of ten acres of irrigated land in the district were hardly any better off. With their agriculture completely lost, and their more spacious houses either completely razed or with just the walls rebuilding would cost way more than what poor Shams Din does not have. The hope in early 2023 was that there would be no visitation and that their agriculture would yield sufficient profits to start rebuilding.

The greater losers, however, are owners of fruit orchards. Lemon, mango and date that grow abundantly in Khairpur district yielded nothing leaving fruit farmers under huge debts. The flooding left large number of these trees not just fruitless, but dead. Some of these orchards, particularly lemon, were planted only three years before the flood and the owner had barely repaid the loan for the purchase of the trees. Just when they thought they were heading for a profitable harvest, all was lost.

In the south in Mirpur Khas district, the story is not very different. Thousands of acres of farmland now look like lakes. Here the damage was done as much by the nonstop rain as it was done by the overflowing Left Bank Outfall Drain (LBOD). For years this drain meant to carry effluent to the sea had been no more than a trickle. Consequently, influential landowners encroached upon its course, blocking it to create farms where historically only barren land had spread.

When the Indus overflowed and with it LBOD, towns and villages around Jhuddo went under. The damage around Jhuddo was mainly because of the unofficial damming of LBOD in its lower reach: it may have blocked tainted water flowing into the farms of the rich and powerful, but it created havoc for ordinary people.

While housing and agriculture was lost, the additional damage was done by the overflowing of effluent from LBOD. The common complaint here, as in Khairpur and other areas, was that flooding had tainted their hand pumps. Thousands of people were therefore drinking poisoned water causing skin and gastro-intestinal diseases. Primary health care units were unable to cope with the flood of humanity pouring in without outside help. Health camps established by CWSA provided some succour. The disaster was simply too great and widespread for its effect to be mitigated by these heroic but small initiatives.

While the civil society has been hard at work, their effort is still too little compared to the impact the floods of 2022 has had on the people of Sindh. A greater effort is needed to bring back people’s lives to normal.

  1. Capital city of Punjab province. The second largest city in Pakistan and 26th largest in the world, with a population of over 13 million.
  2. It is the headquarters of the Attock District and is 36th largest city in the Punjab and 61st largest city in the country, by population.
  3. A sudden flood in a river

Village Dharshi Bhagat lies by the road connecting Samaro town with Samaro Road; the latter being the town’s railhead where the old abandoned metre-gauge railway station still stands for the first two weeks after it started in late July, the rain did not stop for a minute. Thereafter it continued to teem down with brief intervals lasting never more than some minutes until the village went under a metre of water.

Twenty-five-year-old Heeru was only days from delivering her baby when it started. As the water rose, she and some other women made a desperate run to save whatever little cotton they could from the fast drowning field they had so carefully tended the land they worked as labourers. The struggle in mud and water was worth only a few thousand rupees.

With the village going under water, she and her family left their home and the fields and moved to the only stretch of road that was above the dark water. For three months, they lived under a makeshift shelter of bamboo poles holding up plastic sheeting for a roof. It was good fortune that Heeru had salvaged some cotton and there was some cash for food because in the time of the rising waters, she gave birth to her second child, a daughter. When her pains began, her husband hired a motorcycle and ferried Heeru to the Basic Health Unit at Samaro Road where she fortunately got the attention of the doctor and a safe delivery.

Not long after the birth of the child the meagre cash in her kitty ran out and her family subsisted on chilli paste and roti. Their one goat provided a small amount of milk daily. It was a hard life for the family, especially so for the young lactating mother.

Heeru recounted how her firstborn, a son, had died two years ago aged just four months. The child had gone down with fever and convulsions and though the Basic Health Unit at Samaro Road was just 4 km away, the parents were tardy in taking him there. For five days the poor child suffered and when they eventually did get to the BHU, the doctor could do nothing to save the baby.

For some inexplicable reason, seeking medical assistance was simply not a priority for these poor people. They still relied on folk medicine and even considered milk tea some sort of panacea.

Dharshi Bhagat, who gives his name to the village, said Heeru’s husband was lucky to be able to rent a motorcycle because shortly after, the only transport capable of plying on the submerged roads were big four-wheel drive vehicles. An ailing person had to be carried either on a string bed or piggyback all the way to the units either in Samaro or Samaro Road. And this was a time of rampant disease. Fever, skin infections and diarrhoea were raging in the makeshift camp strung out along the road. In that desperate time of zero income, men were seen carrying the ailing to the BHU.

In mid-October, the first Community World Service Asia’s medical mobile unit reached this village. The village was still submerged and the mobile unit had to be parked on the road, the only strip of land free of water. Dharshi Bhagat said this came not a day too soon for who would not have appreciated this gratis service at the doorstep in that time of great adversity.

Lady Health Visitor Farkhanda said the mobile unit had been on the road for ten weeks moving from village to village and treated on average a hundred and fifty patients every day. On the first visit to Dharshi Bhagat, they had a similar number between nine in the morning and three in the afternoon. Referrals of more complicated cases was made to the Samaro town hospital. Common complaints were malaria, water-borne gastro-intestinal, eye and skin infections. This time around, respiratory tract infections had increased and the demand was for ‘pills for strength’, as multivitamin tablets are referred to.

Outside, among the crowd of men waiting to consult the doctor Bhoomo said he felt weak and his ‘liver burned’ and showed a handful of blister-packed multivitamin tablets and an antacid.

“The first time the medical van visited our village, I was suffering from the same, but I had been out cutting mesquite to sell in neighbouring villages and I missed my chance to see the doctor,” said Bhoomo. For him his suffering was secondary. Most essential was for him to make some little cash for food.

Why hadn’t Bhoomo gone to the hospital in town during all this time? “I have no money, the fare out and back is Rs 40, and after I spend a day cutting mesquite, there is only enough cash to purchase food for my family of nine. I cannot afford to go to town.”

On the second visit in mid-November the mobile health unit had in just two hours treated one hundred and thirty patients. And an equal number waited patiently outside. Some like Dheero said they had no complaint and had come only to watch the goings on; most others complained of stomach ache and fever. Nearly all of them had either simply suffered stoically or experimented with folk medication to no effect. The lament was the same all around: they had no money to visit the hospital in town. And they could not afford to take time off from their struggle to earn some money.

Listening to the very vocal Kasturi, suffering in silence seemed to come naturally to them. She had a reasonable income from working as a seamstress while her husband was a door-to-door clothier. Their once comfortable life was now reduced straitened circumstances.

“The crops have all been destroyed. There is no work and therefore no money. Who can order new clothing in these times? The Lord is kind, I took great precautions and my three children did not fall ill, but families with illness could either feed themselves one, or at most two, meals a day. They did not have the means to make frequent trips to the Samaro hospital.”

Dharshi Bhagat was right: the mobile unit had come not a day too soon.

With the support of our partners, CWSA has initiated flood response in the most affected villages in Khairpur District of Sindh.

Latest monsoon rains in Pakistan have once again lead to widespread flooding, taking lives, damaging roads, and disrupting the lives of thousands of local communities that were already grappling with recovery from last year’s floods. The 2022 floods had a profound impact on a large population of Pakistan’s mostly rural community, affecting 33 million people across the country and claiming 1,739 lives1.

CWSA’s health team conducted health consultations and sessions in Ghulam Shabbir Kalhoro village in Taluka Kingri.

In initial response to the current floods, Community World Service Asia’s emergency team has conducted assessments in twenty-five villages, which were previously affected by last year’s floods, within the Khairpur district. This new wave of floods has again ravaged agricultural lands, livestock, and infrastructure of communities living in Taluka2 Sobhodero and Kingri.

The Mobile Health Unit visited different villages to provide primary healthcare to flood affected communities in Khairpur District.

More than 5,600 people and a total of 1,149 households in the two talukas have been severely affected by the latest round of floods. Many affected families have sought refuge on higher grounds. Some women and children have decided to stay in their homes, with the men of the families venturing out in search of daily wages and essential supplies to ensure basic survival at this time of crisis. As connecting roads to this part of the district remain submerged, affected communities have again resorted to using boats to access main roads.

Affected communities in Jummo Panhiyar village were provided with OPD consultations and free medicines.

Community World Service Asia, with the support of its partners, has launched immediate humanitarian response activities to support affected communities in Taluka Sobhodero and Kingri. Through our response, we are providing essential health services through mobile health units, offering curative and preventive consultations, outpatient care, antenatal care, postnatal care, health counseling, and health awareness sessions. The awareness sessions focus on preventive diseases, maternal and neonatal healthcare, and hygiene. Affected communities are in urgent need of food, healthcare services, veterinary support for their livestock, and assistance with transportation through boats to meet their survival needs during this crisis.

Affected communities have again resorted to using boats to access main roads.
The floods have again ravaged agricultural lands, livestock, and infrastructure of communities in Khairpur.

Note: Situation Update 1 on this emergency can be read here.


Shama Mall
Deputy Regional Director
Programs & Organisational Development
Tele: +92-21-34390541-4

Palwashay Arbab
Head of Communication
Tele: +92-21-34390541


1. National Disaster Management Authority (NDMA)
2. In Pakistan, a tehsil or (taluka) is an administrative sub-division of a District.

Photo credit: CWSA staff in Khairpur, Sindh

According to the Flood Forecasting Division, the River Indus has experienced high flood levels at Guddu Barrage, with inflow ranging from 4,70,000 to 5,10,000 cusecs. Additionally, at Taunsa and Sukkur barrages1, Indus has been at a medium flood level.

This week’s monsoon rainfall in the upper catchment areas of the river has caused a surge in water levels at Guddu Barrage, with an inflow of 4,81,913 cusecs and an outflow of 4,61,563 cusecs.

In Ghotki2, a breach in the Zameendari Bund at Indus has resulted in the submergence of cotton, sugarcane and other crops and the disruption of land links for over ten villages, as shared by local sources. Another twenty villages in the Katcha area of Dadu district3 have also been flooded, leaving hundreds of acres of crops submerged. The situation has led people to move to safer areas on their own.

The Flood Forecasting Division predicts that River Indus will reach high flood levels at Guddu and Sukkur barrages within the next 12 to 24 hours, attributing the higher flows to rainfall in the river’s upper catchment areas. The upsurge in water level has also caused flooding in the katcha4 area of Pir Jo Goth and Gambat taluka in Khairpur district, leaving over seventy settlements stranded and at risk. Over 700 households of village Pandhi Mallah in district Khairpur have been left flooded after last night’s rains, with its people displaced and relocated to safe grounds, and disconnected from access to roads.

In upstream areas, the Indus River is experiencing low flood levels at Tarbela, Kalabagh, and Chashma, and medium flood levels at Taunsa Barrage.

Community World Service Asia Response:

Community World Service Asia’s emergency team is in communication with relevant stakeholders, including local authorities, disaster management agencies, and expected affected communities to ensure effective coordination and a timely response. Our team is on the ground, closely monitoring the situation and will immediately start relief operations when and if required. While focusing on preparedness, CWSA has developed a robust emergency response plan that outlines specific roles, responsibilities, and procedures to ensure a coordinated and efficient flood response.


Shama Mall
Deputy Regional Director
Programs & Organisational Development
Tele: 92-21-34390541-4

Palwashay Arbab
Head of Communication
Tele: +92-21-34390541


1. Sukkur Barrage is a barrage on the River Indus near the city of Sukkur in the Sindh province of Pakistan. Sukkur Barrage is used to control water flow in the River Indus for the purposes of irrigation and flood control. Head Taunsa Barrage is a barrage on the River Indus in Taunsa district of Dera Ghazi Khan DistrictPunjab province of Pakistan. And also controls water flow in the River Indus for irrigation and flood control purposes. 

2. Ghotki District is a district of the province of Sindh.

3. Also in Sindh

4. Riverine area