Floods in a faraway country may seem a bit off topic for a blog created to cover influenza, but the last year and a half has been an education for me: Nothing happens in isolation. Epidemics and pandemics don't wait for a convenient time to break out. They just aggravate everything else that's going on, and everything else aggravates the epidemics.
Everything else is indeed going on. Mike Coston and Arkanoid Legent are reporting tonight on H3N2 flu in Hanoi, and Chen Qi is covering dengue and chikungunya in Karnataka. So bear with me while I think about what's happening to the 170,000,000 men, women and children in Pakistan.
This is a new country, founded in 1947 in a ghastly act of near-genocidal ethnic cleansing when the British got out of South Asia. But it sits on some of the oldest civilized ground on earth, where people living in mud-brick villages have earned a living from the Indus River for eight or nine thousand years. They have survived untold disasters before, including Alexander the Great, the Mongols, Tamerlane, and the Moghuls.
Modern Pakistan may lack its ancestors' resilience. Its civilian politics seems to depend on two or three aristocratic families, who kill one another off with dreary frequency. When that doesn't decide the succession, the army steps in.
The aristocrats are smarter and better-educated than the leaders of most western nations, and the generals have the macho charm of those educated at Sandhurst. But it's pretty clear that very few people would want to be ruled by either group...even the Pakistanis themselves.
They rule thanks to their wealth, their class, and the yawning gulf between them and the Indus villagers who support them. The ruling class has actually extracted enough wealth from those villagers to build nuclear weapons and to fund organizations like the Taliban in next-door Afghanistan. The rulers kill each other, so we can assume they're prepared to kill their neighbours. And maybe let their own villagers die as well.
The 1600 or so deaths directly caused by the floods are obviously a grotesque understatement. The country's medical and bureaucratic infrastructure is too threadbare to keep track, so it will take months for WHO and NGOs to find a rough estimate.
Meanwhile, untold hundreds of thousands of children will die or suffer lifelong disability from malnutrition and illness. This demographic collapse will be most evident in the 2020s and 2030s, when those children could have been expected to be in their most productive years.
Untold numbers will also find themselves without work. Their villages will be gone, their fields destroyed. They will rot in rescue camps, or migrate to the big cities to worsen the slum problem. In filthy and overcrowded conditions, they will fall ill again, and pass new diseases on their urban neighbours.
Whoever rules in Islamabad will have to borrow against Pakistan's future to feed those people, just as the Soviets and East Bloc borrowed from the West in the 1970s and 80s, before communism imploded. The loans will buy enough grain to feed (or underfeed) the floods' millions of "affectees."
But Pakistan will eventually implode as well, though not necessarily as peacefully as Poland or Czechoslovakia. At least some of the affectees will revolt rather than quietly die.
And the climatic conditions that triggered these floods will do the same thing in India, Afghanistan, Iran, and Central Asia. The Himalayan glaciers are shrinking even as the monsoons drown the subcontinent. South Asia could become, by midcentury, as much a desert as Saudi Arabia.
No doubt floods like these devastated the villages on the Indus 3,000 years ago, and the villagers survived and rebuilt. But a flood or drought on the Indus in 1,000 BC did not affect Homeric Greece or the Pharaohs, much less the pyramid builders of Central America and the Anasazi farmers of ancient New Mexico. They suffered their own climatic disasters.
We are more connected to Asia than we realize, and we have been for centuries. The Black Death of the 14th century, after all, moved west with the Silk Road caravans from northwest China to the Black Sea and then to Europe. Influenza itself has repeatedly swept the world from its base in the duck ponds and chicken coops of south China.
If we shrug off Pakistan's catastrophe as strictly the Pakistanis' problem, we only ensure that our own catastrophe will be worse, and sooner, than we imagine.
