By Dr Rafia Batool Khan ,
Climate change not only hits the newspaper headlines but also knocks at the doorstep. Each monsoon in the Pakistan heralds less like a renewal of life and more like a rehearsal for ruin. The 2025 floods, that encroached the wide stretches of industrial triangle of Sialkot, Gujrat, Gujranwala and its adjoining areas, were neither the first calamity, nor will they be the last. What has lingered, long after the waters withdrew, is something less visible yet infinitely heavier: the quiet crisis of the human mind.
The flooded fields of Sambrial, a Tehsil of Sialkot district, reveal the scale of destruction left by the 2025 floods. Roads are dry and many fields re-ploughed, but the scars remain. The government’s machinery was in motion 5 teams livestock, agriculture, irrigation, revenue, and land administration were active across the region, documenting losses and coordinating relief.
A survey conducted with a sample of 100 flood affected residents highlighted the mental health impact of the disaster. 82% of respondents showed signs of anxiety, 64% reported severe sleep disturbance, and 43% exhibited symptoms of clinical depression. Many households reported heightened stress, fear, and trauma, particularly in the industrial triangle of Sialkot, Gujrat and Gujranwala and the villages close to the Line of Control (LoC), where pre-existing vulnerability intensified post-flood distress.
The scale of destruction in Sambrial was staggering. Out of 159 villages, 97 villages (around 61%) were affected. Approximately 120,000 people were directly impacted, with over 5,500 homes damaged and 2,300 families displaced temporarily. Nearly 7,000 acres of crops were destroyed, causing economic losses of about PKR 8.5 billion. Critical infrastructure, including 45 schools and 12 health centers, was also affected. Sambrial received 450 mm of rainfall in 48 hours 2.5 times the monthly average causing the Chenab River to rise 5 meters above its danger mark. Compared to previous major floods, the 2025 event affected 25–30% more villages and caused roughly 40% higher economic losses.
Communities near the LoC, already exposed to conflict, reported feeling left out and ignored, as no official teams reached them for assessment or aid. Surveys indicate that 30–40% of households in LoC adjacent villages are at risk of post-traumatic stress or anxiety, highlighting both psychological and logistical neglect. The absence of targeted support has left communities physically, mentally, and socially isolated.
Despite the high risk of water-borne and infectious illnesses, no organized vaccination campaigns or preventive medical measures were carried out, leaving residents apprehensive about cholera, dengue, and other post-flood diseases. Villagers also reported difficulties accessing clean drinking water and medical attention, increasing both physical vulnerability and stress.
Many farmers reported that their crops for the entire year were ruined because floodwaters had not receded in time. Winter crops, which would normally provide income for at least one month, could not be planted. Families faced immediate financial loss, disruption of planned investments, and halted social milestones, including arranging children’s marriages or constructing assets. The destruction of crops not only affected income but also disrupted family planning and long-term stability. Residents expressed concern that the economic fallout could extend beyond a year, limiting the ability to recover from the disaster.
The Punjab’s response apparatus remains focused on visible infrastructure levees, roads, irrigation canals while the invisible infrastructure of resilience has been largely neglected. Relief is measured in tents, not in therapy. Reconstruction counts bricks, not mental, physical, or economic well-being. The teams of the National Disaster Management Authority (NDMA) and Provincial Disaster Management Authority (PDMA) deserve credit for logistical efficiency, but their manuals and response frameworks remain silent on health, livelihood, and psychological care, particularly for communities near the LoC.
According to WHO guidelines on post-disaster psychosocial care, the first 72 hours after a crisis should include psychological first aid brief, humane, non-specialist interventions that can reduce long-term trauma. Yet, in Sialkot, there was no mechanism for even basic emotional triage. Villagers received ration bags and disinfectants, but no structured support for coping with trauma, disease prevention, or financial recovery.
This gap is structural rather than compassionate. Pakistan’s disaster management frameworks still treat psychological, public health, and livelihood rehabilitation as secondary. Without integration of mental health, medical interventions, and economic support into flood response, every flood risks producing long-term, widespread distress, disease outbreaks, and financial ruin. Anxiety, depression, fear of illness, crop loss, and halted family plans undermine both recovery and the capacity to rebuild.
The silence, however, can be addressed. Relief committees could include trained community volunteers in psychological first aid, basic disease prevention, and livelihood assessment. Shelters such as schools and mosques could double as counselling and health hubs. NDMA protocols could give psychosocial, medical, and economic recovery the same priority as food and shelter. Collaboration between SDPI, the Ministry of Climate Change, and provincial health departments could train local schoolteachers, clerics, and Lady Health Workers in basic trauma response, vaccination drives, and financial guidance for families whose livelihoods were lost.
In global discourse, the interlinked mental health, public health, and economic consequences of climate-induced disasters are now gaining systematic recognition. The UNDP’s Human Security Report 2024 aptly characterizes these as the “invisible casualties of climate change.” When post-disaster reconstruction efforts concentrate exclusively on the restoration of physical infrastructure, they inadvertently perpetuate community vulnerability manifesting in sustained psychological trauma, heightened public health risks, and deepening economic precarity .
The coming monsoon will again test systems, empathy, and policy efficiency. Every future flood response must include mental health support, preventive healthcare, and economic recovery assistance; every reconstruction policy must allocate a psychosocial, medical, and financial budget line; every disaster plan must account for fear, trauma, disease, and lost livelihoods alongside food and shelter. Pakistan’s future resilience depends not only on stronger levees but also on the mental, physical, and economic well-being of its communities, particularly marginalized and overlooked in relief planning. The government of Pakistan can opt following measures.
Firstly, Pakistan’s disaster management architecture must institutionalize mental health and psychosocial support as a core component of climate resilience. The NDMA and PDMA should revise their Standard Operating Procedures (SOPs) to include psychological first aid within the first 72 hours of any disaster, as per WHO guidelines. This requires training local responders Lady Health Workers, schoolteachers, and clerics in basic trauma counselling and stress management. Mobile mental health units and tele-counselling services could be embedded into district-level disaster response frameworks, ensuring that psychological recovery is treated as a measurable outcome of relief operations.
Secondly, public health and disease prevention must be integrated into the post-disaster response chain. Vaccination drives, clean water supply, and preventive medical screening should be activated alongside food and shelter provision. The Ministry of Health, in collaboration with the Ministry of Climate Change, should develop a “Climate Disaster Health Protocol”, these should also be included in National Adaptation Plan (NAP) that should mandate immediate deployment of medical teams and vaccines in flood-prone districts. This will reduce secondary health crises and prevent epidemics that often follow floods, particularly in marginalized regions.
Thirdly, economic rehabilitation must be treated as a climate resilience investment rather than a welfare afterthought. Livelihood recovery funds, concessional credit lines, and crop insurance mechanisms should be embedded within disaster recovery budgets. NDMA and provincial departments should partner with the State Bank of Pakistan and microfinance institutions to provide conditional cash transfers for rebuilding livelihoods and restarting agricultural activity. This approach will help families transition from relief to recovery, preventing the erosion of productive capacity and social stability.
Pakistan’s flood management policy must evolve from saving lives temporarily to restoring lives sustainably by rebuilding the mind, protecting health, and revitalizing livelihoods with equal urgency. The water has retreated, but the wounds have not. The real work of healing, slow and unseen, has only just begun.