Islamabad, Pakistan – It has been two weeks since Hasina Mugheri returned to her village in Pakistan’s southern Sindh province, which was devastated by unprecedented floods in August.
Every day, Mugeri relives the trauma of the night she and her family were forced to evacuate their home in the village of Khair Muhammad Mugeri due to rising floodwaters. She was 10 weeks pregnant.
“Eventually we were able to find one [a] a roof over our heads, so I’m very grateful to God for that,” said the 42-year-old.
“But it cost me my child.”
Mugeri recounted how she, her husband and 21 members of their household spent the night outdoors before walking more than five kilometers (three miles) in the rain and darkness to reach a public school in the town of Johi, where they found shelter.
“Within two days of getting there, I started bleeding and asked my husband to take me to the hospital. Doctors said the stress and all the walking probably caused the loss [my] pregnancy. But what else can I do now but pray,” Mugheri told Al Jazeera.
For Mugeri, the loss of her pregnancy was a painful reminder of the last major flood in her village in 2010. Then she also lost a child who was just seven days old.
The repeated trauma left her depressed, she said.
“The last time I had a daughter was nine years ago. I have already suffered multiple miscarriages. You always hope for the best and expect to become a mother again, but then things like this happen,” she recalls.
“I was just completely bedridden in a room full of people with no privacy and no room for sadness.”
One in five million women
Mugheri is one of the five million women of reproductive age currently living in squalid conditions in Pakistan’s flood-affected areas, the vast majority in the worst-hit Sindh province.
According to the United Nations Population Fund (UNFPA), as of November 10, more than 400,000 women are pregnant in Pakistan’s flood-affected regions, with another 136,000 expected to give birth in the next three months.
Dr Nigat Shah, a women’s health specialist attached to the Aga Khan Hospital in Karachi, said that more than maternal and reproductive health issues, it was their mental health that worried her the most.
“We went to multiple camps in Sindh where thousands of women are stranded, living in terrible conditions and their displacement has caused enormous trauma,” she told Al Jazeera.
Although the floods have begun to recede, allowing many to return to what is left of their homes, there is little hope for the millions of people who have lost their belongings and livelihoods.
At least 1,739 people, including 647 children, have died and 33 million people have been affected since record rains began lashing Pakistan in June, according to the country’s disaster management agency.
Sindh and the adjoining province of Balochistan remain the worst affected, with 799 and 336 deaths respectively.
At its peak, the floods, caused by a “monsoon on steroids” as described by UN chief Antonio Guterres, left more than a third of the country submerged.
This resulted in damage to more than 13,000 km (8,000 mi) of road networks, as well as more than two million houses being partially or completely destroyed. One million cattle were lost, as were thousands of acres of farmland.
According to the post-disaster needs assessment report prepared by the government with the help of the United Nations and other international organizations, total damage is estimated at more than $14.9 billion, and total economic losses will reach about $15.2 billion.
The daily struggles continue
But for thousands of women like Mugeri, it’s the day-to-day struggles that overshadow the sheer numbers and systemic infrastructure problems.
Tasmina, a 25-year-old mother of two, said she had no choice but to sell her wedding ring, a gift from her mother, to buy medicine for her family and herself.
She said her husband and children suffered from malaria while she suffered from gastroenteritis when they lived in a camp for displaced people near the city of Johi in Sindh.
“My ring, which was a wedding gift from my mother, cost 10,000 rupees ($44). But when we all got sick, I didn’t have money to buy medicine. I ended up selling it for 3,500 rupees ($15),” she told Al Jazeera.
Recalling her time in the camp, where she spent more than two months, Tasmina said conditions were appalling, with no sanitation or hygiene, as hundreds of men and women were forced to use the same makeshift toilets, with limited water .
“When I got [my] periods, it became even more difficult and embarrassing for me. There was no division, no clean cloth, and not enough water to wash what I had with me. Just thinking about that time makes me cry. Only God is our witness as to how we spent these days,” she told Al Jazeera.
Women suffered the most
Raheema Panhwar, provincial coordinator of WaterAid, a non-profit group that works in the field of sanitation and hygiene, told Al Jazeera that while floods cause pain and misery in communities, women often suffer the most.
“Many girls face trauma and anxiety, especially those who have started their period for the first time. They feel shame and fear because they have no knowledge of how to manage their periods. And there is no adequate support from the family because of the circumstances,” she said.
Dr. Muhammad Juman, director-general of health in Sindh, acknowledged that the scale of the disaster had made it extremely difficult to provide relief.
The women have suffered anxiety and trauma, which is often reflected in the various illnesses they face, he said.
“We have directed a large number of our health workers to go to these camps and places where the affected communities are and they have conducted thousands of sessions. But it’s really a matter of capacity. The flood caused damage to infrastructure resulting in service delivery being affected,” he said.
Juman said they are trying to train their health workers to provide psycho-social support.
“There are a lot of psychological issues that are being reported and we have to prepare for that. We are hiring female staff, such as more doctors, midwives, nurses, etc.’
How and what to restore
Mugeri, who now lives in a tent with her husband and five children as floods destroyed her house, wondered how she would rebuild her life.
“I just wish God wouldn’t put anyone else through this misery. I often have panic attacks and stay up all night,” she said.
“I’ve been through one flood, but this time things are much worse, and for us women, things are much more difficult for us.”