Since June 2022, Pakistan has experienced severe and unprecedented monsoon weather, including 67% additional rainfall in August 2022 as compared to other years. The heavy monsoon rains have triggered the most severe flooding in Pakistan’s recent history, resulting in the washing away of villages, roads and buildings, the displacement of millions of people, and the increase of public health threats in flood-affected areas. Fellows and alumni of the Pakistan Field Epidemiology and Laboratory Training Program (FELTP) have provided crucial support to flood response efforts, including supporting health departments in calamity hit districts, developing emergency surveillance and response systems, and training frontline health staff in affected communities.
FELTP graduates have been working at the district, provincial, and national levels to assist with coordination of efforts across multiple sectors. Within the recently established National Flood Response Coordination Center (NFRCC), FELTP graduates are coordinating disease surveillance and providing daily situational reports to key actors involved in the response. Additionally, the FELTP Coordinator has been serving as the co-chair for daily health cluster meetings with the World Health Organization (WHO), Ministry of National Health Services, UN agencies, non-governmental organizations (NGOs), and provincial health departments to ensure cross-sector collaboration.
These national-level meetings reference data collected and analyzed at Provincial Disease Surveillance Units (PDSRUs), which have been bolstered by the FELTP team’s involvement. The team has established a daily reporting system and regularly monitors trends of communicable diseases in flood affected areas, which helps to develop and inform response plans. As part of these efforts, FELTP alumni also provide technical support to provincial and district health departments to ensure rapid access to essential health services, strengthen and expand disease surveillance and outbreak response, and implement preventive and control measures. They have also assisted these health departments in establishing emergency control rooms and medical camps.
With more than 2 million households damaged from the floods, many individuals are living in open areas with scarce supply of safe drinking water and food, exposing them to a number of post-flood related risks, infectious diseases and other health hazards. The FELTP has assisted with community outreach and engagement efforts, working with community leaders to develop and disseminate messaging about the risk of water- and vector-borne diseases that can result from stagnant flood water. Given the increased risk and occurrence of acute diarrhea, typhoid, malaria, dengue, viral hepatitis, leishmaniasis, and other infectious diseases following the floods, these outreach efforts have been critical in ensuring the health of the population.
Throughout the response, the FELTP has encountered a number of challenges, including communication disruptions and difficult road conditions. Damaged infrastructure has resulted in interruptions to communications channels which are critical for data collection and information exchange; however, the FELTP has been able to develop alternative methods for data reporting to combat these challenges. Additionally, the rough and mountainous terrain where most of the flooding has occurred has made it difficult for response teams to reach remote communities. Despite heavy rain, destroyed or flooded roads, and landslides, FELTP teams have been able to reach every affected locality to implement prevention and control measures, outbreak response and community awareness.
The fellows and alumni are also engaged in facilitating routine immunizations as well as COVID-19 vaccinations. They are working with provincial and federal health authorities for vaccine deployment plans, monitoring of vaccination activities, and reporting data of adverse effects following immunization (AEFI).
The FELTP has been a critical part of the flood response system, underscoring the important role the program plays in strengthening national capacity for public health preparedness, surveillance and response.