More than 42% of households in Peshawar depend on tap water for drinking. According to the Khyber Pakhtunkhwa Health Department’s Climate Health and Vulnerability Assessment, Peshawar ranks as the most affected district in terms of waterborne diseases caused by climate change.

Peshawar lacks a proper sewage system. Wastewater is discharged into drains and rivers without any treatment. This historic city, which also serves as the provincial capital, recorded the highest number of diarrhea, cholera, and typhoid cases in 2024. These alarming statistics raise serious questions about the link between public health and climate change.

Painful Memories

Zahid Afridi, originally from Khyber district, migrated to Peshawar during the era of militancy and has been living here for the past 18 years. He says he frequently changes rental houses every 2 to 5 years due to short-term lease agreements. Zahid has lived in several parts of the city and is currently residing near Customs Chowk. Due to narrow streets and a dysfunctional sewage system, water accumulates whenever it rains, spreading filth and diseases.

The 42-year-old says that he never experienced such severe health problems while living in Khyber district. He blames the absence of a proper sewage system and the consumption of contaminated water for his children’s frequent illnesses. “Living in Peshawar has become a nightmare,” he says.

Rising Disease Burden

Water pollution is rapidly fueling the spread of diseases in Peshawar. In both 2024 and 2025, the city reported the highest number of suspected cases of diarrhea and typhoid.

According to Molvi Amir Shah Memorial Hospital, thousands of cases of diarrhea, dysentery, typhoid, and intestinal parasites were reported among children. In 2024 alone, 68,456 cases were recorded in children under five.

Dr. Sufyan Khalil notes, “We’re even seeing dengue cases during winter now, something that never used to happen.”

Meanwhile, Medical Officer Dr. Fayaz-ul-Mola told TNN that young children and the elderly are the most affected by diarrhea, cholera, and typhoid due to contaminated water. Bathing in polluted water is also causing a rise in skin diseases. He explained that this water contains various bacteria, viruses, and chemicals leading to conditions such as dermatitis, fungal infections, scabies, bacterial infections like impetigo, folliculitis, and eczema.

Dr. Fayaz added that harmful germs also enter the eyes through polluted water, causing conjunctivitis, trachoma, corneal ulcers, fungal infections, eye allergies, and uveitis.

Dermatologist Dr. Shumail Zia emphasized that fungal infections on the skin, particularly Tinea corporis, are rising rapidly due to contaminated water. She also noted an increase in folliculitis, commonly referred to as hair follicle inflammation, which is linked to polluted water.

Climate Change

Unseasonal and intense rains at the end of June and in the current month—clearly linked to climate change—have further strained an already fragile urban system. Peshawar Valley, once a cradle of the Gandhara civilization, is now grappling with poor sanitation and contaminated water.

According to the Regional Meteorological Office, rainfalls are now shorter in duration but heavier in intensity, leading to flash floods in urban areas. Rainfall patterns themselves are also undergoing significant changes.

Water and Sanitation Crisis

Peshawar’s population has crossed 4 million, yet the city lacks an operational sewage treatment plant. All waste is discharged directly into drains and rivers, even in upscale areas.

According to Shaiyda Muhammad, Project Director at the Public Health Engineering Department, 45% of water samples collected from 140 sites across the city were found unfit for drinking.

The city has two proposed sewage treatment plants—one in Hayatabad and another on Warsak Road—but both exist only on paper. The Hayatabad site has been converted into a BRT (Bus Rapid Transit) mall, while construction on the Warsak Road plant has yet to begin.

Lack of Coordination

Advisor to the Chief Minister on Health, Ehtesham Ali, admits, “There is still no regular coordination between the Health Department and the Public Health Engineering Department. Most interactions occur through district administrations or local authorities.”

He explains, “In any epidemic, the Health Department responds first. Only later is the Engineering Department informed to clean water in the affected areas.”

According to the World Health Organization, 80% of diseases are caused by contaminated water, including hepatitis, intestinal, stomach, liver, kidney, and even life-threatening illnesses like cancer. This concerning situation demands urgent and comprehensive action.

In response, the Government of Pakistan has installed numerous water filtration plants across the country, including in the "City of Flowers," Peshawar, to provide clean drinking water. Although a large number of these filtration plants have been set up in specific areas, sadly, only a few are fully functional. Many have not been cleaned for a long time, and several filters are no longer operational.

Furthermore, due to old and worn-out water supply pipes, rainwater mixed with sewage is seeping into the drinking water supply at multiple points.

Due to climate change, not only humans and animals but also agricultural produce, including vegetables and fruits, is being affected, resulting in declining yields. This has now become a serious and worsening crisis.