Prevention or Perpetual Treatment?
Since 2010, more than 4,700 lives have been lost. An estimated seventy billion dollars gone.

Mohsin LeghariSeptember 15, 2025
A superior doctor prevents sickness; a mediocre doctor attends to impending sickness; an inferior doctor treats sickness.

–Chinese proverb.

Now swap “doctor” with “state” and “sickness” with “flood.” Where does Pakistan fit in? It is reported that so far nearly 1,000 people have died, and about three million have been affected or displaced, and it is not over yet as of today. After devastating Punjab, the waters are now entering Sindh. The reality has hit hard. We act as the inferior doctor, scrambling with sandbags once embankments fail, handing out ration packages and tents when farmland is inundated and entire villages vanish underwater, and we probe the causes only after the floods retreat.

A sentiment echoing across social media strikes at the core: it basically says, “What we label as a natural calamity or divine act, developed nations see as a failure in management.” For years, we have pinned floods on fate, yet the true offender is our incompetence.

This was diagnosed after the 2010 floods, when floodwaters submerged one-fifth of the nation and uprooted nearly 20 million residents. Punjab responded by forming a Judicial Flood Inquiry Tribunal, headed by Justice Syed Mansoor Ali Shah. His report, called A Rude Awakening, pulled no punches, accusing the state of “criminal negligence” through officials who proved untrained and unprepared. It recommended zoning floodplains, regular upkeep of barrages, and evaluating flood management structures prior to the start of the kharif season. The tribunal pushed for planned breaches in dire cases and swift evacuations to avert disaster. This laid out a roadmap for prevention. But the advice went unheeded. It was reported that those deemed at fault were later promoted rather than reprimanded. Floodplain rules stayed on paper for fear of losing the political vote bank.

Fast forward twelve years, and the setback struck fiercely in 2022. This was not solely the Indus River’s doing. Sindh transformed into a vast lake. In Punjab, Dera Ghazi Khan and Rajanpur suffered not from the main river but from raging streams descending the Suleman Range, which crashed through communities and pooled behind highways lacking proper drainage. The impact was immense: over $30 billion in combined damages and losses, with 33 million people reeling from the chaos. Familiar issues resurfaced: lax oversight, invaded natural water paths, faulty drains, and obsolete guidelines for dams.

The cost of endless reactive measures drains us deeply. Following 2022, international aid commitments reached $11 billion. Pakistan absorbed under $3 billion, hampered by its inability to draft solid proposals. Meanwhile, our own funding for the water sector dropped by nearly half, even as motorways secured complete budgets. Priorities leaned towards vote-grabbing projects rather than life-preserving barriers.

Now in 2025, history is repeating again. A farmer in Mandi Bahuddin watches his rice fields disappear under a sheet of brown water. A mother in Jalalpur Pirwala sits on a rooftop clutching her children, waiting for rescue boats that are yet to come. Most of this was preventable. The MET department warned of higher monsoons as early as April, but we did not pay heed. The story repeats: we fail to prevent, we fail to anticipate, and then we treat symptoms at unbearable cost.

Since 2010, more than 4,700 lives have been lost. An estimated seventy billion dollars gone.

So, what shapes a genuine remedy? Pakistan needs to map and regulate floodplains all along the Indus Basin instead of pretending they do not exist. Justice Shah called for this back in 2010, yet action lags. The 2016 Flood Plains Regulation Act sits idle in Punjab. I know for a fact that the Punjab Irrigation Department has mapped the areas likely to be inundated at certain flows after extensive research and studies, but they have not been officially notified or implemented. Homes keep being built in dangerous river paths, villages hug protective bunds, and breaches turn into needless horrors. Floodplain zones should be notified immediately, followed by enforcement and humane relocations with fair support. The rivers have claimed their domain; let us not allow anyone to encroach upon it again. The Sindh Irrigation Department should also be able to map the flood zones, if not already done so.

Barrages, guide and protective bunds demand maintenance akin to aviation standards. Just as aeroplanes and other equipment have periodic inspections, so should the barrages. In 2010, some gates were jammed. In 2022, backwater lingered dangerously. A quarterly “Barrage Health Index” should be prepared, documenting gate operability, scour depth, and structural condition. Barrages are lifelines. Neglecting them is criminal.

Dam management also requires an overhaul for today’s climate realities. Facilities like Tarbela, Mangla, and Chashma focus on power and irrigation, neglecting their flood buffering ability. Monsoons now deliver intense, unexpected downpours and extended highs. Operating protocols should be adjusted with weather forecasts in mind, syncing early water releases even at the price of some energy output. Trading lives for electricity is no bargain.

Road and rail routes need urgent rethinking too. Infrastructure should channel water freely, not contain it. Highways and motorways built without consideration of natural water paths trap water and cause great harm. Every new road should undergo a hydraulic audit. Culverts, overflow weirs, and breach points must be standard. Roads should carry people, not drown them. During 2022, these became unintended barriers, holding back water and devastating farms for weeks on end.

We also need to tie forecasts to financing. Forecasts without money are hollow. In 2022, forecast-based financing pilots proved their worth. Livestock staging, cash transfers, and early evacuation reduced losses. Scale it up. When rainfall models flash red, funds should flow automatically to districts in harm’s way. Delay kills.

China learnt after its 1998 floods, which took about 4,000 lives. They planted forests on uplands, revived marshlands, and cleared river spaces. Pakistan’s 4th National Flood Protection Plan, drawing from that model and Shah’s insights from the 2010 report, has lingered since its 2017 draft without full endorsement. Strategies pile up, but execution stalls.

Justice Mansoor Ali Shah, who now sits on the Supreme Court, still raises his voice for climate governance. His 2010 diagnosis is outdated. The 2022 experience confirmed it. The 2025 crisis proves it again. These are not just acts of nature; they are also acts of neglect.

No more reviews. No more hollow vows of change. To become the superior doctor, Pakistan must stop scribbling prescriptions on drenched pages and finally act. Zone. Maintain. Drain. Audit. Warn. Allocate and spend on flood prevention and management.

The proverb says the superior doctor prevents. For far too long, Pakistan has been the inferior doctor. Its citizens deserve better—superior governance of their waters—before the next flood writes yet another obituary for the state. Scientists are forewarning of more rains next year; let us start preparing now.

Mohsin Leghari
The writer is a former Senator, MPA, MNA, and former Minister of Irrigation Punjab.

https://www.nation.com.pk/15-Sep-2025/prevention-or-perpetual-treatment