摘要：The Indus River is the major source of water for the more than 180 million people of Pakistan. A rapidly increasing population over the past 60 years has created new pressures on water that was once a plentiful resource for the health and development of the country. Rising tensions between India and Pakistan, which share the Indus flow, may lead to violent confrontation in an already volatile part of the globe. The recent flooding, which affected more than 20 million people, drew attention to poor management of the rivers of Pakistan. Public health has the scientific knowledge and professional capacity to help develop water management practices that could improve population health in Pakistan. PRESSURES ON THE WATER OF the Indus River, the major water source for the more than 180 million persons living in Pakistan, are increasing, with serious implications for the health of the population. Rural Pakistanis (more than half the population) use irrigation water from the river for domestic purposes, even though it is unfit for drinking and a major cause of stunting and diarrhea. 1 Diarrhea causes 21.6% of infant mortality in rural Pakistan. 2 In Karachi, a megacity of approximately 18 million people, it is estimated that more than 30 000 people, 20 000 of whom are children, die every year because of unsafe water. 3 Control of river flow is still a major challenge for the country, which was tragically demonstrated during recent flooding that affected 20 million people and was described by the secretary general of the United Nations as the worst disaster he had ever seen. 4 Beyond the direct effect on human health, disputes over the flow of the Indus may erupt into a military conflict between India and Pakistan, endangering the lives and security of millions. 5 The future of water flow in the Indus is also threatened by regional environmental changes. 6 Public health professionals must be fully engaged in the development of this crucial resource for the country and the health of its population.
