By: Kashif Shamim Siddiqui
Pakistan’s 2025 monsoon floods have once again devastated Khyber Pakhtunkhwa (KPK), Punjab and Sindh, displacing millions, damaging crops and destroying critical infrastructure. Amid submerged villages, cut-off roads and overwhelmed hospitals, local health workers, especially Lady Health Workers (LHWs), community midwives and vaccinators, have emerged as a frontline defense against the looming health crisis. Their presence within communities, coupled with the trust they command, makes them indispensable when formal health systems are stretched thin or inaccessible. They are often the first to reach affected families, offering life-saving support and connecting them to essential services.
The role of these health workers is multi-dimensional. They are critical in providing surveillance and early warning by identifying diarrhoea, malaria, skin infections, respiratory illnesses and malnutrition at the earliest stage, ensuring timely interventions before outbreaks spiral out of control. They continue maternal and newborn care in disrupted areas, visiting pregnant women, guiding safe deliveries, checking newborns, arranging referrals and ensuring vaccinations are not missed despite chaos. Their ability to deliver simple but vital treatments such as oral rehydration solutions, zinc tablets, first aid and fever management helps prevent a surge in preventable deaths. Just as crucial is their role in risk communication, spreading life-saving messages on hygiene, safe water practices, latrine use and food safety, all of which are critical when contaminated floodwater poses major threats.
To maximize their effectiveness, local health workers require urgent and structured support. They need rapid training modules focused on emergency triage, WASH promotion, surveillance and psychosocial first aid, along with personal protective equipment to protect themselves from infections and hazards. Emergency medical kits containing ORS, zinc, paracetamol, wound care supplies and where possible malaria testing tools must be supplied, along with chlorine tablets, soap and clean water containers to distribute within communities. Communication tools such as mobile phones with airtime, solar chargers and reliable transport are equally vital so they can both report data and reach cut-off families. Supervision and psychosocial support for the workers themselves are essential, given they often face personal losses during floods. Financial stipends and hazard allowances not only recognize their work but also ensure their continued commitment.
For flood-affected communities, the presence of empowered local health workers means reduced mortality from diarrhoeal diseases, sustained maternal and newborn services, quicker detection of outbreaks, and stronger access to humanitarian relief. Communities benefit from familiar, trusted women delivering health care at their doorstep, ensuring no family is left behind, especially in areas where cultural norms restrict women’s mobility or access to male doctors. This grassroots health support also reduces the burden on overstretched hospitals and speeds recovery.
However, the risks of overloading local health workers with responsibilities beyond their capacity must be managed carefully. Their scope must remain focused on essential, high-impact interventions, supported by clear referral systems and district-level backup. Recognizing that these workers are themselves flood victims, support must include safeguarding their families and ensuring their own basic needs are met.
The 2025 floods have shown that investing in community health is not optional but central to effective disaster response. Local health workers are the lifeline of resilience in Pakistan’s flood-hit provinces. With the right training, supplies, supervision and incentives, they save lives, prevent epidemics and preserve dignity in some of the most difficult conditions. Strengthening their role today is the surest way to protect tomorrow’s recovery.
