In Pakistan, the annual monsoon season brings not only relief from searing summer temperatures but also severe public health challenges. One of the most distressing consequences is the spike in child mortality due to waterborne diseases caused by widespread water contamination. Children, especially those under the age of five, are particularly vulnerable due to their weaker immune systems, underdeveloped physiological defenses, and often limited access to timely healthcare. The connection between water contamination and child mortality becomes even more pronounced during the monsoon season, when infrastructure collapses, sanitation systems overflow, and access to clean water is severely disrupted.
Water contamination during the monsoon in Pakistan occurs due to multiple interlinked factors. Heavy rains lead to the overflow of sewage systems and the mixing of fecal matter with drinking water supplies. In many urban and peri-urban areas, outdated drainage systems and poorly maintained pipelines allow for cross-contamination between sewage and water lines. Rural communities often rely on open wells, hand pumps, or surface water for drinking, all of which become highly susceptible to bacterial and viral contamination during flood events. This toxic mix exposes millions of children to pathogens like Escherichia coli, Salmonella, and Vibrio cholerae, which are the leading causes of diarrheal diseases.
Diarrhea remains one of the top killers of children under five in Pakistan. According to UNICEF and the World Health Organization, diarrheal diseases account for approximately 19% of all child deaths in the country. These diseases are not just deadly in themselves, but they also lead to chronic malnutrition and stunting, further compromising a child’s health and development. During the monsoon, the surge in cases of diarrhea, typhoid, and hepatitis A and E among children overwhelms the already under-resourced health infrastructure. Hospitals face acute shortages of rehydration solutions, antibiotics, and safe hospital beds, especially in remote areas. This lack of timely medical intervention exacerbates the mortality rate among children affected by waterborne illnesses.
Moreover, the socio-economic disparities in Pakistan amplify the crisis. Families living in slums or informal settlements are disproportionately affected, as they often lack access to piped water and rely on shared or unsafe sources. The economic burden of disease, including lost income, transportation to healthcare facilities, and medication costs, often forces families to delay or forego treatment altogether. In such settings, girls are particularly at risk, as social norms may prevent them from receiving timely healthcare.
Efforts by the Pakistani government and international agencies have led to some improvements, such as increased vaccination coverage against rotavirus and public awareness campaigns on boiling water and handwashing. However, these efforts remain fragmented and insufficient, especially during emergency monsoon situations. What is urgently needed is a comprehensive public health strategy that combines infrastructure development with community education, disaster preparedness, and targeted healthcare interventions. This includes the installation of chlorination systems at community water sources, regular water quality monitoring, public distribution of water purification tablets, and strengthening primary healthcare services in flood-prone areas.
Climate change adds another dimension to this crisis. With increasing unpredictability and intensity of monsoons, the risks associated with water contamination are expected to rise in the coming years. As floods become more frequent and severe, Pakistan must prioritize climate-resilient infrastructure and adaptive healthcare systems to mitigate child mortality during such environmental events. Eco-Health researchers have repeatedly reported that child mortality linked to water contamination during the monsoon season in Pakistan represents a profound intersection of public health failure, environmental vulnerability, and socio-economic disparity.
