A blog post by Reni Axelrod, Junior Associate
Climate change threatens Pakistani pregnant women’s maternal health. Extreme flooding caused by climate change is increasing throughout the country;[1] Pakistan recently experienced an extreme flood during its 2022 monsoon season.[2] More than 1,460 health facilities[3] were destroyed and 650,000 pregnant women[4] need reproductive health services. Taking a human rights approach to the flooding crisis is necessary to ensure Pakistani pregnant women’s maternal health.
Access to clean, safe water ensures pregnant women’s dignity.[5] Flooding has the greatest impact on pregnant women’s maternal health.[6] Sustainable Development Goal (SDG 3.1.1)[7] is to reduce maternal mortality (death while pregnant or withing 42 days after pregnancy) to 70 per 100,000 live births by 2030. Recurring flooding is preventing Pakistan from reaching SDG 3.1.1.[8]
Water is critical for sanitation and basic living.[9] Women are vulnerable to human rights violations from lack of access to clean, safe water including waterborne disease,[10] disruption in maternal care due to climate displacement,[11] and gender-based violence.[12] Pakistan’s government[13] must center pregnant women’s human right to water in climate adaptation plans or additional public health crises will occur.[14]
Exposure to waterborne diseases threatens the maternal health of Pakistani pregnant women.[15] Flooding contaminates water with viruses and bacteria,[16] thereby increasing exposure to infectious diseases[17] and threatening pregnant women’s health and their infants. Exposure to the parasite toxoplasma gondii in contaminated water, for instance, leads to fetal damage.[18]Water management systems must include developing irrigation systems, harvesting recycled water, and safe water storage.[19]
Flooding leads to pregnant women’s forced migration.[20] During the September 2022 monsoon, 70,000 pregnant women were expected to deliver.[21] Displacement disrupts access to health services[22] including increased risk of maternal complications.[23] Maternal mortality is worsened[24] especially among pregnant women in rural areas who commonly give birth at home.[25] Forced migration causes pregnant women to experience increased mental health stresses that impact infant birthweight and mortality.[26]
Flooding caused by climate change increases emotional, physical, and sexual violence.[27] Women in rural communities are responsible for collecting water.[28] During periods of water scarcity their failure to provide water makes them vulnerable to physical violence.[29] The 2022 flood doubled gender-based violence against Pakistani women.[30] Pakistani women must mobilize as community health workers to provide maternal care during crises.[31]
“Women’s rights are quite simply human rights.”[32] As the 2030 Agenda for Sustainable Development develops,[33]Pakistani women must be empowered as leaders to reduce maternal mortality.[34]
[1] Government of Pakistan Ministry of Water Resources, Annual Flood Report 2017, Office of the Chief Engineering Advisor & Chairman Federal Flood Commission Islamabad 1, 5 (2017) https://mowr.gov.pk/SiteImage/Misc/files/2017%20Annual%20Flood%20Report%20of%20FFC.pdf.
[2] OCHA, Pakistan: 2022 Monsoon Floods – Situation Report No. 5, 1, 1 Reliefweb (Sept. 9, 2022), https://reliefweb.int/report/pakistan/pakistan-2022-monsoon-floods-situation-report-no-5-9-september-2022 [hereinafter OCHA].
[3] Id. at 2.
[4] UNFPA Pakistan, Women and girls bearing the brunt of the Pakistan Monsoon floods (Aug. 30, 2022), https://pakistan.unfpa.org/en/news/women-and-girls-bearing-brunt-pakistan-monsoon-floods.
[5] U.N. Water, Water and Gender, https://www.unwater.org/water-facts/water-and-gender (last accessed Jan. 22, 2023).
[6] Lea H. Mallett, Flooding: what is the impact on pregnancy and child health?, 42 Disasters, 432, 438-39 (2018).
[7] Global SDG Indicator, 3.1.1 Maternal Mortality Ratio (Oct. 31, 2018), https://sdg.tracking-progress.org/indicator/3-1-1-maternal-mortality-ratio-2/.
[8] Skye Wheeler, et al. Short communication: The global community needs to start planning for the impact of the climate crisis on maternal and newborn health, 6 The J. of Climate Change and Health, 1, 2 (May 2022).
[9] U.N., Water and sanitation (2023), https://www.ohchr.org/en/topic/water-and-sanitation.
[10] Afshan Noureen, et al., The Impact of Climate Change on Waterborne Diseases in Pakistan, 15 Sustainability and Climate Change, 138, 139 (Apr. 2022) [hereinafter Noureen].
[11] Sandie Ha, The Changing Climate and Pregnancy Health, 9 Current Envtl. Health Reports, 263, 264, 268 (2022).
[12] Bharat Desai & Moumita Mandal, Role of Climate Change in Exacerbating Sexual and Gender-Based Violence against Women: A New Challenge for International Law, 51 Envtl. Policy and Law, 137, 138 (2021).
[13] Government of Pakistan Ministry of Water Resources, Conceived Projects, https://mowr.gov.pk/ (last accessed Jan. 22, 2023) (referring to future projects focusing on the development of dams and a lack of human rights considerations).
[14] Haider Warraich, et al. Floods in Pakistan: a public health crisis, 89 Bull World Health Organization, 236, 236 (2011).
[15] Noureen, supra note 10, at 139-40.
[16] Id. at 140 (referring to Table 1 indicating the viruses and bacteria linked to infectious diseases).
[17] U.N. News, Pakistan: who warns of significant health risks as floods continue (Aug. 31, 2022), https://news.un.org/en/story/2022/08/1125872.
[18] Noureen, supra note 10, at 140 (referring to Table 1).
[19] Asian Development Bank, Climate Change Profile of Pakistan, 1, 65 (2017) https://www.adb.org/sites/default/files/publication/357876/climate-change-profile-pakistan.pdf.
[20] Asian Development Bank, A Region at Risk: The Human Dimensions of Climate Change in Asia and the Pacific, 1, 81, 82 (2017), https://www.adb.org/sites/default/files/publication/325251/region-risk-climate-change.pdf.
[21] Smriti Mallapaty, Pakistan’s floods have displaced 32 million people – how researchers are helping, 609 Nature (Sept. 9, 2022), https://www.nature.com/articles/d41586-022-02879-2.
[22] Maryam Shabbir Abbasi, et al., Climate Induced Migration Among Women Stories from Muzaffargarh and Tharparkar districts Pakistan, 1, 17-18 (Apr. 2021), https://sdpi.org/assets/lib/uploads/uploads/2021/07/Climate-Induced-Migration-Among-Women.pdf.
[23] Sean Kaisser Shaeen, Maternal mortality in Pakistan: Challenges, efforts, and recommendations, 81 Annals of Medicine and Surgery, 1, 2 (Aug. 18, 2022).
[24] Kim Robin van Daalen, et al., A Scoping Review to Assess Sexual and Reproductive Health Outcomes, Challenges and Recommendations in the Context of Climate Migration, 2 Frontier in Global Women’s Health 1, 2 (Oct. 15, 2021).
[25] Id. at 2.
[26] Charlotta Rylander, et al., Climate change and the potential effects on maternal and pregnancy outcomes: an assessment of the most vulnerable – the mother, fetus, and newborn child, 6 Global Health Action, 1, 6 (Mar. 11, 2013).
[27] Falak Shad Memon, Climate Change and Violence Against Women: Study of a Flood-Affected Population in the Rural Area of Sindh, Pakistan, 27 Pakistan J. of Women’s Studies, 65, 74-76 (2020).
[28] Id. at 68-69.
[29] Id. at 75-77.
[30] OCHA, supra note 2, at 1.
[31] U.N.E.P, Women, energy and water in the Himalayas: training of trainers manual, 1, 69, (2005) https://wedocs.unep.org/handle/20.500.11822/9089.
[32] Jacqui Wise, Maternal mortality is a human rights issue, delegates insist, 335 BMJ 843, 845 (Oct. 2007).
[33] U.N. Transforming Our World: The 2030 Agenda for Sustainable Development, A/RES/70/1, https://sustainabledevelopment.un.org/content/documents/21252030%20Agenda%20for%20Sustainable%20Development%20web.pdf.
[34] Id.