Islamabad: Gender based violence and sexual exploitation could rise in flood hit and disaster affected areas of Pakistan if urgent preventive and health based measures are not taken, public health and mental health experts have warned, calling the situation a looming health and mental health emergency in camps, temporary shelters and high risk districts.
Experts say disasters, displacement and prolonged humanitarian crises create conditions where women and children become more vulnerable to physical, sexual and psychological violence. Overcrowded living spaces, breakdown of community protection systems, poverty and weak access to police and health services increase risks, even if many cases remain hidden and unreported.
National data shows that nearly one in three women in Pakistan experiences physical or sexual violence in her lifetime, while more than half of survivors never seek help. Experts caution that in disaster hit areas, these risks may intensify due to fear, stigma and the absence of safe and confidential reporting and support services, particularly for displaced women and children.
Prof Shahzad Ali Khan, Vice Chancellor of the Health Services Academy, said disaster settings require special attention as they often expose gaps in health, protection and mental health systems. Referring to HSA’s assessment of high risk and flood prone districts, he said health facilities are usually the first point of contact for survivors, yet are rarely equipped to recognise or respond to psychological trauma linked to violence.
“In emergency and displacement settings, women and children may not report violence, but the fear, stress and trauma are clearly present,” Prof Shahzad said. He stressed that violence should be treated as a public health issue, with mental health and psychosocial support integrated into emergency healthcare and humanitarian response.
The HSA working paper highlights several risk factors that could contribute to increased vulnerability in disaster hit areas, including damaged health infrastructure, limited availability of trained staff, lack of female police officers, weak referral pathways and poor coordination between health, police and social welfare departments. Social pressure and fear of retaliation further prevent survivors from coming forward.
To reduce these risks, HSA has proposed a health led response for high risk and disaster affected districts. The framework focuses on early identification of survivors, community based case management using the WHO recommended LIVES approach, psychological first aid, telemedicine services linking districts to specialists, and mobile health units to reach camps and remote communities.
Prof Shahzad said clear referral pathways were essential to prevent survivors from being pushed between institutions. He warned that repeated questioning and lack of coordination can deepen trauma rather than relieve it.
Senior psychiatrist Prof Iqbal Afridi said the mental health impact of violence and fear of violence in disaster settings is often underestimated. He warned that prolonged stress, insecurity and untreated trauma can lead to depression, anxiety, post traumatic stress and self harm, particularly among women and children.
“Even the fear of violence can leave lasting psychological damage,” Prof Afridi said, adding that early mental health support and psychological first aid can prevent long term mental illness and help displaced families cope with loss and uncertainty.
The HSA paper urges federal and provincial governments to proactively address risks of violence in disaster response planning. It recommends establishing dedicated GBV and SEAH units in hospitals, ensuring round the clock medico legal and mental health services in high risk districts, expanding mobile clinics in flood affected areas and training frontline health workers to provide trauma informed care.
Experts warn that unless violence prevention and mental health support are built into disaster response, women and children living in camps and affected communities will remain at risk long after emergencies unfold.