Pakistan’s Cholera-Hit Town Left to Go Thirsty

The development of a deep sea port under the China Pakistan Economic Corridor carries on while the rest of the province suffers water shortage, epidemics and floods

Pakistan’s Cholera-Hit Town Left to Go Thirsty
Fishermen stand on a boat outside Gwadar Port / Photo by Asim Hafeez / Bloomberg via Getty Images

In a small town in the Dera Bugti district in Pakistan’s largest province, Balochistan, the lives of residents are far from the technologically dominated, modern world. Up on a mountain in Balochistan’s desert is the town of Pir Koh. Due to dirt roads and desert plains and multiple security checks, it can take as much as 12 hours to reach there from Quetta, the provincial capital. Its clear removal from technological progress is further highlighted by the fact that it lacks any running water systems. What could be seen as a quaint reality threatens the very lives of its residents.

Pir Koh had not really come up in mainstream media conversations — until now. But even before the deadly floods ravaged the region in August, the town was already reeling with the rise of a deadly cholera epidemic since early May, along with severe water shortages. The news of these crises had reached ears around the globe through international media coverage but only after locals created enough noise on social media for the media to realize what was happening.

The situation is now exponentially worse because of the flash floods that have hit Pakistan hard since early August after an extraordinarily heavy monsoon this year. Over 1,300 people have lost their lives, and a third of the country is under water. Planning Minister Ahsan Iqbal said that $10 billion would be needed for rebuilding and repairing. The devastation has also led to the disconnection of phone and internet lines in Dera Bugti.

As the flood led to more media attention on the area, citizens and those involved in helping out with the crisis first-hand were quick to point out that much of the attention Balochistan’s rural areas have gotten has been because of the story of Baloch folk singer Wahab Bugti. Images of Bugti, who rose to fame earlier this year after rendering the popular song “Kana Yaari” for the latest season of Coke Studio — Pakistan’s largest music production — went viral on social media after his mud house in Dera Bugti collapsed. Many on social media pointed out that instead of just focusing on Bugti, the images should serve as a reminder of how the state has failed the very citizens who contribute to it every day.

Previously, videos of protesters chanting Pir Koh Ko Paani Do (Provide Water to Pir Koh, which has been trending as #PirKohKoPaaniDo) were interspersed with more somber images of young, clearly malnourished children and families in desperate need of water. “Our nearest hospital is more than [150 miles] away; we have almost no access to basic necessities, like health care or water,” a Pir Koh resident who goes by the name Yaqoob told New Lines. According to a 2019 survey, 396,000 children in 14 drought-ridden districts in Balochistan were acutely malnourished, and Dera Bugti had the third-highest number in the province. The already resource-scarce district is facing further devastation as unmaintained dams are giving way under torrential rains.

Little is being done to alleviate long-term issues in the region. Hence, concerns of residents like Yaqoob may not be entirely unfounded. Even coverage by international media that started when the water crisis reached its peak didn’t lead to a solution because Baloch issues have been ignored for so long, both by provincial and federal leadership. Baloch activists and citizens continue to be vocal about their demands for basic resources and better living standards, but they fall on deaf ears. Many feel this discrimination comes from longstanding ethnic rivalries that give Punjab and Sindh provinces precedence over Balochistan and argue that a skewed division of funds has left the Baloch in this state.

Despite the hype around the water crisis and the government’s declaration of an emergency, there are more than a few reasons Pir Koh’s situation got as bad as it did. According to a report published by Dawn, a leading news publication in Pakistan, the District Health Officer identified a pipeline laid by the Oil and Gas Development Corporation Ltd. (OGDCL) as the cause of the outbreak. The pipeline was damaged in some places, causing the contamination of the water with dirt and sewage. In the same report, the OGDCL refutes the claim, adding that it “cannot provide water for 40,000 people, which is the government’s job.”

Locals did not accept the company’s claims and held it accountable for not providing water to Pir Koh and surrounding areas. However, the company’s website still says that it provides water to the region through water tankers, water bowsers, tube wells and pressure pumps. More anger seems to be directed at local politicians, as this isn’t the first time negligence and mismanagement have led to a health crisis. According to government sources, out of the 12.3 million people living in Balochistan, 85% do not have access to clean drinking water.

Last year, a hepatitis outbreak in the province also was caused by lack of clean water. According to hospital statistics, 10,000 patients were diagnosed with Hepatitis C and B across the province during the first half of 2021, and the government only in September started Balochistan’s Free Hepatitis Programme, which focused mainly on providing locals with better medical facilities and clean drinking water. There was also a two-day seminar and free jaundice vaccination drive to raise awareness but once the initial intervention ended, things went back to how they were — with no long-term solutions in place.

Geo News, a media organization in Pakistan, reported how a 2007 scheme called Clean Drinking Water, which was supposed to put up 409 filtration plants in the province for $3.5 million, fell victim to corruption. The National Accountability Bureau attempted to recover some of the money, activated 300 filtration plants and then later installed an additional 150 in 2014. But by 2021, when this last crisis hit, 200 plants across the province had been shut down because of negligence.

While politicians and bureaucrats focus on their own role in this crisis, disdain continues to brew amid those who are suffering. Dr. Haroon Bugti, ex-president of the Baloch Student Action Committee, based in Dera Bugti, is not shy to speak up. “The government has no interest in the issues of the Baloch. Pir Koh is also Balochistan. The pain of the Baloch living in the corners of Balochistan is the same. [The government] is only concerned about the coast and the resources,” said Bugti, alluding to the discrepancies between Gwadar, the administrative capital of Balochistan, which is being developed into a deep sea port under the China Pakistan Economic Corridor, and the rest of Balochistan, whose problems have been brushed under the rug for a long time. With Gwadar turning into the world’s fifth-largest deep sea port and the abundance of gas and oil in Balochistan, the province is crucial to Pakistan’s trade and industry. But the Baloch point out that despite that, they don’t reap any of the benefits of economic or social growth.

In June, when reports of a young boy falling down a hill while searching for water were shared on Twitter, the story was barely covered by mainstream media because the news cycle had moved on by then. However, since the crisis began, over 8,000 people have been affected by the outbreak and fallen prey to the disease and at least 26 people have died, Bugti said. However, local media reported that only seven died. “I have the list [of people affected], but no one wants to ask for it,” Khalid Iqbal, a student in Dera Bugti who started the social media campaign, told New Lines.

Usually, residents rely on ponds and drums placed outside shops and houses that collect rainwater, as the pipeline only provides water to parts of the region. But climate change means less frequent rains and the drying up of the limited streams available, so residents have to resort to stagnant water in wells, which they must share with livestock. The situation has become so dire that families and communities are struggling to find clean water to perform the final bathing rites of the dead.

The water crisis and the associated cholera epidemic have been a long time coming, said Sami Zarkoon, social activist and convener of Civil Society Balochistan. “Lack of long-term planning meant that while the crops harvested in the region have been financially beneficial, they’ve lowered the water table significantly,” he said. Extensive use of tubewells and water-intensive crops use up ground water faster than it can be replenished, and farmers constantly have to dig deeper. Drought conditions are also forcing people to migrate to areas with better water access.

As of 2021, the availability of fresh water in Pakistan has fallen to a level that signifies water scarcity ( below 1,000 cubic meters per capita), according to the IMF. According to Dawn News, 80% of Balochistan’s population is directly or indirectly dependent on agriculture for livelihood. However, out of a total of 48 million acres, only 5 million acres are being cultivated because of the water shortage.

The belief that Baloch communities are left to fend for themselves without support from political leadership is slowly growing into a loud, united voice, one that has energized the growing debate of the separatist movement in the province. Often characterized by armed groups, the movement to demand independence for Balochistan has risen and waned from the 2000s but has gained ground once again since 2020. Locals blame both provincial and federal governments for letting the situation turn so bad that it led to militarization. Clashes between locals and government-led counterinsurgency efforts have resulted in the disappearance of many of the activists. “Unless there’s a major event, Balochistan doesn’t get featured by the media for routine issues or generational damages,” said Zarkoon, referring to how it takes hundreds of people dying, a major crisis to be declared, or unprecedented violence to gather attention — which often means intervention is too late.

Even those who want to help by providing funding or rations are often restricted as even the most basic issues in the region can get highly politicized. Fundraising is hard because being linked to Baloch bank accounts risks being put under scrutiny due to the surveillance and militancy rampant in the region – and even protests for basic necessities are amplified to link them to militant groups.

Nonprofit organizations like Al Khidmat Foundation, HANDS Pakistan and community-focused political organizations, such as Women’s Democratic Forum, have led to the success of immediate fund raising efforts. Jameel Kurd, the president of Al Khidmat’s Balochistan division, has been focused on community building efforts across the realms of healthcare, nutrition and microfinance in the region. The organization has been providing medicine and equipment to local hospitals, arranging water and food for locals, along with giving microfinance loans to individuals to help them start businesses, such as home-based handicrafts or small-scale agriculture.

With a new emergency underway due to the floods, charities and individuals alike have mobilized to help provide relief to victims in some of the hardest hit areas in Punjab, Sindh and Balochistan. Organizations like Al Khidmat are collecting rations, donations and medicines to provide to those who have been displaced and in many cases even rescuing stranded victims. Khudkaar, a social enterprise in Layyah, South Punjab, is distributing cooked food, tents and other essentials even as Layyah itself is at risk of severe flooding.

In Pir Koh, prior to the floods, Al Khidmat had installed hand pumps and wells at community spaces such as the mosque, hospital and the markets so that everyone could benefit from them. But due to the declining water table, these hand pumps and wells can only work where water is available. When the water table falls below 200 to 300 feet, they need to install submersible pumps that need electricity. So they are also installing solar panels. However, the panels along with the necessary filtration plants needed to clean groundwater are expensive and the organization has limited funds. Kurd pointed out how the regional clinic didn’t even have testing kits for cholera, till his organization provided.

Kurd and his team have also provided water tankers, which can carry roughly 250 gallons, made possible through fundraising from Quetta and Gwadar, apart from bottled water to hospital patients recovering from cholera. The tankers are used to fill the drums and water storage units, but this is an expensive short-term solution. Arranging tankers can be hard as many cities in Pakistan have seen the rise of a tanker mafia that capitalizes on water shortages by hiking prices.

The fact that there is a scarcity in Balochistan of basic resources — water, food and electricity — despite its being the country’s most mineral-rich province and Pir Koh being the town where most of the country’s natural gas comes from is seen as an added insult by locals. Residents have taken to Twitter to complain about how gas from Pir Koh is used only to provide for Punjab and other provinces while their communities lie forgotten.

It is apparent that the residents of Pir Koh and surrounding areas at risk will have to bear all crises alone. These communities have been isolated, both physically and mentally, for so long that even those wanting to help don’t know where to start. Social media has been helpful in getting attention, but as frustrations continue to rise, there are concerns that it will promote existing and new stereotypes around Balochistan, which include ideas that the Baloch are violent or associated with militant groups.

Hence, locals are ready to offer support to build resources. “Any organization that can help us with the water and health crises is welcome as we want to build permanent support systems in the area. I can provide any help they would need to settle here,” Iqbal said. Until there is a long-term solution, there’s only so much that tankers and emergency relief can do. “Long-term help to sustain livelihoods and providing basic necessities is something the government needs to do. Charity and one-time efforts are not going to help forever,” said Zarkoon, but until a better long-term initiative comes along, these citizen-led donation drives are what keep citizens across the country alive at this point.

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