Climate emergency: Women and girls living in Pakistan flood zone suffering from urinary tract infections and reproductive complications in part due to lack of clean water, sanitation and hygiene - WaterAid

14 November 2022
Before the floods destroyed her home, mother of seven, Rasheeda, was already vulnerable to infection due to a prolapsed uterus. The 45-year-old is now experiencing abdominal pains and has a serious uterine infection.  The family have been living with  ...
Image: WaterAid/ Khaula Jamil

“The doctor advised me to remove my uterus because it is infecting other parts of my body too. We have lost everything in the floods, and we cannot afford any such surgery.” Rasheeda, 45, Dadu district, Sindh Province

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As world leaders are meeting at COP27 to discuss the gendered impacts of climate change today, women and girls in Pakistan are struggling right now with urinary tract infections (UTIs), reproductive issues and other health complications in the wake of the devastating floods that submerged one third of the country earlier this year.

Stagnant water, unhygienic conditions, poor sanitation and a lack of access to medical facilities batter their health, with one woman with an underlying health condition advised by doctors to have a hysterectomy, and another fearing for the life of her unborn child – WaterAid reports.

Three months on, the development organisation visited communities in the Badin and Dadu districts of Sindh province and found women and girls experiencing trauma and anxiety, with some fearful of menstruating due to a lack of privacy and sufficient access to clean menstrual products or cloths. Some were having to resort to tearing their “dupatta” [scarves] and other clothing to manage their periods.

Tahmina, a local nurse working with women and girls from camps in Dadu, told WaterAid that most of the women she meets complain of abdominal cramps, excessive bleeding and unusual discharge. She has seen symptoms associated with UTIs “significantly increase” and estimates that “70 per cent” of women she meets are suffering from the condition. Tahmina said that the unhygienic conditions and contaminated water are contributing to the health issues women and girls are experiencing. She told WaterAid:

“Unhygienic conditions, using of the same cloth for longer periods, holding urine for longer periods, using contaminated water for drinking and washing purposes and lack of handwashing are contributing a lot to this. Due to trauma and anxiety, women are in shock.  

“Moreover, miscarriages were at a peak during the initial days of the floods. I got to know one case of a still birth. I was told that the woman couldn’t get timely medical assistance during her labour pains and the child died before birth.”

Rubina was six months pregnant when she was forced to flee her home in the village of Bachal Laghari, Johi in Dadu. Three months on and full-term, the 32-year-old now lives with her husband and four daughters in a makeshift camp in the Flood Protection Bund in Johi city and fears for the health of her baby and children. She said:

“Living in a tent is not a life that I saw for my child and I am not sure whether my child or I will be able to survive in such a critical situation.

“I am aware that the stagnant water will take more than three months to be absorbed by the soil, so I just get goose-bumps when I think of living here for the next four months. My family has lost everything, but we do not want to lose this baby.” 

Rubina is one of the estimated 650,000 pregnant women in flood-affected areas of Pakistan who are in need of maternal health services to ensure safe pregnancy and childbirth.[1] An estimated 8.2 million women living in the flood zone are thought to be of reproductive age.[2]

Another woman WaterAid met, 45-year-old Rasheeda, was vulnerable to infection prior to the floods due to a prolapsed uterus. Now, she has been wearing the same menstrual cloth - without soap and water to clean it properly - for the past three months. She is experiencing abdominal pains and has a serious uterine infection. Rasheeda, a mother of seven, said:

“When I moved in here, there was no toilet or clean water and even now we are living without it. Therefore, I am forced to use my menstrual cloth without washing it with soap or washing powder but just with dirty flood water. I used to bury my cloth in the ground but now I wash my cloth in the dirty flood water so that it can be used again and again.

“I went to a free medical camp nearby and the doctor advised me to remove my uterus because it is infecting other parts of my body too. We have lost everything in the floods, and we cannot afford any such surgery. 

“Also, our workload has increased in these camps because now we must fetch water for drinking, cooking and toilet use but I am unable to do any house chores due to my health issues. I just lie all day on the bed and my daughter looks after me and other tasks as well.”

Many of the women and girls WaterAid met fled their homes without any possessions. As a result, they said they had no choice but to resort to using their clothes to manage their menstruation. Rabia, 40, said:

“When I left my home, I could not take any extra cloths or pads to use during my period. I was just wearing a suit, and I tore my dupatta [scarf] when, after two days, I got my period. I had to wash it again and again but due to the rains it could not dry. Using the same wet cloth during those days was impacting my health. I got itching and pain in my lower body, which was consistent for so many days.”

Others spoke of struggling to manage their periods in temporary camps, often on busy roadsides, where there is no privacy. Nazia, 12, started her period for the first time whilst living in a camp in Hayat Khaskheli village, Badin. She said:

“I am yet to forget how helpless and embarrassed I felt when I had my first period. There were strangers [men and women] as our neighbours in the camps. They were outside and I was not comfortable going out to wash my menstrual cloths, so I waited till dark. This was devastating.”  

Women and girls are disproportionately affected by the impacts of climate change. With gender the theme at COP27 today, WaterAid is calling on world leaders to channel more money towards water, sanitation and hygiene projects so that women and girls who are bearing the brunt of climate change can better cope with its impacts.

Raheema Panhwar, WaterAid Provincial Coordinator in Sindh, said:

“The UN Secretary General, Antonio Guterres, declared at COP that ‘we’re on a highway to climate hell’. Well, women and girls in Pakistan are living that hell right now.

“I challenge world leaders to listen to the words of these women and girls in Pakistan who are on the climate change front line and do all they can to help them and the millions more like them across the globe.

“If they fail to act, many more lives will be hanging in the balance. Clean water, sanitation and hygiene promotion are essential for women and girls to stay disease free, go to school, earn a living and be more self-reliant. They cannot wait any longer for world leaders to act – the time is now.”

WaterAid is working around the clock in Sindh province to help thousands of families affected by the floods and to distribute hygiene kits with antibacterial soap, toothpaste and mosquito repellent. We are disinfecting drinking water, building temporary toilets and supporting women and girls with menstrual hygiene kits.

To donate to WaterAid Pakistan’s appeal:


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Notes to Editors:

WaterAid is working to make clean water, decent toilets and good hygiene normal for everyone, everywhere within a generation. The international not-for-profit organisation works in 28 countries to change the lives of the poorest and most marginalised people. Since 1981, WaterAid has reached 28 million people with clean water and nearly 29 million people with decent toilets.

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  • 771 million people in the world – one in ten – do not have clean water close to home[1].
  • Almost 1.7 billion people in the world – more than one in five – do not have a decent toilet of their own[2].
  • Over 300,000 children under five die every year from diarrhoeal diseases caused by poor water and sanitation. That's more than 800 children a day, or one child every two minutes[3].
  • Investing in safely managed water, sanitation and hygiene services provides up to 21 times more value than it costs[4].

[1] WHO/UNICEF (2021) Progress on household drinking water, sanitation and hygiene 2000-2020. Joint Monitoring Programme. Geneva: World Health Organisation.

[2] WHO/UNICEF (2021) Progress on household drinking water, sanitation and hygiene 2000-2020. Joint Monitoring Programme. Geneva: World Health Organisation.

[3] WaterAid calculations based on: Prüss-Ustün A, et al. (2019). Burden of Disease from Inadequate Water, Sanitation and Hygiene for Selected Adverse Health Outcomes: An Updated Analysis with a Focus on Low- and Middle-Income Countries. International Journal of Hygiene and Environmental Health. vol 222, no 5, pp 765-777. AND The Institute for Health Metrics and Evaluation (2020) Global Burden of Disease Study 2019. Seattle, WA: University of Washington.

[4] WaterAid. (2021) Mission-critical: Invest in water, sanitation and hygiene for a healthy and green economic recovery.