The National Disaster Management Authority (NDMA) on Thursday warned that extreme heatwave conditions would persist across parts of Sindh and Punjab in June, with temperatures likely to remain above 48 degrees Celsius.

The authority’s National Emergency Operations Centre said that Umerkot, Tharparkar, Tando Ala Yar, Matiari and Sanghar districts in Sindh are expected to be affected, while in Punjab, Rahim Yar Khan and Bahawalpur are most likely to experience heatwave conditions.

In its advisory, NDMA also said that from May 31 to June 5, dust storms, gusty winds and light rain are also likely to occur in the upper regions of the country.

Extreme Weather Conditions

On Thursday, harsh weather conditions persisted across the Sindh province, even though temperatures dropped in most cities.

The Met Office recorded the maximum temperature in Jacobabad at 50.5°C, followed by Dadu at 49°C . Except for Karachi, which barely missed the mark with a high of 39.5°C and 63 per cent humidity, all other cities in the province registered temperatures above the 40 degree-mark.

Severe heatwave conditions persist across most parts of the province with daytime maximum temperature being 6-8 degrees above normal in Dadu, Kambar Shahd­adkot, Larkana, Jacobabad, Shik­arpur, Kashmore, Ghotki, Sukkur, Khairpur, Naushahro Feroze, Shaheed Benazirabad districts and 5-7 degrees above normal in Sang­har, Hyderabad, Mitiari, Tando Allah Yar, Tando Moha­mmad Khan, Mirpur Khas, Umerkot, Tharparkar and Badin districts.

The heatwave conditions are likely to persist till June 1st.

Warning the authorities to remain alert and take necessary measures, the NDMA advisory urged citizens to stay hydrated, avoid outdoor activities between 11am and 3pm.

Many labourers from remote areas travel daily to cities for work, but the current heatwave has severely disrupted their livelihoods pattern and led to worsening health conditions. The extreme heat makes commuting difficult.

The heatwave has also impacted people staying at home, as inconsistent electricity and lack of cooling options limit their ability to cope with prolonged heat stress. The ongoing hot and dry weather is stressing water reservoirs, crops, vegetables, and orchards, while also increasing energy and water demand, which is difficult to manage during the current crisis.

Community World Service Asia’s Response:

Community World Service Asia (CWSA), in collaboration with district authorities, has established a heatstroke centre/camp at the District Headquarters (DHQ) Hospital in Umerkot. The CWSA team initially launched their services by providing cold drinking water, conducting awareness sessions, and referring heatstroke patients to the DHQ. These awareness sessions are delivered directly to pedestrians, patients, and their attendants, messages to prevent heat strokes and raise awareness on precautionary measures are also broadcasted over speakers for public awareness. Every day, more than 1,000 people visit the centre to quench their thirst, as there is no fresh water facility available nearby to them. People not only come to drink water but also carry some back for family members or relatives who are hospitalised at the DHQ. So far, 20 critical patients have been referred to the emergency department after receiving initial treatment.

The CWSA health team has set up heatstroke corners at each public dispensary operated by CWSA to manage emergency cases and serve patients visiting from nearby villages seeking urgent medical services in the extreme heat. The team provides cold drinking water, first aid, ORS, and glucose sachets to visitors seeking medical care.

With additional support, CWSA also plans to establish three heatwave facilitation centres for three months in Umerkot district which will offer clean, cold drinking water, juice and shaded rest areas. Each centre will have generators, pedestal fans, stretchers, necessary furniture, basic medical equipment, and medicines. Two Lady Health Visitors (LHVs) and two medical technicians will rotate among the centres. The paramedic staff will perform emergency procedures such as checking blood pressure, administering medications, clearing airways, and initiating IVs if necessary. They will also apply cold bandages or towels to reduce body temperature. Critical patients will be referred to the nearest healthcare facility, with transportation provided.

These centres will also distribute informational, educational, and communication (IEC) materials to raise awareness about heat-related illnesses. The centres will operate throughout the peak summer months until the end of August.


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

Palwashay Arbab
Head of Communication
Tele: 92-21-34390541-4

Relief Web
Pakistan Metrological department

Pakistan’s National Disaster Management Authority (NDMA) has issued a heatwave alert for most parts of the country, especially for Punjab and Sindh provinces.

“It is forecasted that heatwave conditions are likely to develop over most parts of the country, especially Punjab and Sindh from May 21 and likely to advance into severe heatwave conditions from May 23 to May 27,” announced NDMA on Thursday.

The forecast delineates three separate heat wave spells. The initial spell is expected to persist for two to three days, followed by a subsequent spell lasting four to five days towards the end of May. Temperatures are anticipated to further escalate up to 45 degrees Celsius in June. The NDMA spokesperson has cautioned about the likelihood of a third heatwave spell in the initial ten days of the month, which could last for 3 to 5 days.

The NDMA underscores that heat waves will impact both human and animal populations, necessitating proactive measures before the onset of the anticipated heatwaves nationwide.

During the second heatwave, which is anticipated to persist for four to five days, the impact is expected to be felt particularly in Tharparkar, Umerkot, Sanghar, Badin, and Khairpur districts of Sindh.

Reflecting on past experiences, Pakistan encountered its worst heatwave in 2022, as highlighted in the 2022 report by Amnesty International. The report underscores the lethal repercussions of extreme heat, especially for more vulnerable communities and populations such as children, the elderly, individuals with disabilities, and those with chronic diseases.

Heatwaves exacerbate health conditions, leading to heat strokes, cramps, and aggravating pre-existing health issues such as diabetes, ultimately culminating in fatalities or accelerated deterioration of health.

Warnings have been issued by the provincial and district governments in Sindh, Punjab and KPK provinces of extreme weather in coming days and have advised people to take precautionary measures such as drinking plenty of water and avoiding direct exposure to the sun. The government is seeking assistance from humanitarian organisations in establishing heatwave camps/centres where affected people may find shelter and cold water, as well as receive basic first-aid treatment.

Community World Service Asia’s Response:

Community World Service Asia (CWSA), in partnership with district authorities, plans to establish four heatwave centres or camps in Umerkot district. These include one central site in Umerkot city and three additional camps near health facilities already supported via CWSA projects: Government dispensary Ramsar, Government Dispensary Jhamrari, and Government Dispensary Cheelband. These camps aim to offer basic services such as first aid, shelter, seating, clean drinking water, and juices to vulnerable individuals in the area, including pedestrians exposed to the sun and at risk of dehydration. With the expected rise in heatwave occurrences, CWSA will plan to expand its efforts to provide similar assistance, as well as first-aid treatment and public awareness campaigns in areas where it maintains operational presence.

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

Palwashay Arbab
Head of Communication
Tele: 92-21-34390541-4

Relief Web
Pakistan Metrological department
The Nation Newspaper
The Dawn Newspaper

Lal Ji, his wife and three children of village Umeed Ali Chandio just outside Nabisar (Umerkot district) live in a very neat, well-kept, almost picturesque home. He is a landless farmer who works eight acres of a landlord’s holding and shares the proceeds with the owner. But he blindly followed farming procedures unchanged for centuries. He cites the example of how millets, guar and mauth lentils were sowed all together in the same plots despite each having a different ripening time.

“When the first crop was ready and we harvested, we damaged nearly half of the remaining unripe species underfoot and with the sickle. That was the way passed down to us by our elders and it simply did not occur to us that planting each specie in separate plots could double the yield of those ripening later. It had to be the staff and trainers of this organisation (Community World Service Asia (CWSA)) to teach us how to do the right thing under!” says Lal Ji.

Asked why it was like that and why he or other farmers did not think logically to increase their yield, Lal Ji simply shrugs and says that was the way of the elders. “But now we are awakened and I am myself surprised how such a simple thing eluded us,” he adds.

If that ancient practice put Thar farmers at a disadvantage, the periodic disasters added to the deterrent. In 2021, Thar was invaded by a pestilence of locust. That year Lal Ji had invested PKR 40,000 (Approx. USD 143) in the eight acres he was farming. This sum had all been borrowed from the landlord and when the locusts wiped out every last bit of green from his fields. He went under debt and had to live by selling off some of his livestock. The year that followed was hardly any better. If there was no locust, the summer rains failed and once again Lal Ji kept body and soul together by disposing off some more of his livestock.

The beginning of 2022 brought in succour. The multi-purpose cash grant, agricultural and vegetable seeds together with training under CWSA & DKH’s food security and livelihood support, smoothed the bumpy road Lal Ji was treading. His excitement about learning to plant millets, guar and mauth in different plots is still viable two years after learning this evident truth. The cash grant helped him pay off his debt and the year when the rest of Sindh was drowned out by the worst deluge known in living memory, his fields in the troughs of the dunes did well with the natural irrigation.

In December 2023, he recounted how he had harvested 400 kilograms each of millets, guar beans and mauth. The millets he kept for his family while the rest he sold. However, being the judicious man that he is, Lal Ji retained enough seeds for his 2024 summer plantation.

Another thing that Lal Ji and the others learned in the training was that selling the harvest wholesale fetched better prices. Earlier they would be approached by the bania (Indian caste consisting generally of moneylenders or merchants) from town who would offer the farmers a price for the standing crop. Since these poor farmers did not have the means to truck their harvest to the market, they reluctantly accepted the offer even when they knew it was fifty percent below the market price. Those who did not, would harvest and pack 40-kilogram sacks to haul to market by donkey as and when they required cash. Though they got marginally more per kilogram than selling the standing crop, the price was still below the market rate.

The training taught them to work cooperatively. In late 2022, when the separately planted crops were nearing harvest, the bania arrived with his offer only to be disappointed. He was told that this time the farmers were to bring their goods to him. And so, Lal Ji and five others filled up their sacks, hired a pick-up truck and hauled the harvest to the market where they sought the best buyer. The profit astonished the group. Once again Lal Ji is amazed why they had not thought of this simple mechanism by themselves.

It takes motivation, a bit of awareness raising and the freedom from worry for communities to think of the future. Following the first CWSA intervention, the village organisation repeatedly beset the District Education Officer and got a regular teacher for the village school who, they insisted, must be a local person and not from another district. This was to ensure interest and regular presence. The teacher, a Nabisar young man, now attends school daily.

Meanwhile, Lal Ji sends his two sons and daughter to the school in Nabisar town. They walk the three kilometres to and fro. For pre-teenage children that’s a tough walk through the sand, but Lal Ji says that the produce of the kitchen garden has added so much vigour to their lives for the children to even be tired when they return in the afternoon. “They also take PKR 20 each for something to eat from their school tuck shop,” says the man.

Sixty rupees daily sounds expensive and Lal Ji says he had always given his children this daily allowance. In days of adversity, he borrowed the sum from the village shop keeper. Now he gives it out from his own purse.

Almost breathless in his narration Lal Ji moves on to the boon of hydroponic agriculture. It is the greatest discovery in Lal Ji’s vocabulary. He shows off his trays of young maize seedlings and narrates how he has already fed one round of this miracle to his three goats even as the second is ready for cutting. The two goats that are in milk have markedly increased yield and his wife is able to give the three children half a glass each with breakfast.

A few houses away, young Bilawal is a livestock keeper with thirty goats who had long supplied the village with dairy products. He too has hydroponic trays in a shed for his livestock and has already fed his livestock three rounds from them. He says his four trays are too few for his stock and plans to increase them to twelve.

“Earlier I got not more than 250 ml of milk a day from each goat. This hydroponic feed is always available, even in the driest part of summer. And now my goats yield twice as much milk,” recounts Bilawal. From the five to six litres of milk from ten lactating goats he produces yogurt and clarified butter (ghee). While the yogurt is used at home, the ghee is a cash produce.

Bilawal says that livestock feed was always a problem during the drier months of summer. As a result, milk output almost dried up during those times. But since he has discovered hydroponic gardening, his goats are yielding very well. If things go well, Bilawal hopes to add a couple of buffaloes to his stock before the end of 2024.

It seems the livestock farmers of village Umeed Ali Chandio have hit the lode.

Sorath lives in village Thantrai, a thirty-minute bus ride from Umerkot, with its schools and colleges. Yet she is a farm labourer and has never received any formal education. So is her husband. But her daughter and three younger sons all attend a primary school about two kilometres from the village. Though she now feels it should have been that way for her as well, but even for her children it was not always like this.

Why, only four years ago, like every other woman, Sorath too was against sending her daughter to school. For one, it was a bit of a walk from home and then girls were not supposed to be educated ‘lest they get strange ideas in their heads’. As well as all that, as farm labourers, she and her husband rarely got work every day and their monthly average income was never above PKR 5000 (Approx. USD 18). That would have been too little to maintain four children’s education despite school being free.

Rewind three years into the past and one finds Community World Service Asia’s social mobilisers visiting the village. The awareness raising sessions that followed had a deep impression on this apparently very clever woman. Here was talk of the equality of genders and of the ability of women to do anything that a man could and yet also give birth which man could not. Here she heard that it was because of all this that the girl child had the same right as her brother to be educated.

“I thought to myself that I have been illiterate all my life and therefore condemned to being a farm labourer who spends full summer days picking cotton for a mere PKR 300 (Approx. USD 1). Why does my daughter have to be similarly handicapped?” says Sorath. After the first couple of sessions with the social mobilisers, Sorath took her daughter to school where she learned that without the children’s B Form1 as issued by the National Database and Registration Authority, the children could not be enrolled.

That was the first thing Sorath and her husband went after. Armed with that document the girl who, in the words of her mother, ‘just growing old helping me with housework’ was put in school. Sorath now became the sole crusader in Thantrai for the cause of girls’ education. She went from door to door exhorting parents to step out and do the needful. Those who mouthed the ancient ‘wisdom’ of denying girls education were sharply rebuked and presented with the example of her own daughter in school. She taunted parents for planning their daughters’ future to be just as their own past and present had been. Unrelenting in her canvassing, Sorath soon had forty girls from her para (precinct) of the village in school.

“My daughter is so happy about her education, she is up early and dressed long before it is time to walk to school. She gets her brothers ready and then goes around the para coaxing the other girls to hurry,” says Sorath. Unsurprisingly, the girl who started late is already in Grade 3 and doing well.

In acknowledgement of her school enrolment campaign, the District Education Office organised a seminar in Umerkot where Sorath was a delegate. But on stage, she experienced a bit of a stage fright and did not say as much as she would otherwise in community consultations and her door to door campaigning. Nevertheless, the officers in attendance saw the fire inside and resolved to take her to the provincial seminar in Karachi. Sorath says she had never even been to Mirpur Khas and was in a state of sheer fright that she would be lost in the city. Even though no one from her family had ever been to the city, she planned to take her husband, father-in-law and her three sons to help her navigate the big city. It took some considerable effort by Nusrat, the CWSA social mobiliser, to assure her that all would be well because she would be with Sorath. In the end, her husband only accompanied her.

Once in the city, Sorath and her man, despite being chaperoned, were alarmed. The tall buildings, the speeding traffic, the endless bustle of the sea of humanity were all new to them. Seeing the signs on the roads, Sorath says she thought of her daughter who would have been able to read for them and know which way to go and a wave of satisfaction swept over her for having done the right thing in sending the child to school.

Before she was called on stage, a short documentary about her life in the village was screened. Only three days earlier, a team had arrived with an ‘airplane’ (drone) to film her at work around the home and now the whole world was seeing how she, a simple farm labourer, spent the days of her life. As she was called to step onto the stage, fright took hold of her. But once behind the lectern, that fear dissolved, and Sorath spoke of how CWSA social mobilisers had altered her view on the need for education for the girl child. And that she became the first mother in the village to send their daughter to school.

She spoke of her tireless campaign around her village for families to procure the B Form for their children without which they could not be in school. And she told the audience how she had virtually harangued women to not be afraid of their daughters’ education. In the end she demanded of the provincial education minister to provide her village a school – one that was preferably secondary level. The applause was respect and appreciation Sorath had never known before. One hopes that the minister’s promise of seeing to it that the village had a school was not drowned out in the din of clapping.

Back at home, she went around telling the others what the big city and its even bigger ocean looked like. Why, she was the first one in the village to have taken this trip. And if like her these women ensured their children’s education, they too were likely to make a similar trip sometime in future.

Sorath recounts that the girls who attend school can clearly be told apart. They have neater appearances, combed hair and they carry themselves with more grace than their peers who have not yet started school. Harchand para, on the other side of the village, still has most girls out of school and that is now Sorath’s target. “There are at least sixty young girls there who I want to see in the classroom,” she says. Sorath has heard girls whispering that they want to be like the visiting social mobilisers of CWSA and she tells them they can be all that and more if they attend school. She admits it was this very strategy that got parents and girls of her own para to seek education.

“I know college education will be expensive. But no matter how long and how hard I have to pick cotton and hoe the landlord’s fields, I’ll do it and see my daughter through to the highest level of education she wants to attain,” says Sorath.

One can see that this is not just an empty boast. It is clear that Sorath’s connection to her land and her commitment to fostering growth is not just in crops, but in the minds and lives of the girls in her village.

  1. Child Registration Certificate (CRC) ↩︎

In a straight line, Old Subhani lies 30 kilometres due east of Umerkot town; it is a tad longer by the tarmac road. Here Jagisa is a member of the Advisory Committee established in October 2022 after the Community World Service Asia’s training sessions under the HERD project. She says she did not miss a single session. Jagisa is the kind of person who needs no prompting to speak and is quick to relate how being a part of the embroidery makers of Taanka she learned at least one new stitch she had never known before.

“Hurmuchi is a stitch that adds so much value to our work. Earlier we were doing straightforward applique rallis. Now there is greater variety in our products,” says Jagisa. “Just a year before the training a typical ralli bedspread would sell for no more than PKR 800 (Approx. USD 2.8) in the village. It would fetch the same price in Umerkot.”

Now a ralli of the same size fetches PKR 1500 (Approx. USD 5.3) in the village. The better design has greater demand in Umerkot where their menfolk sell them. And if the men only knew the art of haggling, they could get a couple of hundred rupees more. The Taanka group in Old Subhani is also turning out traditional Sindhi embroidered caps. Jagisa relates that the contractor supplies them the raw material and pays labour at PKR 1000 per cap (Approx. USD 3.5). Normally, it would take any woman fifteen to twenty days to turn out one of the more intricately patterned cap. A simpler one takes under ten days. However, if they get their own material, Jagisa says their profit would be in the range of PKR 800 (Approx. USD 6.3).

Kasuba, also a member of the Taanka group, points out that this new stitch being unknown in their village before the training, is now practiced by every applique maker. She says there were several young women who had not joined the training sessions and she has taken it upon herself to teach hurmuchi to all those women and even much younger girls.

Speaking of the drought of 2021, Lakhma, a member of the Resolution Committee, says it was a sort of blessing in disguise for the village. In such a situation in the past, leaving a man or two in each para (precinct) of the village, the community would migrate to the irrigated districts west of Umerkot. “First off, we got monthly rations for six months from CWSA which obviated the need to migrate. That meant our children who would be pulled out of school continued their education. Then we also got two goats per household and that was all the more reason to stay put,” she says.

Lakhma points out how the long trek to the irrigated area sometimes killed off their livestock. But for some years now, they no longer walk as it was before the web of tarmac was laid across the desert. Now they can get on the taxis that zoom around the desert. But living away from home was never free of insecurity and discomfort. There they had to build their temporary shelters of bamboo and wattle, usually open on one side and without a door leaving no room for privacy. “We did not migrate either in 2022 or this year, our children have remained in school and we are in our own homes,” she says.

Now, July has always been the start of the cotton picking season in the canal-irrigated districts and that was one activity the women of Thar never missed. Though the work was very hard, it nonetheless meant good money. But this year when the contractor came to recruit pickers from Old Subhani, Lakhma saw a relative and her husband preparing to go. “They would have been gone for two months and school was reopening in August. I told them to stay. There was plenty of work with the road building crews near the village. Here the men work during the day and come home to sleep with the family,” she says.

Convinced by Lakhma’s argument, the family turned down the contractor’s offer and stayed. The man and his older son are now employed on a road crew and as Lakhma said, both men return in the evening to sleep in their own home. And they together have PKR 1500 to show for their labours. She believes this being the only family that almost went and then didn’t in the end, it was the last time the cotton contractor called upon them. “He knows our ways have changed,” she adds.

On a more physical level, the village is turning green: women are planting trees in their courtyards. Besides the usual ber fruit (Genus Zizyphus) and date palm, women are experimenting with chikoo (sapodilla) and having heard from nearby villages that they do well, are also planting lemon trees.

A new level of awareness is now upon all the women who have undergone the CWSA training sessions. From Old Subhani and other villages, one hears a common refrain on how the gender awareness sessions have helped these communities. Customarily, men were served food first and the best of it too. Women satisfied themselves later with the leftovers. Now families dine together and the menu is shared out equally among girls and boys. The thought is banished that men having to go out to labour required better food. Now, they are mindful of the fact that tending livestock, fetching water from the well and keeping the home clean was also labour intensive.

Kasuba points out that chores outside in the fields are done collectively and when they are finished they collect firewood on the way back. She says that her son returns from school at 2:00 in the afternoon and after his meal, goes out to fetch water and firewood. Time was when firewood collection was considered manful enough, fetching water was strictly a woman’s job. Across the Thar Desert, the greatest mark printed in the sand by CWSA is the reason for communities to abjure the annual transmigration to join the wheat harvest and later cotton picking as a means of earning a livelihood. Their staying home means children who would otherwise have migrated with them in March and lost out two months of schooling before the summer vacations, now continue their education.

Middle-aged Krishen Kohli lives in the hamlet of Hanif Khanzada, ten kilometres from Tando Jan Mohammad in Mirpur Khas district. He is a landless farmer who works as a labourer for a local landowner. He has six daughters and a son. Their son came at number four. “We wanted a few more sons so we kept at it and all God gave us was another three daughters,” he says with a chuckle.

He owns no property; even the home he lives in is built on the landlord’s land and he makes a very meagre living from his work which is irregular. Krishen believes that a child sent into the world is by the will of God and so it is His job to provide them food. Even if that food is only chilli paste and millet bread? “Yes. The child is fated to have only that much.” Krishen’s faith in kismet is as firm as that of anyone who is very poor and has no control over circumstances. In any case, he knows of no family where the man and wife have lived together for fifteen years or more and have fewer than ten children. As for himself, he says he has had enough. He does not want any more children.

Amidst the flood crisis, Kirshan’s residence suffered extensive damage as a result of the flood. In response, he undertook the task of constructing a new dwelling using locally available materials such as wood and mud. Additionally, Kirshan faced health challenges, prompting him to seek medical assistance from the Mobile Health Unit (MHU) of Community World Service Asia due to the inaccessibility of conventional hospitals. The MHU played a pivotal role in providing relief during these difficult circumstances.

Community World Service Asia’s (CWSA) Mobile Health Unit (MHU) supported by Catholic Agency for Overseas Development (CAFOD) and Disasters Emergency Committee (DEC) was on a follow up visit after the first round. On both occasions Krishen had attended the health awareness session delivered by the CWSA social mobiliser and agrees that he and his wife should have had fewer children.

He was very pleased with the health camp. For the past about seven years, he has had ‘heat in the stomach’, the usual local term for acidity, and constipation but he did not go to the government hospital at Tando Jan Mohammad. Instead, he consulted a private doctor whose fee was PKR 500 (Approx. USD 1.7) and to fill his prescription Krishen parted with PKR 1300 (Approx. USD 4.5). Adding to that the to and fro fare, the cost of the visit went up to PKR 2500 (Approx. USD 8.8). That was beyond the capacity of a poor landless peasant and most of it was taken on loan from the landlord to be adjusted against Krishen’s wages. “The medication lasted me three months and when the course was done, I remained well for another five or six months,” reports the man.

Dismissive of the government facility in Tando Jan Mohammad, Krishen says their free medication never works. Fifteen days earlier, on the first visit of the mobile health unit, he was given five pills, one for a day. And he had never felt better. This was such effective medication, he says, that it has improved his appetite as well. Now he was back for it. The health project had been extended on this very day and the facility was available to the village for more time. If Krishen were to visit the medical practitioner in town in 2023, he estimates he would be set back by about PKR 5000 (Approx. USD 17.6).

Gauri, another fellow resident of Tando Jam, is pregnant with her seventh child and she is not even thirty years old yet. She too has attended the health sessions and heard all about family spacing and that a small family is better fed than a large brood. Like Krishen, she too is not really convinced about a small family being ideal. One can hardly expect that when you live in a social and cultural eco-system that favours huge families.

The first two of Gauri’s babies were delivered by her mother, an experienced midwife. But then she was too old and did not wish to endanger the third child so Gauri went to the government hospital at Tando Jan Mohammad. “The doctor shouted at me, telling me to get back and wait outside. We are poor people and that is how they attend to us,” she complains. She sighs about the expense of coming and going and then being treated badly by the medical staff. After the first visit, she gave up and consulted a private maternity clinic that delivered her next two babies. Each visit delivery cost her PKR 20,000 (Approx. 70).

That put her husband under a huge debt to the landlord and it took a couple of years to repay. In which time Gauri had two more children who were delivered by an inexperienced midwife from a neighbouring settlement. And in September 2023, she was pregnant for the seventh time with plenty of child-bearing years ahead of her!

As useful as it is to treat recurrent scabies and respiratory tract infections – the most common complaints in the area – it is necessary to intensify health sessions on sexual and reproductive health of women and young girls in such areas. There needs to be greater emphasis on post-partum care and nutrition of families, women and children alike. Through this project, community mobilisers and health practitioners have engaged with communities on raising awareness and initiating dialogue on these needs but the focus has largely been on providing immediate health care to flood affected communities suffering from diseases and illnesses or needing maternal and neonatal care. There is definitely space to do more.

Meanwhile, the seventy odd women and men waiting in the shade of the trees outside the mobile health unit were happy that they were getting medication that worked. And it was totally free of cost. For women like Gauri who had only a few minutes earlier shrilly complained that government doctors did not even listen to her and others like her, the medical officer in the health facility was an angel.

Sindh Province in Pakistan has seen a wave of climate-induced disasters and other crises in recent years. Drought, Locust Attacks, the COVID-19 Pandemic, and Flooding, have all left district Umerkot and Sindh’s desert region particularly hard hit. Umerkot in particular is historically prone to moderate droughts and is categorised as highly vulnerable according to the Drought Vulnerability Index. With the support of Australian partners, Community World Service Asia is working to provide essential health and quality education services to communities affected by climate-related issues and displacement in Umerkot.