The post-flood mental health crisis in Balochistan

The floods, which started in July 2022, wreaked havoc in 32 districts, forcing 1.3 million people to relocate in desperate need of shelter and emergency relief.


February 6, 2023

ISLAMABAD – Are natural calamities a gendered issue? Perhaps not in themselves. But despite nature’s indiscriminate course, the aftermath of natural disasters is undoubtedly gendered.

According to the UNDP, women and children are 14 times more likely to die in a natural disaster. Access to female hygiene, lack of financial empowerment and gender-based violence all come together to exacerbate women’s suffering during times of destruction.

The devastating floods of 2022 have once again affected women disproportionately. The floods, which started in July 2022, wreaked havoc in 32 out of 35 districts of Balochistan, forcing 1.3 million people to relocate in desperate need of shelter and emergency relief.

As per the provincial government of Balochistan, the floods completely washed away 64,000 homes, while causing partial damage to another 185,000. Meanwhile, almost 500,000 livestock were killed and thousands of acres of cultivated land was destroyed. In District Lasbela alone, the flood water washed away over four-fifths of homes, crops, and livestock.

Mental health epidemic
As a psychologist working with the Peoples Primary Health Initiative, I have been conducting outreach field visits in Lasbela since September 2022 to provide mental health counselling to flood survivors. During these visits, I have spoken to hundreds of women and have observed that poor mental health is an epidemic across all flood-affected districts in Balochistan.

Male residents of Lasbela are gathered to speak to mental health workers. — Photo provided by author

Male residents of Lasbela are gathered to speak to mental health workers. — Photo provided by author

An alarming trend I noticed was that nearly all of the women I spoke to, said they were experiencing stress, anxiety, or trauma as they thought about the future — the safety of their families and means of livelihood.

Men face similar mental health issues, but they have the option of discussing their problems with friends over tea or dinner. Disturbingly, mental health taboo and stereotyping restrict women from doing the same. Lack of proper counselling continues to exacerbate suffering.

As a psychologist, I thought I had already seen the worst. Psychological damage from nearly two decades of conflict and violence in Balochistan — where families of missing persons struggle to find their loved ones and others have lost theirs to bombings. But the mass mental health challenge brought about by the 2022 floods was unprecedented even for me.

Lives uprooted
“I never saw this sort of flooding in my living memory,” said 70-year-old Murad Bakhsh Lasi from Lasbela’s Lakhra village. “It displaced thousands of people. Thousands are homeless. My family took refuge in another family member’s house as our houses went under water.”

Murad’s wife, Jan Bibi, was more concerned and worried than Murad himself.

After lunch, she was describing how they fled during the flood, when a wave of anxiety took over her. All of a sudden, the 55-year-old stood up and screamed: “We are ruined.” Her daughter instantly stood up behind her and tried to console her. She started running outside barefoot, frantically.

I felt embarrassed to have asked her about the night she and her family had to leave behind everything — their roof and livelihood, their livestock, seven goats and a cow — to seek shelter at another family member’s house around 30 kilometres away.

“Those animals were our whole life’s capital. We lost everything we had, and it has become increasingly difficult for Murad to arrange meals for the family twice a day. When I think of my children and Murad, I become more disturbed,” said an emotionally distressed Jan Bibi.

The loss of life
Since the floods last year, sudden panic attacks and anxiety have been a frequent part of 38-year-old Mahdim’s life. Meeting and talking to her was painful and distressing, to say the least. “I lost three minor children when the rooftop of our house fell,” Mahdim, who hails from a remote village, Deerja, in Uthal, Lasbela district, told me with a shattered voice.

Women attend a counselling session at a medical camp in Lasbela, Balochistan. — Photo provided by author

An elderly woman is checked for physical symptoms by health staff at a camp in Lasbela, Balochistan. — Photo provided by author

When the roof collapsed, her husband, Shafi Muhammad Shahook, and mother-in-law were injured. Three of her children were killed on the spot. This has caused severe mental and physical health issues for Mahdim, including disruption in her menstrual cycle.

Her family said even doctors were clueless about what was wrong with her. The family consulted several doctors, but she has shown no signs of recovery. “I don’t know what I am facing,” she said, defeatedly.

Her family also took her to a faith healer in Hub, but that did not work either. In Mahdim’s town, people prefer going to faith healers and religious clerics over healthcare professional, highlighting a lack of awareness and trust in mental healthcare.

Mahdim now prefers to lead an isolated life, with little to no interaction even with her family. When she experiences disturbing thoughts, she immerses her hands and feet in freezing cold water, which she argues gives her temporary respite. But the panic attacks continue to occur almost daily.

Dur Bibi
The Government of Pakistan and the United Nations launched an appeal for $8 billion to support flood victims and managed to secure about $10.7bn in aid and loans. However, it is yet to be seen whether that money reaches flood-affected victims in the districts of Balochistan, where people have been desperately looking for help.

I informed 60-year-old Dur Bibi and her family in Oraki, Lasbela about the aid pledges. In spite of everything, she was optimistic that the money raised in Geneva would reach her family. “[The] flood destroyed everything we had. So far, we only have sorrows, sad memories, and depression. We are optimistic some help will come to us one day.”

Dur Bibi is a mother of three. One of her children has a mental disability. Two others, aged 30 and 35, cultivated land and sold animals before the floods.

A psychologist counsels a female patient at a medical camp in Balochistan. — Photo provided by author

A psychologist counsels a group of women at a medical camp in Lasbela, Balochistan. — Photo provided by author

One night, when it rained excessively, the family’s shabbily-constructed house could not hold up. As a result, the roof collapsed. The rubble fell over Dur Bibi’s son, injuring his spinal cord. He is paralysed today, and Dur Bibi is traumatised by seeing him in such a miserable condition.

Circumstances have forced Dur Bibi to work in the crop fields daily. She works more than 10 hours a day to help her eldest son feed the family. But her health, depression and traumatic stress have become a roadblock for her.

“At this age, I am going to the crop field only to make some money to give the best possible medical treatment to my paralysed son,” the exhausted woman told me.

Regrettably, the governmental and non-governmental organisations engaged in flood relief work have focused on improving access to rations, but have given little thought to access to mental healthcare and well-being. Due to the lack of proper mental health counselling facilities to deal with physical and economic stress as well as the undeniable trauma, Balochistan has recently seen a drastic surge in the suicide rate.

Women and youth are at massive risk of post-traumatic stress disorder (PTSD) in all of Balochistan’s flood-hit areas. But the situation for Lasbela’s poverty-ridden residents is even more distressing as there are hardly any other sources of livelihood, except agriculture. The destruction of property and agricultural land followed by lack of jobs, loss of livestock, and lack of psychological counselling have, therefore, drastically increased stress, depression, and anxiety among flood victims.

It is crucial for organisations working for flood-victims to prioritise access to mental health services and counselling for those affected by the disaster, in order to prevent further deterioration of their mental wellbeing. Unless that happens, the victims, particularly the most vulnerable — women and children — will continue to live under the clouds of depression, anxiety and other ailments associated with PTSD.

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