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For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

By The Global Fund

April 13^th, 2023

Nothing could stop the flood waters.

Fazila, a 25-year-old midwife, received a red alert to evacuate her village in Pakistan’s Sindh province.

For the next eight days, under the blazing Pakistani heat, Fazila moved all her things to a safe place – a house on a hill that had remained dry during past monsoon-season floods.

Then Fazila and her mother fled for safety.

But this flooding was different. A few days later their village was completely under water, including the house where Fazila had carefully stored everything they owned. Fazila and her mother spent the next two weeks living in a tent in a makeshift camp on a bridge.

For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

“It was a really difficult time It was very hot and there was no running water or washroom,” says Fazila. “Everything we had was under water.”

When they were finally able to return to their one-room home, the water inside stood as tall as Fazila. The walls were cracked, the kitchen and bathroom were destroyed, and everything was covered with mud and garbage. They pitched a tent in the courtyard next to their destroyed home.

For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

“It has been months and there is still (flood) water standing in many villages. People are still living in tents,” says Fazila.

Fazila and her mother find themselves in the same situation, as their house remains unsafe and impossible to live in.

Protecting Others While Caught in Crises

As Fazila navigates her way through her own crisis, she is also protecting her community.

Fazila is a midwife at the Indus Hospital in Sehwan, Pakistan. At age 16 she saw her aunt die in childbirth and decided she would become a doctor to protect other women. Her family couldn’t afford medical school, so she became a midwife instead.

Shortly after returning to her destroyed home, Fazila began working in mobile health units set up by the Indus Hospital and Health Network with support from the Global Fund to Fight AIDS, Tuberculosis and Malaria.

For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

The health units were dispatched in August to reach communities most severely affected by the flooding with vital health services. When the flood waters were at their highest, Fazila and her colleagues travelled by boat to reach communities that had been completely cut off by the rising water.

Today, these mobile clinics continue to bring essential health services to communities that have yet to recover from last summer’s devastating and unprecedented emergency.

One of Fazila’s roles on the mobile health unit is testing and treating people for malaria, as cases started to rapidly increase with the rising flood waters, the preferred breeding ground for mosquitos that transmit the disease.

For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

Climate Change Fuels the Spread of Malaria

Climate change is responsible for more intense and more frequent extreme weather events such as storms, droughts, wildfires and floods. It was a severe heat wave followed by heavier-than-usual monsoon rains and melting Himalayan glaciers that led to Pakistan’s unprecedented floods last year – and then a massive surge in malaria cases.

Fazila says that she remembers 50% of her patients in the mobile clinic testing positive for the disease.

According to the World Health Organization, in 2022 there were more than 1.6 million confirmed cases of malaria in 60 of Pakistan’s districts – a fourfold increase from the 400,000 cases recorded the year before.

There was also a higher proportion of malaria cases coming from mosquitoes carrying the more deadly Plasmodium falciparum species of the disease, which is typically found in parts of Africa – not in Asia.

For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

The Executive Director of Indus Hospital and Health Network, Dr. Mah Talat, recalls clouds of mosquitoes so thick that she and her colleagues could barely see through them. She says every person she met who was impacted by the flooding either had malaria themselves or had a family member who had the disease. She says the flooding and resulting health crisis were devastating – and that the emergency is far from over.

"The rains have started again, and we are receiving reports of malaria cases increasing as April marks the beginning of the first of two transmission seasons,” she says. “Homes and health facilities are still damaged, health workers haven’t recovered, and huge pools of stagnant flood water remain. We need to act now to ensure this year’s monsoon season isn't more tragic than last year.”

The Global Fund’s Rapid Response

The Global Fund responded rapidly to the flooding and resulting health emergency in Pakistan.

In the immediate aftermath of the flooding, Global Fund investments supported emergency health camps and mobile clinics where Fazila and colleagues provided vital health services, including malaria testing and treatment. Global Fund support was also used to provide clean water, emergency food packs and generators.

Malaria is one of the most climate-sensitive infectious diseases - in many regions of the world climate change is driving up malaria cases and deaths, often among the poorest and most remote communities.

Today, the Global Fund is supporting ongoing malaria control activities across Pakistan, including community-based malaria tests and treatment, distribution of insecticide-treated nets, indoor residual spraying and education campaigns for communities with the highest burden of the disease. Investments have also been used to repair and renovate laboratories and clinics that were damaged or destroyed during the floods.

Little by little, Fazila is trying to repair her home and replace the belongings that she and her mother lost.

But she worries about the approaching monsoon season this summer.

“The flooding will keep happening so we should make plans, so we are better prepared to deal with these difficulties,” she says.

For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

For Fazila and Millions of Others in Pakistan, Climate Change Brings Extreme Floods and Malaria

Footnotes

Written by Melanie Sharpe, reporting by Tazeen Bari and photos by Saiyna Bashir. With many thanks to Indus Hospital and Health Network in Pakistan for their support.

FootNotes

Written by Melanie Sharpe, reporting by Tazeen Bari and photos by Saiyna Bashir. With many thanks to Indus Hospital and Health Network in Pakistan for their support.

© 2026 The Global Fund

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