Public and environmental health are two intimately linked concepts that together define the overall health of the community or the country. For the major part of development, these two concepts were tackled separately. A good environment provides clean air, water, and fertile land for agriculture, inputs for production, and other basic needs. The health of the environment affects the health of the people.
The deteriorating environmental health leads to poor community health as people get sick because of the worsening air, water, and noise situation. According to the World Health Organization, environmental risks like unsafe water and inadequate sanitation, poor indoor and outdoor air quality, exposure to toxic or hazardous waste and chemicals, and climate change must be dealt with to ensure good individual and community health.
The situation of water and inadequate sanitation is appalling in Pakistan even after 75 years of independence. WaterAid, an international non-governmental organization, focused on water, sanitation, and hygiene—1 in 10 people has no access to clean water, 1 in 3 has no decent toilet, and almost 20,000 children under 5 years of age die each year from diarrhea in Pakistan.
As per Pakistan Demographic and Health Survey, 70 percent of households have improved sanitation with 25 percent having flushable toilets linked to the septic tank. The situation is grim, but it is disconcerting that things are not getting better progressively. The issue of water access is getting acute across the urban spaces in the country, with Karachi leading the chart. The perennial issue of water provision persists and areas that receive water are unable to ensure the supply of clean water leading to public health hazards.
The second important element is air quality. The annual smog outcry from Lahore has jolted the authorities to act, but the situation is getting worse. Pakistan ranked third after Bangladesh and Chad with the worst air quality index in 2021. The indoor air quality is equally bad. According to the Pakistan Demographic and Health Survey, 49 percent of households still use solid fuel for cooking. The worsening air quality is attributed to vehicular traffic, unfiltered factory emissions, and agricultural burnings. The increasing urbanization and the congestion in cities are adding more to the problem.
The third essential element is exposure to toxic waste and chemicals. People falling ill have less idea of the reasons for their illness. These toxins and chemicals are from industrial emissions and effluents often unmonitored and contaminate water, air and soils. People are exposed to these risks; however, the exposure is skewed toward the poor.
The socioeconomically disadvantaged are particularly at risk because of their proximity to industries and lack of early health guidance and access. The motor vehicular toxins have increased manifold. According to WHO, it rose fivefold. In addition, micro-plastics are not even considered a threat, given lax regulations on the usage of plastic in the country. According to the World Wide Fund for Nature (WWF), Pakistan uses 55 billion bags annually.
All these essential elements bring us to the final environmental risk, climate change. Every element discussed is part of a whole that is climate change. It is an impending crisis that nudged countries and leaders to focus on the health of the environment for the health of the people. Community health is an extension of environmental health. Premature deaths from chemical toxins, waterborne diseases, bad air quality, and poor sanitation issues can be avoided if the environment is given proper attention. Clean air, water, sanitation and green spaces will reduce mortality and morbidity and enhance the quality of life.