25/08/2026
The News on Sunday
The hidden cost
Javed Khan Mohmand
Political Economy
August 23, 2026
Beyond damaged homes and lost livelihoods, floods are leaving communities with lasting psychological trauma
“Is there going to be another flood? If so, where will we go?” For 50-year-old Naheed Bibi, who lives near the Kabul River in Nowshera district, the question is not hypothetical.
She has seen floodwaters destroy her home twice, first in 2010 and again in 2022. Each time, the water eventually receded. Her family returned, rebuilt and tried to begin again, but the fear stayed.
Whenever the sky darkens and rain begins, Naheed no longer feels safe at home. Sometimes she stays with her brother-in-law. She watches the sky anxiously, keeps awake at night and cries, convinced that there is going to be another flood. “She feels that her house is not safe,” a family member says. “A flood is not just a flood for her. It takes away everything she has.”
Naheed recalls that floods destroyed her house, crops and livelihood. “It feels as if this year, too, we will lose our wheat crop,” she says. “This is the food we depend on for the whole year. We do not want another flood to force us out of our homes again. We cannot keep living in tents and depend on government assistance.”
For Naheed and thousands of others living beside rivers and streams in Khyber Pakhtunkhwa, the danger does not end when the water disappears. The flood may recede from the village; it does not necessarily recede from the mind.
Climate change is usually described through statistics: rising temperatures, heavier rainfall, damaged houses, destroyed crops, and displaced families. But there is another consequence that is harder to measure: fear.
A report published in the Journal of Global Health states that climate change is increasingly affecting mental health and psychological wellbeing. Floods, extreme heat, air pollution and other climate-related disasters can contribute to anxiety, depression, trauma and emotional distress.
The psychological distress associated with environmental and climate threats is increasingly described as eco-anxiety. For children and young people, it can mean persistent worry about the future, fear, uncertainty and helplessness.
The UNICEF reports that nearly 60 per cent of young people surveyed are very or extremely worried about environmental problems. Between 50 and 67 per cent say climate change makes them feel sad, afraid, anxious, angry or helpless. 45 per cent say these emotions have affected their daily lives, including sleep, concentration and education.
For someone who has watched a river swallow a home, the fear is different; it has a memory.
The province has repeatedly experienced devastating floods and rain-related disasters. According to the Provincial Disaster Management Authority’s 2022 report, August 2022 brought the highest rainfall recorded in the province since 1961. The province received an average of 192.7 millimetres of rain that month, compared with a normal average of 56.2mm.
The rains and floods killed 306 people and injured 369. Some 91,463 houses were completely or partially damaged. Schools and other infrastructure were also affected. The 2025 monsoon brought another heavy toll. PDMA figures show that 650 people died in rain- and flood-related incidents across the province, including 245 children and 145 women. Another 446 people were injured. Some 7,152 livestock were killed and 3,806 houses were completely or partially destroyed.
Since March 25 of the current year, another 45 people have died and 105 have been injured in rain-related incidents. Those killed included 23 children, 17 men and five women. For families such as Naheed’s, another flood will not simply mean finding temporary shelter, it could mean losing once again what took years to rebuild.
In Buner, memories of recent flooding remain vivid.
Zawar Ali Shah, a student at the University of Buner, says people in affected communities remain “paralysed by fear.”
“A large number of women from the area are still living with their relatives and refusing to come back, fearing more floods,” he says. For some families, returning home has become psychologically harder than rebuilding.
Shah lost his brother in the flood. He remembers the panic that spread through his village when a stream flooded on August 31. Everyone rushed towards a nearby mountain for safety. “Women clutching their babies ran, crying hysterically,” he recalls.
For survivors, the next flood can begin in the mind long before the water arrives. Dr Afsar Ali, a medical officer with the NGO Muslim Hands, says at least 21 percent of 200 patients examined by his team suffered from anxiety and post-traumatic stress disorder. After counselling, he says, patients were referred to the district headquarters hospital for psychological rehabilitation.
“People are too busy with reconstruction, taking care of the injured and running after aid,” he says. “When all this is over, they will be hit harder by depression and trauma.” For now, survival keeps people occupied. Later, there may be time to remember, he adds.
Women and children can face particular psychological pressures during disasters. Dr Iftikhar Ahmad, director of health at the Red Crescent, KP chapter, says people repeatedly exposed to earthquakes, floods and other natural disasters are increasingly experiencing anxiety and depression. Adolescents, particularly girls, can face additional pressures when families are displaced and forced to live in temporary shelters. “Adolescent boys and girls are already under mental stress,” he says. When disasters force them from their homes into tents, their psychological condition can deteriorate further.
Pregnant women are also particularly vulnerable to increased stress, anger and depression, he adds. Samreen Afridi, an assistant director and psychologist at the KP Red Crescent, says women and men were both found to be experiencing mental health problems after the Buner floods.
Many women suffered anxiety, depression and panic attacks because men were often away when the floods struck, leaving women to face the emergency with their children. Afridi cautions against labelling every distressed survivor as mentally ill. But timely counselling, she says, is crucial. “Psychological first aid” can be particularly important after a disaster.
The experience of flood survivors in KP reflects a global concern. The Intergovernmental Panel on Climate Change has warned that climate change is increasing risks to health, including mental health. Its assessments note that health systems are often under-resourced and insufficiently prepared to deal with growing climate-related health impacts.
The World Health Organisation has similarly warned that climate change is increasing social, environmental and economic risks that affect mental health and psychological wellbeing. These effects can be direct: extreme weather and disasters can cause trauma and psychological distress. They can also be indirect: food and water insecurity, declining agricultural production, economic losses and displacement can deepen anxiety and uncertainty.
For young people, the fear may be about what the future holds. For flood survivors in the province, the future can feel frightening because the past keeps returning. Climate change is not a distant image. It is the river next to the house.
The psychological consequences of repeat disasters are emerging while mental health services in KP remain limited.
Khyber Pakhtunkhwa Mental Health Act, 2017, established a legal framework for mental healthcare, including a Mental Health Authority and psychiatric facilities. Nearly nine years later, however, the law has yet to be fully implemented, with little progress on establishing the authority and modern facilities envisioned under it.
The gap is particularly concerning in remote districts, where access to psychologists, psychiatrists and counselling remains limited. PDMA spokesperson Anwar Shad says recurring disasters such as floods have negatively affected the mental health of communities in several districts.
He says the PDMA, in collaboration with other stakeholders, has prepared and launched a Disaster Risk Reduction Policy that includes psychological support for disaster-affected communities.
Health Minister Khaliq-ur Rehman says the provincial government is planning changes in the mental health sector, including psychologists at district headquarters hospitals. The process, he says, has already been completed in some hospitals. “The goal is to make psychological support available closer to communities so anxiety, depression and other mental health problems can be identified and treated earlier, he says.
For years, disaster response has focused on what can be seen and counted: rescuing people, providing food and clean water, establishing shelters, repairing roads and rebuilding homes. However, Naheed’s experience reveals another emergency, one that does not appear in photographs of flooded villages or lists of damaged houses. Naheed has already watched two floods take away her home and livelihood. Now every spell of brings back the question: what if it happens again?
For communities living along the rivers and streams of KP, resilience must mean more than stronger embankments, evacuation plans and emergency shelters. It must also include psychological first aid, counselling and accessible mental health services.
The contributor is a Peshawar-based journalist. He tweets
