NOT only did the floods wash away fields, livestock, livelihood and homes, they also exacerbated the hunger and malnutrition crisis in the country and trapped communities in less-visible diseases, leaving millions at risk. Public discussion often focuses on communicable diseases in the wake of natural disasters, such as cholera and dengue. But the impact of non-communicable diseases (NCDs) on health is rarely discussed. These include heart, kidney and respiratory conditions, which are aggravated when food, medicine and healthcare systems are disrupted.

Globally, NCDs account for 71 per cent of deaths. They include preventable cardiovascular disease. Over 620m people worldwide are estimated to have CVDs, and LMICs like Pakistan carry the heaviest burden. Between 2025 and 2050, CVD cases worldwide are projected to rise by nearly 90pc. Preventive action must be taken now.

In countries like Pakistan, which frequently experience disasters, ignoring NCDs not only costs lives, it also undermines long-term recovery efforts. About 80pc of heart diseases can be prevented by monitoring behavioural and environmental changes if detected early. South Asian countries, including Pakistan, have a higher risk of CVD than people of other origins as they tend to develop central obesity (fat around the abdomen), which increases insulin resistance, raising the risk of Type 2 diabetes, high triglycerides and low HDL.

The flood crisis this year has killed hundreds and destroyed vast tracts of farmland. Crop devastation and loss of livestock have driven severe food insecurity, while roads, hospitals and clinics have become either inaccessible or lie in ruins. Relief efforts, understandably centred on immediate injuries and infectious diseases, often fail to address chronic conditions such as hypertension or diabetes, even though uncontrolled blood pressure and cholesterol are among the leading causes of heart failure and stroke.

Heart health must be addressed in disaster planning.

Research shows that natural disasters often precipitate heart attacks, strokes and acute arrhythmias due to a combination of intense stress, loss of medicines, less diversity of diet and interrupted access to healthcare. Flood survivors are particularly vulnerable because displacement itself creates physical as well as emotional strain for those living in camps, relying on aid and facing trauma.

‘Don’t Miss a Beat’, the 2025 theme for World Heart Day, which was observed yesterday, is a reminder of how critical continuous heart care is during climate disasters. Sudden breaks in treatment for hypertension or diabetes can tip a patient from stability into a crisis. Even missing medication for a few days can trigger this. Stress and trauma can aggravate underlying heart-related conditions, raising the likelihood of strokes or sudden cardiac arrest.

Heart health is inseparable from disaster preparedness, and addressing NCDs as part of the climate disaster response is essential for LMICs. Nutrition is one of the most overlooked aspects of disaster response. Malnutrition and micronutrient deficiencies in Pakistan are already high and could regress further in the months ahead with inflation and poor access to hygiene and sanitation.

Balanced, heart-protective diets are essential for recovery. Relief agencies must distribute foods that provide sustained energy and support cardiovascular health with better choices, including lentils, beans, whole grains, vegetables, seasonal fruit, nuts, powdered milk and modest sources of lean protein such as eggs or fish. Reducing added salt, excessive sugar and fried foods is just as important to avoid aggravating CVD risks.

To prevent dea­ths due to heart conditions during climate disasters, cer­-tain measures must be built into relief strategies. Infecti­ous diseases surve­illance teams, be­­si­des administering vaccinations, can check blood pressure and cholesterol and blood sugar levels during relief operations, especially for people over 40 years, pregnant or post-menopausal women as well as elderly citizens who bear a higher burden of both malnutrition and heart disease. They must be prioritised in food and medicine distribution.

Local volunteers must be trained to support basic cardiovascular and diabetes monitoring and facilitate early referral to medical services. Government and NGOs should stock antibiotics and chronic disease drugs (blood pressure pills, diabetes medication, statins) in mobile clinics and disaster camps. Beyond a robust emergency response, Pakistan must invest in flood defences and a resilient healthcare infrastructure in rural regions most at risk, ensuring that patients have access to regular treatment even under extreme weather conditions.

Rezzan Khan is a consultant nutritionist at Shifa International Hospital, Islamabad. Tabinda Ashraf Shahid is editor, Scientific Investigation and Global Network of Scientist (SIGNS).

Published in Dawn, September 30th, 2025