CROSS Pakistan from the floodplains of Punjab to the heat-stricken cities of Sindh the climate crisis is taking a quiet, deadly toll. Children and the elderly are dying not just from drowning or heatstroke, but from the diseases, displacement and neglect that follow. Yet the true scale of this loss remains hidden. According to a new Amnesty International report, fewer than 5pc of deaths in Pakistan are officially recorded. Most go undocumented during disasters. The report reveals a bleak picture. In Badin, child mortality surged by 57pc during the 2022 floods. In Karachi, morgues overflowed during the 2024 heatwave.

Older adults with chronic illness and young children, whose bodies cannot regulate temperature, are the most vulnerable yet the least visible in data, policy and disaster planning.

The government owes them more. Health spending must rise from 2.91pc of GDP (based on 2021-22 numbers) to meet global norms. Healthcare workers must be trained to recognise and manage climate-related illness in children and the elderly.

Death registration should be expanded by removing fees and using outreach models that improved birth registration. Older people must be included in health data systems and protected with a universal pension to reduce economic vulnerability during heatwaves and floods. Children`s access to education must be preserved in disaster times through resilient schools and alternative teaching methods. Displacement camps must be tailored to the needs of children and older people. Local disaster authorities must be funded to deliver early warnings, cooling centres, and plans that prioritise the vulnerable. Restrictions on NGOs that delay relief work must be lifted. There is also a role for the international community. Climate finance to Pakistan must come in the form of grants, not loans, and must prioritise adaptation and social protection. Heatwaves, floods, or storms should not be a death sentence. The state must act and the world must assist to protect those most at risk.