By Asma Ali
Master of Arts(MA)
English Literature

Women’s Personal Hygiene:
Complete Silence About Self-Care…Why?
خود کی دیکھ بھال بارے مکمل خاموشی۔۔۔۔۔ کیوں؟
महिलाओं की व्यक्तिगत स्वच्छता:
स्व-देखभाल के बारे में पूरी तरह से चुप्पी… क्यों?

The gap between self-care and silence in women’s personal hygiene is created by persistent social stigmas, lack of education, and systemic barriers that prevent open discourse and access to essential products and facilities. This silence can have significant negative impacts on physical and mental health, affecting everything from daily comfort to long-term well-being. Social stigmas and cultural taboos around menstruation and other aspects of female personal hygiene create a culture of silence that has severe consequences.  Hygiene is the ability to keep the practices, habits and conditions which fosters evidence of cleanliness and health to reduce risk of transmission of disease.

Hygiene includes personal hygiene which means keeping yourself clean; washing your body; practicing dental hygiene; washing your hands; genital hygiene and wearing clean clothing. It also includes environmental hygiene, which means ensuring that your environment is clean and sanitary hygiene; access and use of safe drinking water, appropriate waste disposal, and proper waste management. It involves food hygiene, which means food must be safely prepared, safely cooked, and safely stored.

Ultimately, hygiene means using good hygiene practices to assure that individuals or communities remain healthy and free from illness.

Good personal hygiene is important because it protects us from getting sick and from exposing others to sickness. It is also important for our self-esteem and social presentation. Personal hygiene can be divided into several key types, which focuses on a different part of the body.

1. Hand Hygiene:

Hand hygiene is the most important hygiene type because our hands harbor countless germs from what we touch in our surroundings every day. Cleaning our hands before meals, after using the toilet, and after touching unclean surfaces is the only way we will stay healthy while avoiding the spreading of germs and infection.

2. Oral Hygiene:

Oral hygiene refers to the cleaning of our mouth, gums, and teeth. Tooth brushing two times a day, flossing, and rinsing with water after meals can help prevent bad breath, cavities, gum diseases, etc.

3. Body Hygiene:

The human body accumulates sweat and sheds dead skin cells periodically. By bathing or showering frequently, you will remove this dirt, sweat, and bacteria keeping the skin clean and fresh.

Regarding hair hygiene, washing hair is part of caring for your body and you don’t want to support dandruff or scalp infections, or have a hairdo that’s so maintained, it attracts lice. Clean and well cared hair is an element of neatness and shows good hygiene practices. Nail hygiene is important because dirt and germs hide-out under fingernails and toenails. Clean and trimmed nails keep dirt and bacteria from entering the mouth, when eating or touching food.

Feet are often enclosed and sweaty for long hours in shoes, and fungus can grow rather easily on feet, so wash them every day, keep them dry, and wear clean socks ensures good foot hygiene.

Genital hygiene is often overlooked, embarrassingly neglected because of cultural taboos, yet good genital hygiene is important for comfort and health. Good hygiene of genital areas including washing the private parts regularly, clean underwear and cleanliness regarding menstrual hygiene (for women) to avoid bad odors or infections.

4. Clean Clothes:

Clean clothing is part of personal hygiene, as it helps you feel fresh, helps you avoid skin problems, and helps develop respect for oneself. Changing your clothes every day; including socks and undergarments; and properly washing them helps you feel fresh every day.

Hygiene is not just washing hands or washing one’s private parts, there is a journey to rebuilding a life based on hygiene, confidence and health.

In Pakistan, oral hygiene, genital hygiene and hand hygiene are the most often neglected areas of personal hygiene. Oral hygiene, for example, is mostly neglected as a large part of society brush their teeth irregularly and do not see a dentist until a cavity destroys a tooth, or long-term bacteria formations resulting in gum diseases, and possible toothless life. Genital hygiene is considered taboo and shameful which has caused infections to occur in women and men through silence. Finally, hand hygiene is an issue where people do the simplest thing with the least effort to wash their hands before and after consuming food or after using the washroom, leading them to ignore washing their hands ultimately putting themselves at risk for disease.

Women’s Hygiene: A Worldwide Problem:

Women’s personal hygiene neglect is not simply a ‘Pakistan’ problem but a worldwide problem of various degrees. Many developing countries, in places such as South Asia, Africa and parts of the Middle East share the same barriers and situations to neglecting women, as a result, women have been experiencing menstrual health problems and sexual health problems as a result of poor hygiene. Many women suffer due to lack of education and knowledge of menstruation and reproductive health, access to sanitary products, stigma and taboos related to culture, and forced silence over their reproductive health.For example, in others part of India and Africa, millions women do not have safe menstrual products, only unsafe options that expose them to infections and are generally poor hygiene. When referring to the developed world, like the US or Europe, we have increased access to hygiene products, clean water, and healthcare facilities. The differences, however, remain that stigma and misunderstanding still exists and issues of vaginal health, menstruation, and all things reproductive hygiene remain taboo and silenced.

Across all countries, women’s hygiene is often framed as either a beauty standard, or taboo. Women’s hygiene is addressed infrequently and not as a basic aspect of health and empowerment. Whether it is a village in Pakistan, a community in Africa, or a city in the West, the challenge remains transition from silence, shame, and misinformation, to awareness, openness, and genuine self-care.

The Most Overlooked Hygiene Habits of Women in Pakistan:

In Pakistan, when talking about hygiene practices of women, there is considerable difference in what women have to face due to culturally-driven taboos, lack of economic opportunities or simply the lack of awareness.

Genital health, dental health, and even basic cleanliness are frequently overlooked, not for a lack of caring from women, but because society has stripped women down to their outward appearance. This results in a culture where women may appear flawless in public, yet are silently suffering in private homes. Breaking that silence is not just hygiene… it’s health, it’s dignity, it’s empowerment.

Genital hygiene is the most overlooked hygiene habit. Because it is rarely discussed openly, many women do not receive accurate direction on how best to care for their privates. Pubic hair is natural and starts growing with puberty. It provides a protective layer against friction and infections. However, when it is left untrimmed and not cleaned regularly, sweat, urine, and menstrual blood can collect in the hair. This often results in bad odor, itching, and bacterial growth. The neglect can result in infections, discomfort, and odor but women end up suffering silently out of embarrassment. Along with genital hygiene, menstrual hygiene is closely related and thousands of women and girls within Pakistan still rely on unwashed cloths or rationing their change of pads due to poverty or lack of access or disposal available to them. These practices can lead to urinary/reproductive tract infections.

Overview: Women’s Personal Hygiene in Pakistan:

1. Menstrual Hygiene:

Across different cultures, menstruation is often stigmatized as “dirty,” “unclean,” or “impure”. This has created a self-reinforcing cycle where: 

• Silence perpetuates stigma: A lack of open conversation means misinformation and harmful myths continue to flourish, leaving girls and women unprepared for their menstrual cycles.
• Stigma enforces concealment: To avoid embarrassment, women often take great pains to hide their menstruation, which adds to feelings of shame and discomfort. The need for concealment can influence daily practices, such as wearing baggy clothes or creating elaborate routines to ensure no one finds out.
• Advertisements reinforce the trend: Mainstream media frequently emphasizes discretion and freshness in marketing feminine hygiene products, using blue liquid instead of red, which further promotes the notion that menstruation is something to be discreetly managed and concealed. 

Pakistani society can help promote better health and hygiene for our women only once it overcomes the taboo and shame associated with menstruation

Many women and girls in Pakistan hear misinformation or myths about menstruation; such as “if you bathe during your menstrual period it will hurt you,” or “you shouldn’t eat some specific food”

Menstrual hygiene is not formally included in the school curriculum, leaving adolescents to rely significantly on mothers or peers, who may also lack adequate knowledge.

Poor knowledge and practices:

With respect to menstrual hygiene, more than half of adolescent girls in Gilgit are poor with respect to knowledge, attitude and practices.

Among rural ethnic groups (Kalash vs Kho women), 90% of Kalash women had good menstrual hygiene practices compared to only 46% for Kho women.

In Hyderabad, Sindh, 60.2% of girls used cloth as menstrual absorbent, which often contributed to absenteeism due to fear of staining and lack of clean changing facilities. In Karachi, nearly 50% of women used appropriate menstrual materials (sanitary pads, etc).

A national-level figure suggests that upwards of 79% of menstruating girls in Pakistan do not manage menstruation in a hygienic manner, which greatly increases the risk of urinary tract infections, pelvic infections, and infertility.

Period Poverty, current flooding & Crisis Response:

During the unprecedented flooding that influenced an estimated eight million reproductive-age women across Pakistan, many of these women ended up using leaves from trees because they lacked sufficient access to menstrual supplies. Mahwari Justice, HER Pakistan’s grassroots support group, and other organizations provided menstrual kits, taught women how to make reusable pads, and advocated for ditching the taxes on necessary hygiene products.

Barriers to Proper Hygiene in General:

Many areas have limited sanitation, only about 42% of Pakistan’s population had access to sanitation in 2009, and many individuals still engaged in open defecation as recently as 2018. Also, schools do not address menstrual waste removal, promoting unhygienic methods of disposal.

The absence of WASH facilities in schools While programs like UNICEF’s WASH-in-Schools do exist, menstrual hygiene management (MHM) is often deprioritized in the school context. Genital hygiene is probably the most neglected part of personal care among men and women in Pakistan. Culture prevents men and women discussing the issue openly; young girls are left to find their own way without proper guidance from mothers or schools. Additionally, domestic and public settings give women no privacy for comfortable hygienic management or products.

The ignorance around women’s personal hygiene in Pakistan is not necessarily only due to poverty, but a combination of social, cultural and structural factors.

Cultural Taboos:

Talking about women’s bodies, especially around genital and menstrual hygiene are taboo topics and therefore, silent and shameful. This silence also prevents mothers, teachers and even health workers from helping girls learn as well. Many women have grown up without being taught why it is important to clean regularly, how to have safe sanitary practices while having their periods and the importance of hygiene.

Myths and Misconceptions:

Dangerous myths, like that bathing often is bad while having a period, and that washing your private parts is not important, only reinforces neglect. Many women assume that because this part of the body is not visible to others, it does not require the same attention as face or hands.

When women experience issues, like infections or foul odor, they often do not seek medical attention because they are embarrassed and afraid of being judged.

Women’s intimate hygiene is seldom an agenda in national health campaigns, and therefore, remains a blind spot.

Too often women in Pakistan operate under debilitating myths about hygiene—such as that gynecologist visits are only for women who are married, the reality is that early checks can prevent serious complications.

Too many women are still engaging in unsafe behaviors, despite exposure to these myths negatively impacting their health. A common myth for women across all age ranges is that scented soaps, sprays, and perfumes keep the intimate area clean, when in reality they disturb the natural balance resulting in irritation. As for the above point that is perhaps the worst of all, claiming poor hygiene is simply a deficiency of poverty, reveals that barriers are far deeper; barriers of taboos, barriers of awareness and ultimately where the priority lies, where women prioritize makeup, hair and clothing over the much more important reality that beauty and health begins with care for one’s body. These myths mask a very dangerous truth: Health begins with awareness, not with silence.

Ways to Tackle the Issue:

To improve women’s personal hygiene in Pakistan, awareness and organization not only need to happen at an individual level, but also need to be systemic. These are some of the most effective methods we have observed.

Ending the Silence:

Open communication around women’s health needs to be encouraged at home, in schools and through media campaigns particularly when discussing genital health and menstrual hygiene. This change in socialization encourages normalised conversations and aides in destigmatisation.

Health Education:

Hygiene education should be incorporated into schools curriculum and coursework in community-based organizations. Once young girls (and boys) are taught safe hygiene practices, they can develop them into life habits.

Awareness Campaigns:

Local non-governmental organizations, health workers, and media channels should raise awareness through workshops, posters and/or radio/television programs in local languages to educate rural communities.

Affordable and Accessible Products:

Affordable sanitary pads, soap, and safe drinking water access in rural areas must be possible. Providing subsidized, or reusable sanitary products would enhance low-income women’s hygiene management strategies.

Privacy and Sanitary Facilities:

Sanitary facilities must consist of clean, private bathrooms for use in schools, workplaces, and public spaces. In most cases, if a woman must experience a lack of privacy she will adopt unhealthy hygiene practices and avoid maintaining hygiene.

Healthcare Support:

Doctors and health workers should be trained to discuss hygiene issues among women, or other women’s issues, without malice and to encourage women in coming forth with their perceived problems with fewer feelings of embarrassment after receiving advice about bad hygiene practices and how to treat them.

Community Role:

Community members, including educators, parents and religious leaders, can play a role in educating individuals about correct knowledge, wrong beliefs, and good practice.

Real Beauty:

The sad truth related to the problem of women’s personal hygiene in Pakistan is that many women themselves overlook the significance of personal hygiene, focusing instead on their outward appearance. However, the intended goal of ‘presenting oneself nicely’ is defined as stylised hair, clean clothes, makeup and perfume—qualities that one can assign as beauty in others’ eyes. Thus, the impression produced by that appearance is not rooted in hygiene itself.

Real beauty is not measured by polished appearance, it is measured by the lack of infections, bad odor, and the pro-wrapped diseases that exist there from neglect.

Role of Men and Society:

The assumption when one talks about women’s hygiene is that women should be solely responsible for the hygiene issues mentioned above. However, this assumption is wholly dependent upon how society, and more particularly men, treat the issues. In many families, issues related to menstruation, issues related to genital health, or even simple hygiene issues are treated as “shameful” or “inappropriate” subjects to discuss. A father and a brother consider it a taboo to discuss such issues, and a husband often certainly does not consider issues relating to hygiene as important, in fact they probably even find such discussions annoying. If the subject of hygiene is considered to be “shameful”, how can women begin to ask questions, seek help or advice, or even recognize or acknowledge their own health care needs.

Real changes will only result when men, families, and communities see women’s hygiene as a matter of public health, dignity, and well-being and not a matter of “private female”.

Ultimately, the answer is changing attitudes, increasing access, promoting open dialogue, and, when women receive knowledge, dignity and resources; personal hygiene will no longer be an issue that is neglected.

Women’s Daily Hygiene Routine:

An easy daily routine can keep women healthy; a simple daily routine that is followed each day can prevent many health problems. Wash your face, hands, and your genitals with lukewarm water every morning and evening. No soap, not even gentle soaps, should be used to wash these areas. You should brush your teeth twice a day, and always floss after brushing, for good oral hygiene. Shower regularly, also after any physical activity in which you happen to sweat. When showering, always go back to your undergarments, and wear fresh, clean cotton underwear to allow restricted movement of air, and a reduction of bacteria. Change sanitary pads and tampons every 4-6 hours during menstruation. Wash your hands before you start, and right after you finish using sanitary products. Reduce the amount of body hair found in sensitive areas like the underarms and the bikini line, as it holds more sweat and odor. Pat yourself dry with a clean towel after washing your body. Drink plenty of clean water, and try to eat a balanced diet to assist with inner hygiene. When hygiene has frequent reminders of being a neglected priority, simple basics can change it into a nurturing aspect of your daily routine.

Occasional Hygiene Routine:

Besides daily care, women create a hygiene routine approved for the long run through a weekly and occasional routine as well. The intention is to prevent health issues. No bodily hair in your underarms or on your body helps reduce interaction with sweat, odor, and bacteria, at least once or twice a week the hair is to be trimmed from your underarm area and body. Using hot water wash your pillow cases, bottom sheets and towels to kill germs and replace with unused clean towels, and sheets. Gently exfoliate the body at least once a week to remove dead cells and keep fresh. Disinfect personal items to limit contamination such as your water bottle, hair combs, and make-up applicators. Book a medical check-up with your gynecologist or dentist, you may not have visible symptoms but this will help catch early infections, to help with health issues. Therefore with these components of weekly, occasional and daily, we complete an entire hygiene routine that protects health and beauty.

Health Care Products for Women’s Hygiene:

1. Gentle Intimate Wash (pH-Balanced):

You can use a gentle, pH-balanced intimate wash 2-3 times a week to help you feel fresh, while allowing the natural vaginal flora to maintain itself. Simply apply a small amount to the external area (this is the only part that should be used); rinse with lukewarm water, and dry it off by patting the area dry. Do not use any product that is harsh, scented, or chemical-based since they can aggravate the skin and lead to infections.

2. Feminine Hygiene Products (Sanitary Pads, Tampons, and Menstrual Cups):

Feminine hygiene products are used differently, depending on the method of menstruation. Sanitary pads should be changed every 4–6 hours, and again, disposed of in a covered bin, and hands washed both before and after use. Tampons also need to be changed every 4–6 hours in order to reduce the risk of Toxic Shock Syndrome (TSS). Menstrual cups should be washed with warm water before use and then again after use, sterilized once per month by boiling the cup in water, and emptied every 6-8 hours.

3. Antibacterial or Unscented Wipes (For Travel):

When there is no water available–like when you are traveling; alcohol-free, unscented wipes may be beneficial. Wipes should be used externally. Wipes should never replace washing with water daily.

4. Cotton Underwear and Panty Liners:

Breathable cotton underwear is best for daily wear, and should be changed at least once every 24 hours.

5. Antifungal or Medicated Powder for Areas that Sweat (Humidity Regions):

For areas that readily sweat (e.g. the armpits, groin), lightly dusting antifungal or medicated powder on these places post-shower may help to keep moisture away from the skin and quell possible fungal infections. These products shouldn’t be used long-term unless advised by a physician.

6. Routine Visits to their Doctor and Prescribed Products:

If there is atypical discharge, prolonged odor, itchiness, or irritation, a woman should contact their gynecologist. The physician may prescribe antifungal cream, probiotics, or medicated washes, which should not be used any more than directed.

Doctor’s Do’s and Don’ts:

The doctor’s best piece of advice is that ladies embrace simple hygiene steps that are done consistently. Clean and wash the genital area daily with clean water; wipe from front to back, see a gynecologist annually. At the same time, women must also avoid bad practices, including using scented sprays, deodorants, or powders on the intimate area, vaginal douching, wearing tight synthetic clothing for prolonged periods, and keeping sanitary products longer than recommended. Most importantly, is when you notice any sign of discomfort—unusual discharge, foul odor or itching—never ignore it. See a doctor promptly, as early consultation may prevent serious infections.

Conclusion:

There is more than just soap, water or a sanitary product involved in women’s personal hygiene in Pakistan; there is dignity, identity and feelings of worth. The silence around this issue has turned a universal human need into an invisible struggle. To break the silence is

not an issue of privilege; it is an issue of justice. A woman who learns that her body is something to care for without shame, is a woman who is not only protecting her health, but is also restoring her right to live in confidence and respect. So, the real solution is not hygiene kits or even campaigns, but rewriting the cultural script; to be one where caring for the body and its functions is lauded as strength rather than silenced as taboo.

“When women learn to care for their inner cleanliness as much as they care for their outward beauty, and when society encourages that rather than silence it, hygiene will no longer be an unspoken struggle but a visible marker of health, dignity, and empowerment.”

“The future of women’s health in Pakistan will not depend on the perfumes, powders, and appearances, but on the courage to communicate, the will to care, and the wisdom to consider hygiene as the basis of real beauty.”

We tell girls to cover their bodies, but we do not teach them to care for their bodies; and therein lies the real threat. This is a reality that speaks to the heart of the issue; women are socialized to care about modesty, appearances, and outward presentation, but not the critical practice of caring about their inner cleanliness. The issues discussed are frequently overlooked by women themselves, who then focus attention to clothing, make-up and external beauty, neglecting the true basis for being healthy and truly attractive to it is actually personal-hygiene. Empowerment starts not with beauty or clothing, but with awareness and self-care. The only way forward is to stop the silence and to teach women to take care of hygiene as a component of dignity, faith, and health. Then, the women can move to being not merely “seen to be proper” but actually healthy and thus confident, healthy and honored.

“True empowerment begins not with the lipstick on a woman’s face, but with the care she gives to the body no one else sees.”

Disclaimer:

Sada-E-Watan provides news and opinion articles as a service to our readers. These articles and news items come from sources outside of our organization. Where possible, the author and the source are documented within each article. Statements and opinions expressed in these articles are solely those of the author (reporter/newspaper) or authors (reporters/newspapers) and may or may not be shared by the staff and management of Sada-E-Watan. Sada-E-Watan was created to provide one convenient central location where a user can quickly scan headlines from many news sources. The headlines listed on Sada-E-Watan pages are links to stories on the sites where these stories are located. The goal of Sada-E-Watan is to help readers access stories on web sites that they would normally not have time to view on a regular basis and to add value to the news source sites by mentioning their name on top, so readers can view these sites..

The Sada-E-Watan takes no responsibility for any loss or damage suffered as a result of using the linked websites or as a result of using the information published on any of the pages of the linked websites.

Whilst every effort is made to ensure downloadable content is free from viruses, Sada-E-Watan cannot accept any liability for damages resulting from virus infection. You should take adequate steps to ensure your virus check regularly when using any device. If you have any questions or comments about Sada-E-Watan, please contact us at: radio@sada-e-watan.com۔

Dr. Ramsha Zafar
Physician/Internal Medicine

Trauma and Physical Injuries from Floods in Pakistan
پاکستان میں سیلاب سے جسمانی ذخم  اور صدمے
पाकिस्तान में बाढ़ से शारीरिक चोटें और आघात

Pakistan’s recent floods have significantly impacted human health, leading to widespread outbreaks of infectious diseases, displacement, and mental health issues. The floods have created conditions conducive to the spread of waterborne illnesses like cholera, typhoid, and diarrhea, as well as vector-borne diseases such as dengue fever and malaria. Additionally, the displacement of millions of people has created overcrowded conditions in temporary shelters, further exacerbating the risk of disease transmission and contributing to mental health challenges.

It has been observed that children are disproportionately affected by the disaster, losing homes and livelihoods. One parent described their child becoming severely ill with malaria and fever after the floods. The combination of heat and humidity is expected to lead to more outbreaks and potentially new diseases. 

Floods in Pakistan are not merely seasonal disasters—they are recurring national emergencies. When Pakistan floods, the devastation is felt in every layer of society. From crushing mudslides in the north to submerged homes in the plains, communities across the country face not just physical injuries, but emotional scars that endure long after the waters recede. Over the past two decades, the country has been battered by devastating floods, each wave worse than the last, displacing millions and causing significant physical and psychological damage.

In the summer of 2025, northern regions like Gilgit-Baltistan were hit by a deadly combination of accelerated glacial melt and record-breaking monsoon rains. In valleys such as Chilas and Skardu, flash floods triggered massive landslides, submerging roads and sweeping away entire vehicles. Rescue teams had to call off searches for several individuals presumed dead after being engulfed by roaring torrents.

Nationwide, the impact was widespread. By late July 2025, more than 300 lives had been lost, including a disturbing number of children. Over 700 people were injured, many from electrocution, collapsing structures, or being struck by floating debris. Entire communities were forced to flee with little more than the clothes on their backs.

This echoes the scale of devastation seen in the catastrophic floods of 2022, when one-third of the country was underwater. That disaster displaced over 33 million people, left nearly 13,000 injured, and destroyed more than 2,000 healthcare facilities. Millions lost access to even basic medical care.

The July 2025 “Flood of Stones” Incident in Naran–Babusar

In late July 2025, the Babusar and Naran regions, stretching across parts of Gilgit-Baltistan and Khyber Pakhtunkhwa, experienced a catastrophic natural disaster known locally as the “Flood of Stones.” Torrential monsoon rains triggered a violent flash flood carrying huge boulders, mud, and debris that rushed down the steep valleys with immense force. This sudden surge of stone-laden water caused severe destruction, blocking the vital road segment connecting Jalkhad to Besal and isolating multiple communities and travelers.

The flash flood struck without much warning, trapping over 160 tourists and their vehicles between the areas of Naran, Jalkhad, Barwai, and Besal. Rescue teams from Rescue 1122 faced extremely dangerous conditions as they waded through floodwaters near Besal to reach stranded individuals. While the operation was largely successful in evacuating people safely to nearby hotels and shelters, the disaster unfortunately claimed several lives. Official reports confirmed that five people lost their lives due to drowning and injuries sustained from being struck by flying debris during the flash flood.

In addition to the fatalities, many others suffered from minor injuries such as severe body pain, vomiting, and hypoglycemia. First responders quickly provided medical aid and distributed clean drinking water to those affected.

Authorities were quick to respond. Over the course of the night, the Kaghan Development Authority (KDA) and National Highway Authority (NHA) deployed heavy machinery to clear boulders and mud, ultimately reopening the critical roadway by early morning.

Authorities had previously issued warnings amid the persistent heavy rains. The Mansehra Police had advised tourists to avoid non-essential travel to Naran and Kaghan, citing increased risks of landslides, flash floods, and road blockages. Meanwhile, meteorological departments issued alerts about the potential for glacial lake outburst floods (GLOFs) in northern areas, warning that rapid glacial melting due to rising temperatures could lead to similar sudden floods in the future. Travelers were urged to remain alert, keep in contact with local facilitation centers, and heed official advisories to minimize risk.

The Swat River Tragedy: A Sudden Ravage

In late June 2025, pre-monsoon downpours unleashed a sudden flash flood in the picturesque Swat Valley of Khyber Pakhtunkhwa. Tourists and locals who had gathered along the calm riverbanks for picnics were caught completely off guard.

In a cruel instant, the serene landscape turned into a raging torrent, swallowing several people in its course.

District authorities later reported that at least 17 members of an extended family were swept away while trying to enjoy a peaceful morning by the river. Four were rescued, but tragically, 12 bodies were later recovered, and one person remained missing. In response, authorities imposed an immediate ban on riverside encroachments and suspended mining activities along the Swat River. The event highlighted significant gaps in disaster preparedness, as there were no early warning systems in place and rescue operations faced challenges.

The Hassanabad (Hunza) Incident: GLOF Shatters Karakoram Highway

In early August 2025, the quiet mountain village of Hassanabad in the Hunza Valley faced a sudden and powerful disaster when a glacial lake outburst flood (GLOF) occurred due to the melting of the Shisper Glacier. This type of flood happens when water that has built up behind a natural ice or rock dam suddenly bursts through, releasing a massive amount of water in a short time. In this case, the floodwater surged down the Hassanabad Nullah, a seasonal stream that flows through the area, carrying with it rocks, mud, and debris. The flood was so strong that it broke through the protective embankments and seriously damaged a portion of the Karakoram Highway (KKH)—one of the most important roads in Pakistan that connects the country to China and serves as a vital route for trade, tourism, and local travel.

Although there were no human casualties, the impact on the region was severe. Farmlands were washed away, destroying standing crops that many families depended on for food and income. Power lines and other infrastructure were also damaged, causing electricity outages and communication issues in nearby areas. In a race against time, authorities quickly dismantled four houses located in the flood’s path to prevent a greater tragedy. The destruction of the highway left entire communities temporarily isolated and disrupted the flow of goods, services, and travelers in both directions.

This tragic event highlights the growing threat of climate change and glacial melt in northern Pakistan. Villages like Hassanabad, which sits close to the Shisper Glacier, are becoming increasingly vulnerable to such sudden natural disasters. With around 200 families living in the village, their safety depends on better preparation for future floods. Experts stress the need for stronger embankments, early warning systems using sensors and weather alerts, and improved land-use planning to reduce the risk to people and infrastructure. If immediate steps are not taken, similar or even more dangerous events could strike again in the coming years, endangering lives, damaging the Karakoram Highway further, and isolating already remote communities.

Physical Injuries and Health Impacts

Floodwaters are often violent and unpredictable. In the hilly areas of northern Pakistan, landslides and flash floods trap residents in remote valleys. People fleeing on foot have sustained broken limbs, deep cuts, and traumatic head injuries from falling rocks and collapsing slopes.

In low-lying parts of Punjab and Sindh, people navigating the waters on foot or using unsafe makeshift rafts have suffered injuries from sharp objects submerged in murky water—metal scraps, broken glass, jagged wood, or barbed wire. In one tragic case, a father in southern Punjab sliced his leg on a submerged tin sheet while carrying his daughter to safety. By the time he received proper treatment, the wound had become dangerously infected.

Electrocution is another common danger, especially in urban areas like Karachi and Lahore, where live wires often dangle in floodwaters. Several deaths have been reported due to electrical shocks while attempting to power pumps or generators in submerged homes.

Burn injuries are also recorded when people use kerosene stoves in tight, wet spaces or try to cook in partially flooded kitchens. Hypothermia becomes a real threat, particularly in mountain regions, where people remain soaked for hours or days while waiting for rescue.

Infectious and Environmental Hazards

Standing water creates a perfect breeding ground for disease. In Balochistan and Sindh, long after the waters recede, cases of waterborne illnesses surge—typhoid, hepatitis A and E, acute diarrhea, and cholera. Children are the worst affected. In flooded villages outside Larkana, parents have reported young children experiencing constant vomiting, high fever, and skin rashes after playing in contaminated water.

Skin infections like scabies and cellulitis are rampant in overcrowded camps. The lack of clean water to wash wounds or clothes only worsens the situation. Eye infections, fungal rashes, and respiratory issues become common in enclosed, humid shelters.

In Khyber Pakhtunkhwa, residents of flood-hit areas have reported a noticeable increase in snake and spider bites. With their natural habitats submerged, these creatures seek refuge in homes, schools, and even relief tents, often resulting in painful encounters—especially for children and women doing chores.

Healthcare Access Challenges

One of the gravest consequences of flood disasters is the breakdown of the healthcare system. In rural areas of Punjab and Balochistan, entire clinics have been wiped out, and the remaining ones are overwhelmed. In some regions, patients walk for hours to reach a working health center, only to find no doctors or medicines available.

During the 2022 floods, many patients suffering from injuries or infections had no access to care for days. In areas like Dera Ghazi Khan and Jacobabad, mothers gave birth in unsanitary tents without medical supervision, leading to a rise in maternal and neonatal complications.

Mobile medical units and relief camps, while helpful, are often under-equipped and understaffed. Long queues of injured people wait for treatment, many of them worsening with time due to lack of timely intervention.

Mental Health and Psychological Trauma

While the physical toll of floods is visible, the psychological trauma often remains hidden. Survivors carry invisible scars. Many relive the horror of drowning relatives, losing homes, or being separated from loved ones in the chaos.

In Khyber Pakhtunkhwa, especially among women and children in flood-hit areas, symptoms of Post Trauma Stress Disorder are widespread. Survivors often report being haunted by nightmares, anxiety attacks during rainfall, and constant worry about their safety. Some even experience suicidal thoughts, overwhelmed by loss and hopelessness.

Regional Patterns and Vulnerabilities

In Hyderabad, a post-flood study revealed that nearly two-thirds of affected residents struggled with anxiety and depression. Many women, having lost their homes and sources of income, reported severe emotional distress but lacked access to counseling or mental health professionals.

In South Punjab, children show troubling signs: difficulty concentrating, aggression, bed-wetting, and social withdrawal. Girls, in particular, exhibit deeper emotional wounds—especially those who witnessed the death of pets or family members or experienced repeated displacement.

Moreover, one of the biggest challenges is the lack of mental health infrastructure. In large parts of Balochistan and Sindh, there are no psychiatrists available at the district level. Even where help exists, stigma and lack of awareness discourage people from seeking support.

Compounded Vulnerabilities

Large Households in Rural Punjab: With many members at home young children and elders, families were slower to respond to evacuation warnings. This led to a higher incidence of injuries and emotional distress among multi-generational households.

Low-Income and Remote Communities: In remote valleys or isolated settlements, healthcare access was severely limited. A single motorcycle ambulance, when it managed to arrive, often handled multiple trauma cases at once, overwhelming local healthcare providers.

Voices from the Ground

In a flood camp in Nowshera, a mother of four described the misery her family faced: “All of us are itching, covered in rashes. My youngest daughter cries all night. We have no soap, no medicine.” Health workers in the area documented thousands of cases of skin infections and malaria within weeks.

In Quetta, malnutrition became a silent killer. Before the floods, more than half the province’s children already faced chronic malnourishment. After the floods, food insecurity soared. Relief efforts were slow, and mothers could be seen rationing dry bread and tea among five or six hungry mouths.

Preventing Floods in Pakistan: A Critical Need for Action

Flooding is one of the most devastating natural disasters in Pakistan, repeatedly wreaking havoc on lives, infrastructure, agriculture, and the economy. From the Indus River basin to glacial lake outburst floods (GLOFs) in the north, the country faces an increasing threat due to climate change, poor planning, and outdated infrastructure.

1. Strengthening Early Warning Systems

Early warning can save lives and reduce damage by giving people time to evacuate or take protective actions.

· Expand Meteorological Capacity: Upgrade Pakistan Meteorological Department (PMD) tools to use satellite-based forecasting, radar systems, and AI-powered flood prediction models.

· Real-Time Monitoring: Install more weather and water-level monitoring stations across vulnerable regions, especially along rivers and near glacial lakes.

· Community Alert Systems: Use SMS, loudspeaker announcements, local radio, and social media to broadcast flood alerts in regional languages, especially to remote or marginalized communities.

2. Glacial Lake Outburst Flood (GLOF) Risk Management

Melting glaciers in northern Pakistan are forming unstable lakes, which can burst and flood mountain villages with little warning.

· Lake Monitoring & Drainage: Regularly monitor glacial lakes using drones and satellite imagery. Where needed, construct controlled drainage channels to reduce lake pressure.

· Protective Infrastructure: Build and reinforce embankments and flood diversion channels in high-risk areas.

· Community Training: Train local residents in emergency response, evacuation drills, and basic glaciology to empower self-rescue in isolated areas.

3. River Management and Infrastructure Upgrades

The Indus River system is highly prone to overflowing during heavy monsoon seasons.

· Dredging & Maintenance: Regularly dredge rivers and canals to remove silt that reduces water-carrying capacity.

· Dam and Barrage Modernization: Strengthen aging dams and barrages to handle higher water volumes, and install automated gates for better water flow control.

· Embankment Construction: Build strong levees and embankments in vulnerable rural and urban areas, especially along the Indus, Ravi, and Chenab rivers.

4. Sustainable Urban Planning

Urban flooding in cities like Karachi and Lahore is often caused by blocked drainage systems and unregulated construction.

· Stormwater Drainage Systems: Upgrade and maintain drainage networks, especially in flood-prone urban centers. Introduce rainwater harvesting to reduce run-off.

· Ban on Encroachments: Remove illegal constructions on natural waterways, and implement strict zoning regulations.

· Permeable Surfaces: Promote the use of permeable pavements and green spaces to allow better water absorption during heavy rains.

5. Reforestation and Watershed Management

Forests and natural vegetation play a critical role in reducing runoff, preventing soil erosion, and stabilizing slopes.

· Afforestation Projects: Expand tree planting in flood-prone districts, especially in upper catchment areas.

· Wetland Restoration: Protect and restore natural wetlands and floodplains that act as buffers during heavy rains.

· Sustainable Agriculture: Encourage terrace farming and contour plowing to reduce surface water flow in hilly areas.

6. Community Awareness and Education

Empowered communities are the first line of defense in flood situations.

· Public Campaigns: Run year-round awareness drives through media and schools on flood risks and preparedness.

· Disaster Education: Integrate disaster response training into school curricula and local government outreach programs.

· Local Volunteer Networks: Form and support local disaster response teams equipped with basic tools and training.

7. Institutional Reforms and Policy Implementation

Effective flood prevention requires coordination across multiple levels of government.

· National Flood Management Plan: Develop a long-term, unified flood management strategy involving federal, provincial, and local authorities.

· Climate-Resilient Policies: Integrate climate change adaptation into infrastructure planning, agriculture, and housing development.

· Funding & Partnerships: Secure consistent funding for flood management through public-private partnerships, international donors, and climate finance mechanisms like the Green Climate Fund.

8. Climate Change Mitigation

As global temperatures rise, extreme weather events and glacial melting are intensifying flood risks.

· Reduce Emissions: Invest in renewable energy, energy-efficient infrastructure, and cleaner transportation.

· Climate Research: Support scientific studies on Pakistan’s climate risks to guide data-driven policies.

· International Cooperation: Engage in regional dialogue on river basin management and climate adaptation strategies with neighboring countries.

Conclusion

Floods in Pakistan are not isolated events rather they are life-altering disasters that leave deep physical and emotional scars. While the destruction of infrastructure and loss of life is visible and devastating, the injuries and trauma that linger in the body and mind are equally catastrophic. Addressing this crisis demands more than temporary aid. It requires a national commitment to building resilient health systems, training mental health professionals, and ensuring no Pakistani is left behind whether stranded on a rooftop or drowning in silent despair.

By Asma Ali
Master of Arts (MA)
English Literature

Prayer Over Pills:
When Belief Risks Becoming Betrayal
:دعاؤں کو دواؤں پر ترجیح
جب عقیدہ دھوکہ بن جائے
:गोलियों की जगह प्रार्थना
जब विश्वास विश्वासघात बनने का जोखिम उठाता है

“True belief does not shun the cure—it welcomes it as grace in another form.”
“The divine does not demand your silence when there is a scream of pain.”
“When faith becomes a wall against healing, it no longer shelters—it suffocates.”
“A prayer may lift the soul, but a pill may save the body—both are sacred in their own way.”
“To let someone suffer while you pray is not faith—it is quiet cruelty dressed in devotion.”
“When belief blinds us to reality, it stops being divine—it becomes denial.”

There are moments in life when faith feels like the only thread holding us together—when the weight of a diagnosis or the fear of losing someone makes us fall to our knees in search of divine mercy. In those sacred moments, we whisper prayers with trembling hands, hoping the heavens will hear us. But what happens when our devotion to the divine overshadows the very remedies placed within our reach? When belief, instead of being a source of strength, becomes a wall between suffering and salvation?

Faith and medicine don’t have to stand on opposite sides. They can walk side by side—each offering something the other cannot. Faith gives us hope, strength, and the belief that we are not alone in our pain. Medicine gives us the tools, knowledge, and care to heal the body. Together, they can create a path that treats both the soul and the suffering.

This article is not an argument against faith—but a reflection on its misplacement. It’s about the quiet tragedies that unfold when pills are rejected for prayers alone, when medical science is seen not as a gift but as a threat to spiritual purity. It’s about the children left untreated, the elderly neglected, and the silence that follows decisions made in the name of God—but against the will to heal.

At the intersection of belief and responsibility lies a difficult truth: when we abandon care under the guise of conviction, belief can become betrayal.

In many corners of Pakistan—rural villages, crowded cities, even within educated households—a dangerous silence surrounds illness. A child with seizures is not rushed to a neurologist; instead, a black thread is tied around their wrist. A woman suffering from depression is not offered therapy; she’s taken to a pir who whispers over water and calls it healing. A man writhing in pain from an undiagnosed condition is told, “It’s a test from God, Be patient.”

Time after time, illness is not named—it is spiritualized. A headache becomes the evil eye. A fever is seen as a test from God. A mental breakdown is blamed on jinn possession. And while prayers are offered and amulets are worn, real treatment is delayed—or denied altogether.

By the time the truth arrives, it’s often too late. The child stops breathing. The woman loses herself. The man dies waiting for a cure that never came, because belief stood guard at the door of medicine and refused to let it in.

This isn’t just a matter of ignorance—it’s a cycle born from fear, tradition, and a deep mistrust of science. It’s passed down like folklore, told in whispers, sealed in silence. And perhaps the greatest tragedy is that these deaths don’t make headlines—they are buried quietly, under the weight of phrases like “taqdeer ka likha” (what was written in fate).

But fate did not fail them. We did.

In a world where medical science now prints human organs, edits DNA, and can prolong life beyond what seemed imaginable just decades ago, a curious paradox still holds firm: when illness strikes, many people don’t turn to science—they turn to prayer.

Not as comfortable. Not as a companion to treatment. But as the treatment.

It’s not an anomaly. It’s a legacy. A long and complicated lineage of belief that runs across cultures, languages, and centuries—one that sometimes sees prayer not as a balm for the spirit, but as a cure for the body. Even when it’s not. Even when it can’t be.

Because for some, taking a pill feels like a betrayal. As if placing faith in medicine somehow means placing doubt in God.

But at what point does that devotion cross a line—from personal conviction into public crisis? From faith into fatalism?

Prayer doesn’t come with side effects. It doesn’t require a prescription. You don’t need money, insurance, or access to a pharmacy. For people in pain—especially those abandoned by broken healthcare systems—that simplicity is seductive. It feels pure. It feels powerful.

But it can also be deadly.

A child with Type 1 diabetes does not get better because someone fasts and prays. A tumor doesn’t shrink because hands were laid on someone in a church pew. These aren’t abstract claims. They’re autopsy reports. Obituaries. Quiet tragedies that never make the news.

And here’s the hard truth: these choices are rarely made out of ignorance. Often, they’re rooted in love. In desperation. In the belief that to rely on medicine is to suggest that divine intervention isn’t enough.

But faith and medicine were never meant to compete. They were meant to cooperate.

Look closely and you’ll see something striking: nearly every major religion holds space for science. The Bible, the Quran, the Torah, the Vedas—all emphasize wisdom, the value of knowledge, the importance of healing.

Look closely and you’ll see something striking: nearly every major religion holds space for science. The Bible, the Quran, the Torah, the Vedas—all emphasize wisdom, the value of knowledge, the importance of healing.

In the Christian tradition, Luke—a gospel writer—was a physician. Islam teaches that for every illness, there is a cure. Hinduism reveres Ayurveda as sacred knowledge gifted by the gods themselves. Judaism insists on pikuach nefesh—the principle that saving a life overrides almost any religious law.

So where did this idea come from—that medicine is a lack of faith?

Maybe it’s fear. Or ego. Or the seductive simplicity of magical thinking: the belief that we can pray a disease away and prove ourselves worthy in the process.But perhaps the more courageous act of faith is accepting that God’s work might already be in motion—through doctors. Through science. Through the very hands holding the scalpel.

Let’s be clear: if an adult wants to refuse treatment and face death on their knees in prayer, that is their right.

But when that decision is made for someone else—a child, a dependent, someone unable to choose—it stops being faith and starts looking like negligence.

And this is where the ethical ground becomes unsteady.

How do we reconcile religious freedom with basic human rights? At what point does “trusting God” become a shield for avoiding responsibility?

Parents who refused blood transfusions for religious reasons. Guardians who rejected chemotherapy in favor of spiritual fasting. The outcomes are almost always the same: the prayers were sincere. The funerals were real.

The most dangerous myth we’ve inherited is that there’s a binary: believe in God or believe in science. It’s a lie. And it’s costing lives.

Faith doesn’t have to crumble under a microscope. Medicine doesn’t have to eclipse mystery. In fact, some of the most devout scientists—the ones mapping genomes, discovering vaccines, performing open-heart surgeries—see their work as an act of worship.

They’re not choosing between miracles and medicine. They believe medicine is a miracle.

There are hospitals where imams, priests, rabbis, and chaplains walk side by side with surgeons. Rooms where prayers are said before anesthesia is administered. Communities where faith amplifies healing instead of obstructing it.

This isn’t a weakness. It’s maturity. It’s the acknowledgment that healing is not always linear, and rarely simple—but that denying what can help because it wasn’t born in a temple or mosque is a kind of spiritual hubris.

Choosing prayer over pills isn’t just a personal health decision—it’s a moral stance. It says something about how we see suffering, who we think deserves healing, and what we’re willing to risk in the name of righteousness.

But the most dangerous assumption is that one must choose. We don’t have to pick sides between soul and science. We just have to pick wisely—especially when lives are on the line.

Faith can still be our compass. But medicine must be the map.

Because belief should never be what stands between a person and a second chance.

In Pakistan, illness is often met first with a whispered prayer. Then another. Then dozens, sometimes hundreds—chanted at mosques, inscribed on amulets, sent up by trembling hands toward an unseen sky. Prayer here is not just a comfort; it is a protocol. But what happens when that becomes the only protocol? When pills are abandoned, doctors are mistrusted, and disease is handed over to the divine?

What happens is already happening. In rural villages and urban slums alike, children die of preventable diseases. Women perish in childbirth without ever seeing a hospital. Tuberculosis, hepatitis, even polio—diseases the rest of the world has long contained—still claim lives in Pakistan not because the country lacks medicine, but because too many choose not to use it.

Blind faith is not just a personal belief here—it has become a public health crisis.

Pakistan is not a country without medical infrastructure. It has brilliant doctors, globally renowned hospitals, and pockets of cutting-edge research. But access to medicine is only half the battle. The other half is cultural resistance—an unspoken war between belief and biology.

In many communities, illness is seen not as a medical condition but as a test from God, a result of sins, or even the effect of jinn. Spiritual healers, pirs, and faqeers operate unchecked, prescribing verses over vaccines, talismans over tablets. The language of science struggles to penetrate a landscape where divine will is invoked in every diagnosis.

The cost? In measurable numbers: over 400,000 child deaths per year, many from treatable conditions like pneumonia and diarrhea. In immeasurable ones: a loss of potential, a perpetuation of ignorance, a generational inheritance of fear over fact.

It’s easy to blame poverty, illiteracy, or poor governance. But those are only part of the problem. There is a deeper, more corrosive force at play: mistrust.

Decades of state failure, inconsistent healthcare delivery, and corruption have eroded confidence in medical institutions. Hospitals are seen as impersonal. Doctors are suspected of greed. Pharmaceutical companies are painted as foreign exploiters. And in that vacuum of trust, faith swoops in—not as a companion to medicine, but as its replacement.

Mosques fill up faster than clinics. People would rather pay for a prayer session than a diagnosis. A mother who loses her child to measles may blame fate, not the choice to refuse a vaccine. In this world, medicine is not just questioned—it is rejected.

“The pious are not those who reject medicine, but those who see it as God’s mercy.”

Faith, in its purest form, can be a powerful source of hope. But when wielded carelessly, it becomes a tool of oppression. It is used to silence inquiry, to stigmatize illness, to shame those who suffer.

Women are perhaps the greatest casualties of this blind faith. In conservative pockets of the country, seeking medical help—especially from male doctors—is discouraged. Pregnancy complications are left to “God’s will.” Mental illness is attributed to demonic possession. Victims of epilepsy or depression are hidden away, not treated.

When prayer becomes a prison, faith is no longer holy—it is harmful.

Pakistan is a nuclear-armed country where you can still find parents refusing polio drops because they believe it will sterilize their children. A country with a national healthcare budget dwarfed by religious spending. A country where a man with a stethoscope is questioned, while a man with a string of beads is revered.

And yet, this isn’t just about rural superstition. Even in educated, urban households, you’ll hear phrases like “Allah shifa de ga” before you hear “let’s go to the doctor.” The assumption isn’t that medicine heals—but that healing, ultimately, only comes from above.

Faith is not the enemy. But blind faith is. Especially when it costs lives.

Here are real-life incidents from Pakistan that tragically reflect how belief in black magic, jinn, or divine testing can lead to dangerous negligence.

1. The Child with Epilepsy – Diagnosed as Possessed

In a village near Bahawalpur, a 10-year-old boy named Sameer began having seizures. His parents believed he was under the influence of a jinn. Instead of taking him to a doctor, they took him to a local pir (spiritual healer), who beat the child with a peacock feather and made him drink “blessed” water. For months, the family followed rituals while his condition worsened. By the time they finally consulted a neurologist in Multan, it was too late—Sameer died of complications from untreated epilepsy.

2. The Mother with Postpartum Depression – Called ‘Cursed’

In Karachi, a young woman named Sadia began showing signs of severe postpartum depression after the birth of her second child. Her family thought she was being punished by God for “not being thankful.” She was locked in a room, given taweez (amulets), and kept away from her children. No psychiatrist was consulted. One night, overwhelmed and isolated, Sadia ended her life. Her suicide was quietly called “mental weakness” and buried with her.

3. The Girl with Cancer – Misdiagnosed as Nazar (Evil Eye)

In interior Sindh, a 14-year-old girl named Aaliya developed a lump in her neck. Her family assumed it was due to nazar (evil eye). Neighbors suggested visiting a local shrine instead of a hospital. She was kept on herbal teas and spiritual baths for nearly a year. When the lump grew worse and pain became unbearable, they finally went to a hospital in Hyderabad—only to be told it was late-stage lymphoma. She died within two months.

4. The Man with Schizophrenia – Chained in His Own Home

Rashid, a 27-year-old from Faisalabad, started hearing voices and behaving erratically. His relatives believed he was “majzoob” (spiritually touched or mad due to divine connection). Instead of psychiatric care, he was chained to a bed, beaten by a faqeer (wandering spiritual figure), and force-fed dum ka paani (prayed-over water). He remained untreated for years. Eventually, he escaped and went missing—never to be found again.

These stories are not isolated—they are painfully common. Behind each is a grieving family, a child without a future, a mother without support, a mind left to shatter in silence. They show the cost of misplaced faith—not in religion, but in misinterpretation and fear disguised as devotion.

This is not a call to abandon prayer. It is a plea to balance it with reason. To understand that medicine is not a betrayal of belief—it is a manifestation of it.

What We Can Do: A Path Forward

1. Community Awareness Drives Launch grassroots-level awareness campaigns in Urdu and regional languages, focused on differentiating between illness and superstition. Use mosques, community centers, and local media.

2. Involve Religious Scholars Collaborate with respected Islamic scholars who can preach the compatibility of medicine with faith during sermons, making people realize that seeking treatment is also part of faith.

3. Train Lady Health Workers & Teachers Equip frontline health workers and schoolteachers to identify symptoms of common medical and mental health issues. Let them become the first bridge between community and care.

4. Strengthen Mental Health Services Push for free mental health hotlines, mobile clinics, and rural counseling centers, so help feels close, not distant or shameful.

5. Regulate Spiritual Healers Create laws that prevent abuse by unqualified spiritual healers. Healing shrines and peers must not operate in ways that endanger lives.

6. Media Responsibility Encourage Pakistani dramas, films, and talk shows to portray illness more responsibly—highlighting recovery through medical care, not mysticism.

Pakistan must invest not only in hospitals, but in public awareness. Doctors must become community allies, not distant figures behind desks. Medical literacy must begin in mosques, in homes, in schools. Religious leaders must be engaged as partners, not opponents, in health initiatives.

Because no amount of prayer will substitute for a ventilator. No talisman will replace a vaccine. And no nation can survive when its people trust miracles more than medicine.

Final Word: A Call for Compassionate Wisdom

Faith can move mountains. But it cannot—must not—be the reason a child dies from diarrhea. Or a mother bleeds out in labor. Or a man coughs himself to death from untreated TB.

Prayer belongs beside the pill, not in place of it. Anything less is not belief—it is betrayal.

In the end, this is not a battle between prayer and pills. It is a plea for balance—a reminder that faith and medicine were never meant to be enemies. Prayers lift our spirits, but medicine carries the body. When we deny one for the other, we betray both.

Pakistan is a land of deep spiritual roots. But somewhere along the way, we began mistaking superstition for submission, and silence for surrender. Illness—whether of the body or the mind—is not a punishment. It is not always a test. Sometimes, it’s just a cry for help. And we owe it to each other—not just as doctors or believers, but as human beings—to respond with compassion and reason, not just ritual.

The question is no longer “Is it jinn or black magic?” The real question is: “Why do we wait until it’s too late to seek what could save us?”

Let’s stop choosing between belief and healing. Let’s choose both—wisely, and in time.

“Science is not the enemy of faith—it’s often its answer.”
“Belief should heal, not harm.”
“True faith shares the pain, not just the prayer.”
“Prayer offers hope of healing, but medicine promises the path.”

Dr. Ramsha Zafar
Physician/Internal Medicine
Video: YouTube

Disinformation, Distrust, and Disease:
The Triple Threat Fueling Polio’s Survival in Pakistan
:غلط معلومات، بےاعتمادی اور بیماری
پاکستان میں پولیو کو زندہ رکھنے کے تین خطرات
: गलत सूचना, अविश्वास और बीमारी
पाकिस्तान में पोलियो को जीवित रखने के लिए तीन खतरे

In Pakistan, the fight against polio isn’t just about a disease—it’s about fear, misinformation, and a deep sense of distrust. For many families, polio remains a harsh reality, not just because the virus is still here, but because of the barriers that stand in the way of ending it. While medical experts have long known the solution, there’s a battle happening on the ground—one that is shaped by rumors, beliefs, and a lack of trust in the people who are supposed to protect them.

Misinformation about the polio vaccine runs rampant in many communities. False stories and misconceptions spread like wildfire, making parents afraid to vaccinate their children. But it’s not just the rumors—it’s the years of mistrust in the system, in the government, and even in the international aid efforts. These feelings, built over time through political struggles and broken promises, make it even harder to reach the children who need protection the most.

The result? The polio virus continues to spread, and children continue to suffer, not just from the disease, but from a community’s failure to come together in the fight against it. This article will explore the three forces—disinformation, distrust, and disease—that are keeping polio alive in Pakistan, and why overcoming them is crucial for the future of countless children.

Pakistan, along with Afghanistan, is one of the few remaining countries where polio is still endemic. Despite significant efforts, the virus continues to circulate, posing a threat to children in the country.

Poliomyelitis (polio) remains a persistent challenge in Pakistan despite decades of concerted global efforts aimed at eradication. Polio is a highly infectious viral disease that primarily affects children under the age of five, leading to paralysis, disability, and sometimes death. While significant progress has been made worldwide in reducing the incidence of polio, Pakistan continues to report a significant number of cases, making it one of the last remaining polio-endemic countries alongside Afghanistan.

Polio in Pakistan – An Overview

Polio, caused by the poliovirus, affects the central nervous system and can lead to irreversible paralysis. The virus spreads primarily through contaminated water and food and can be prevented through immunization. Pakistan’s ongoing battle with polio is largely due to a combination of socio-political, logistical, and cultural barriers.

Detection of Poliovirus in Sewage Samples

Between January 6 and 15, 2025, environmental samples collected from 26 districts tested positive for wild poliovirus type 1 (WPV1). The affected districts spanned all four provinces:

● Sindh: Hyderabad, Jacobabad, Jamshoro, Kambar, Karachi (Central, East, Keamari, Korangi, Malir, South), Mirpur Khas, Shaheed Benazirabad, Sujawal, Sukkur.

● Khyber Pakhtunkhwa: Peshawar, Bajaur, Dera Ismail Khan, Tank.

● Balochistan: Chaman, Loralai, Pishin, Quetta, Zhob.

● Punjab: Lahore, Multan, Rawalpindi, Gujranwala, Gujrat, Okara, Rahim Yar Khan, Bahawalpur, Dera Ghazi Khan.

Implications of Sewage-Based Surveillance

The detection of WPV1 in sewage indicates active transmission of the virus within these communities. Sewage surveillance serves as an early warning system, often identifying the presence of the virus before clinical cases are reported. This method allows health authorities to target interventions more effectively, focusing on areas with confirmed environmental contamination. Despite the country’s progress in immunization coverage, cases of wild poliovirus (WPV) continue to surface.

● Current Statistics: As of early 2025, Pakistan has reported 74 polio cases, a significant rise from previous years. This indicates the persistence of the virus and the challenges in reaching all children with vaccines.

● Geographic Distribution: Polio cases are predominantly reported from the tribal areas of Khyber Pakhtunkhwa, Balochistan, and parts of Sindh, where insecurity, political instability, and inaccessibility have complicated vaccination efforts.

Understanding the Polio Virus

Poliomyelitis is caused by the poliovirus, which belongs to the enterovirus family. There are three types of polio viruses (types 1, 2, and 3), with type 1 still circulating in a few countries, including Pakistan.

Spread of Polio in Pakistan

Polio remains endemic in Pakistan, primarily due to factors associated with the country’s social, economic, and healthcare conditions. The virus spreads primarily through the fecal-oral route, which means it is contracted when contaminated food, water, or surfaces come into contact with the mouth. The key factors influencing the spread of the virus in Pakistan include:

1. Low Vaccination Coverage

Despite decades-long efforts to eradicate polio, low vaccination coverage remains a major obstacle. This is largely due to multiple overlapping factors such as logistical barriers, poverty, and a fragile healthcare infrastructure. In remote villages and urban slums, many children are consistently missed during national immunization rounds. These areas often lack proper roads, electricity, and communication networks, making it difficult for health workers to reach every household. Additionally, families living in extreme poverty may not prioritize vaccination, either due to lack of awareness or more immediate survival concerns like food and shelter.

2. Poor Sanitation and Hygiene in Slum Areas

A significant portion of Pakistan’s population resides in urban slums and informal settlements, where sanitation conditions are severely compromised. These areas often lack basic facilities such as toilets, waste disposal systems, and access to clean drinking water. As polio is primarily transmitted through the fecal-oral route, the combination of open defecation, contaminated water sources, and poor hygiene practices creates an ideal environment for the virus to spread. Children who play in dirty surroundings or consume unsafe water are at an especially high risk of contracting the virus, regardless of vaccination status.

3. Cultural Misbeliefs and Religious Resistance

Deep-rooted cultural and religious misconceptions continue to fuel vaccine hesitancy in several regions. Misinformation campaigns—often driven by mistrust of government or foreign health interventions—have led some communities to believe that the polio vaccine is harmful. Common myths include the belief that the vaccine causes infertility or that it is a Western ploy to harm Muslim populations. These misbeliefs are particularly prevalent in tribal areas and among uneducated populations, where poverty and low literacy rates limit access to credible health information.

4. Insecurity, Conflict, and Mistrust

In regions plagued by militancy and conflict, such as parts of Khyber Pakhtunkhwa, Balochistan, and Sindh, health workers face life-threatening risks. In these unstable zones, mistrust toward outsiders is common, and vaccination teams are often viewed with suspicion. Militants have targeted polio workers, claiming the vaccine is part of a spying mission. Fear and violence have led many families to decline vaccinations to avoid attention or perceived retaliation. The volatile security situation, coupled with poor local infrastructure and governance, makes consistent immunization campaigns nearly impossible in these areas.

5. Weak Healthcare Infrastructure

Pakistan’s healthcare system struggles with underfunding, lack of trained personnel, and inadequate outreach programs, especially in impoverished and rural settings. Many basic health units are non-functional, and cold chain logistics (essential for vaccine preservation) are often unreliable in remote regions. Poor infrastructure—such as damaged roads, lack of transportation, and minimal healthcare staffing—prevents timely and effective vaccine delivery. For families in slums or distant villages, even reaching a health facility can be a costly and time-consuming endeavor.

6. Poverty and Marginalization

Poverty underpins nearly every barrier to polio eradication in Pakistan. In low-income families, especially those living in overcrowded slums or rural settlements, daily survival often takes precedence over preventive health measures. Parents may not see the value of a vaccine for a disease they don’t understand, especially when faced with immediate concerns like food insecurity and unemployment. Additionally, poor nutrition—common among children in poverty—weakens the immune system, making them more vulnerable to infections even if partially vaccinated.

7. Environmental Contamination and Virus Circulation

Environmental surveillance in Pakistan has detected poliovirus in sewage systems, indicating ongoing silent transmission. This means that even if visible cases of polio decrease, the virus may still be circulating within communities due to unsanitary conditions. Slum areas, where open drains and exposed sewage are common, serve as reservoirs for virus persistence. In these environments, one infected child can continue to spread the virus to many others, especially where herd immunity is not achieved due to low vaccination rates.

Pakistan is still endemic for polio because of a long history of attacks on polio workers. 

Symptoms of Polio Virus

Polio (poliomyelitis) is a highly contagious viral infection caused by the poliovirus. The symptoms of polio can vary significantly, with some individuals being asymptomatic, while others may experience severe neurological consequences. The symptoms typically appear within 6 to 20 days after exposure to the virus.

Common Symptoms of Polio:

1. Fever – Often one of the first signs of infection.

2. Fatigue – A feeling of general exhaustion, often leading to weakness and difficulty in physical activities.

3. Headache – Mild to severe headaches.

4. Stiffness in the Neck and Back – Characteristic of the disease, caused by the virus affecting the spinal cord.

5. Muscle Weakness – This may eventually lead to paralysis. Muscle weakness usually starts in the legs and can progress to other parts of the body.

6. Pain in Limbs – Muscle pain or tenderness can occur, particularly in the arms or legs.

7. Vomiting and Nausea – Some people may experience gastrointestinal symptoms like vomiting.

8. Paralysis (in severe cases) – This is the most concerning symptom. Polio can cause permanent paralysis, usually in the legs, and may even affect the diaphragm, impairing breathing. The paralysis can be asymmetrical (affecting one side of the body more than the other).

Types of Polio:

1. Non-paralytic Polio – This type includes flu-like symptoms such as fever, headache, and muscle pain but does not cause permanent paralysis.

2. Paralytic Polio – This is the most severe form, where the virus damages the spinal cord and brain stem, leading to paralysis. This form can be life-threatening, especially if the respiratory muscles are affected.

Immunization and Prevention:

The use of oral polio vaccine (OPV) and inactivated polio vaccine (IPV) has been instrumental in reducing global cases of polio by over 99%. However, a gap in vaccination coverage, especially in high-risk areas, has allowed the virus to persist.

Challenges in Eradication

Despite being one of the last countries where polio remains endemic, Pakistan faces multiple challenges in eradicating polio. These challenges are compounded by a combination of security issues, misinformation, and logistical difficulties.

● Security Concerns: One of the most significant barriers to polio eradication in Pakistan is the security situation in regions such as North and South Waziristan, Khyber Pakhtunkhwa, and Balochistan. The presence of militant groups in these areas has resulted in frequent attacks on polio vaccination teams and law enforcement officers, making it difficult for health workers to safely administer vaccines.

● Misinformation and Vaccine Hesitancy: Vaccine hesitancy remains a significant issue, especially in rural and conflict-prone regions. There are widespread misconceptions and myths about the polio vaccine, with some people believing it causes infertility or that it is part of a foreign conspiracy. These beliefs have led to refusals, hindering vaccination efforts.

● Inaccessible Areas: In areas affected by conflict or in remote rural regions, vaccination teams struggle to reach children due to physical inaccessibility, social instability, or political resistance.

The Role of the Government of Pakistan

The Government of Pakistan plays a crucial role in the ongoing effort to eradicate polio. Efforts include:

● Polio Eradication Initiatives: Pakistan’s government has implemented nationwide polio eradication campaigns, which involve mass vaccination efforts, surveillance, and case detection. The government has set up an Emergency Operations Center (EOC) to coordinate efforts, monitor progress, and respond to challenges.

● Polio Control Program: The Pakistan Polio Eradication Program (PPEP) works in close collaboration with health departments, local governments, and international partners to ensure that polio vaccination teams are deployed efficiently, especially in high-risk areas.

Global and National Efforts in Polio Eradication

Despite these challenges, both national and international efforts continue to focus on eradicating polio from Pakistan. Key strategies include:

● Increased Vaccination Drives: The government, in partnership with international organizations, conducts national immunization days and focused campaigns to vaccinate every child under 5, even in the most remote areas.

● Polio Surveillance Programs: Environmental monitoring and surveillance of sewage systems continue to provide crucial data on the presence of the poliovirus, guiding vaccination efforts.

● Community Engagement: Efforts to engage local communities, religious leaders, and traditional healers aim to reduce resistance and increase acceptance of the polio vaccine.

● Security Measures for Health Workers: Security measures are being ramped up in high-risk areas to protect polio vaccination teams from attacks, and armed forces are often involved in ensuring safety.

● Global Support: International organizations like the WHO, UNICEF, and the Gates Foundation have played a pivotal role in supporting Pakistan’s polio eradication initiatives through funding, technical assistance, and advocacy.

Role of the World Health Organization (WHO)

The World Health Organization (WHO) has been at the forefront of the global initiative to eradicate polio. WHO has played a critical role in Pakistan’s polio eradication efforts by:

● Providing Technical Assistance: WHO provides technical support in the form of guidelines for vaccination, surveillance, and outbreak response.

● Polio Surveillance: WHO coordinates efforts to track the transmission of poliovirus through surveillance systems that detect new cases and monitor the spread of the virus.

● Supporting Vaccination Campaigns: WHO provides funding, training, and logistic support for vaccination campaigns, especially in hard-to-reach and conflict zones.

The Role of Other International Partners

Several international organizations and countries have collaborated with Pakistan in its fight against polio.

Some of the key contributors include:

UNICEF: UNICEF provides critical support in terms of funding, resources, and logistical assistance. It also works to raise awareness about the importance of vaccination, especially in areas where polio vaccine hesitancy is prevalent.

● Bill & Melinda Gates Foundation: The Gates Foundation has been a major partner in the Global Polio Eradication Initiative (GPEI), providing substantial financial resources to ensure the sustainability of vaccination campaigns and the continuation of eradication efforts.

● Rotary International: Rotary International has been a long-time partner in the fight against polio, providing funding, advocacy, and volunteer support.

Impact of Polio on Pakistan

Polio has had a significant impact on Pakistan in terms of both health and socioeconomic factors.

● Health Impact: Polio has left thousands of children paralyzed, with many of them unable to lead independent lives. The emotional and physical toll on families is immense.

● Economic Consequences: The economic burden of polio is high due to the long-term care required for those affected. Families often face substantial medical expenses, and the government must allocate resources for polio vaccination programs and healthcare.

● Psychosocial Impact: The fear of polio and its long-lasting effects also place a burden on communities, leading to a lack of confidence in the healthcare system.

International Aid and Financial Support

International aid has been instrumental in supporting Pakistan’s polio eradication efforts. Financial contributions from international donors have helped ensure that polio vaccines are available, especially in remote and underprivileged areas.

● GPEI Fund: The Global Polio Eradication Initiative (GPEI) is one of the main global platforms supporting Pakistan’s polio eradication efforts. The initiative has received funding from governments, the private sector, and philanthropic organizations.

● Saudi Arabia’s Contribution: Saudi Arabia has made substantial contributions to the GPEI, including a commitment of $500 million to support polio vaccination efforts in Pakistan and Afghanistan. This financial support is aimed at providing vaccines, training, and logistical support.

Conclusion

Polio remains a pressing health issue in Pakistan, but it is not an insurmountable challenge. With the combined efforts of the Pakistani government, international organizations, and local communities, there is hope that polio can eventually be eradicated. The role of global partners

like the WHO, UNICEF, the Bill & Melinda Gates Foundation, and others has been invaluable in supporting Pakistan’s eradication efforts.

However, significant challenges remain, and overcoming them requires continued commitment, strategic planning, and the support of both national and international actors. As long as polio continues to affect children in Pakistan, the fight for eradication must persist until the disease is eliminated worldwide.

Polio is not just a health crisis—it’s a reflection of a system that has failed to protect our children, but more importantly, it’s a wake-up call for us as a nation. For years, Pakistan has struggled to eliminate polio, and while there have been efforts, the virus is still far too prevalent. But the truth is, the drawbacks in our system are not just technical—they are rooted in misinformation, lack of trust, and deeply ingrained barriers that we, as a country, have the power to address.

The polio vaccination campaigns have faced countless hurdles: poor coordination, inadequate outreach in rural areas, and the persistence of false information about the safety of vaccines. These obstacles are not just logistical; they are deeply tied to the disinformation that spreads like wildfire in communities, stoking fear and resistance. This misinformation, combined with historical mistrust in governmental initiatives, has created a perfect storm that keeps the virus alive. Yet, these challenges are not insurmountable.

As a nation, we have everything we need to defeat this disease—we have the vaccines, the medical expertise, and the global support. But what we lack is the unity and collective resolve to break through the barriers that continue to perpetuate polio’s survival. The question isn’t whether we can end polio; it’s whether we, as a nation, can confront the challenges that have allowed it to persist.

This is in our hands. It’s not just about the health of our children; it’s about the future of Pakistan. By addressing the misinformation, rebuilding trust in our healthcare system, and ensuring that every child gets vaccinated, we can create a polio-free future. This fight is ours to win—and it starts with us, together.