Sujawal: A Generation at Risk

Pakistan risks losing not just children to malnutrition today, but the productive potential of an entire generation tomorrow.

Maha Dev Makwano

Every day we read stories from the nutrition-specific interventions agencies in the less privileged areas of Sindh. I can quote an example from the flood-scarred district of Sujawal, reported by aid agency; a 16-month-old girl named Shabira could not yet stand on her own feet. Doctors had told her mother, Farzana, to prepare for the worst, however her mother was already ready for the worst inside. But, thanks to a therapeutic feeding program, Shabira is crawling, curious, and very much alive, this one is quoted somewhere that’s why I am refereeing, however in districts like Sujawal, Tharparkar and Matiari I have seen thousands of cases (children from 6 months – 59 months), at risk of death, they received due care and they became alive and healthy. These stories are infrequent spark of hope in a province where malnutrition is quietly consuming an entire generation of children. In field on daily basis I see mothers with their children rushing to the doctors bare-feet and having almost know awareness regarding the malnutrition conditions of the children and same goes with the merely available for the population – posted for trainings and overloaded by additional tasks Lady health Workers.

However, the data is older which everybody knows but we still refer a 7-8 tear old data for the national figures which are compiled during the mentioned period however, collected and analyzed long agon since the quoted period; paints an ugly picture. According to the latest Integrated Phase Classification (IPC) analysis covering Balochistan, Khyber Pakhtunkhwa and Sindh, 2.71 million children aged six months to five years are now suffering from acute malnutrition — a sharp rise from the 2.14 million reported in the previous assessment. Of these, an estimated 706,000 children are battling severe acute malnutrition (SAM), placing them at direct risk of death, while roughly 2 million face moderate acute malnutrition. The crisis is projected to persist through September 2026, with only a slight seasonal improvement expected.

Nowhere is the emergency more visible than in Sujawal, a fertile district of 7,335 square kilometers hugging the Indus River — a geography that should promise richness but instead brings destitution. Of its roughly 839,000 residents, less than four in ten are covered by Lady Health Worker services, leaving 584,169 people effectively outside the formal healthcare net. The same planning and provisions continue for other than health services as well with almost same brilliance.

The nutrition indicators are stark: over half of Sujawal’s children are underweight, more than a quarter are wasted, and stunting affects an extraordinary 53.6 percent of children under five meaning more than half the district’s youngest generation may never reach their full physical or cognitive potential as of the given situations for the majority of the population. Local health units now estimate that nearly 30,000 children across the district are living with acute malnutrition, according to recent field reporting, limited fixed outpatient therapeutic treatment sites and fixed supplementary feeding program units operate to serve them leaving a big coverage.

Behind these numbers lies a tangle of everyday deprivation. Nearly 80 percent of households in rural pockets of Sujawal lack clean drinking water, electricity, functioning healthcare, or schools. The nearest hospital or dispensary is, on average, 12 kilometers away — a formidable distance where roads are poor and transport is scarce. For a mother with a fading child, that distance can be the difference between recovery and tragedy, where the recovery is unaffordable and the tragedies are fate.

Malnutrition in Sindh cannot be separated from gender inequality. Where certain practices and norms limit the feeding choices for male and female children with equality, while women and girls suffer in a certain way. Early marriage and repeated, closely spaced pregnancies leave many young mothers anaemic, fragile for more disease and medical complications, nutritionists estimate anaemia affects more than 45 percent of women in the province, long before they are physically ready to carry a healthy pregnancy to term. The result is a grim inheritance, underweight mothers giving birth to underweight children, who in turn grow up without the nutrients their bodies and brains need to develop normally.

The reflection for this concern is rightly raised from Tharparkar and yet to be reported form other districts too, where there are almost no arrangements for the low-birth-weight children and their mothers. A recent report published in The Express Tribune highlights a thoughtful newborn health crisis at Civil Hospital Mithi, Tharparkar (specifically reported and the chunk of data is not included). As many as 480 newborns died during the first eight months of 2026, out of 2,273 babies admitted to the hospital’s Neonatal Intensive Care Unit (NICU). So far form the reports, malnutrition, low birth weight, infections, premature births and other medical complications were identified as major contributing factors to the deaths. The highest number of deaths of children admitted -75- was recorded in May 2026. The report also notes that 126 children were taken home by their parents against medical advice, due to worst stay arrangements within hospital premises. Health authorities have reportedly not maintained or shared detailed information on newborn deaths, raising concerns about transparency, healthcare quality and the overall maternal and child health situation in Tharparkar. The status of children in Sujawal is worse than this however the strategy works in most of the districts, if they don’t report there will be no issues to handle, so rather than efforts on health issues, just don’t report.

Aid agencies stress that the coming months, before the next slender season sets in, represent a critical window. Scaling up community-based management of acute malnutrition and other relevant approaches, expanding therapeutic feeding sites, and improving access to clean water are seen as the most immediate levers available to prevent further deterioration including mobile medical camps for identified specific settings. Here, scaling up means the carpet coverage for a considerable period, if we want to secure a generations’ potential.

For the children at risk due to malnutrition, timely intervention meant the difference between loss and survival. For hundreds of thousands of other families across Sujawal and Sindh’s flood-battered districts and underprivileged districts, that same intervention remains, for now, tragically out of reach. Without urgent and sustained investment, nutrition and health workers warn, Pakistan risks losing not just children to malnutrition today, but the productive potential of an entire generation tomorrow.

Read: Education: The Unmet Right in Sujawal

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Maha Dev Makwano is an author, poet, and development and humanitarian practitioner with expertise in public health, nutrition, non-formal education, and rural development. He is doing MPhil in Rural Development. He can be reached at mahadevmakwano@gmail.com