As world leaders address COP27 in Egypt to try to reinvigorate stalled global climate talks, survivors of Pakistan’s heaviest flooding in living memory are facing a health crisis, with stagnating floodwaters fuelling a rise in malaria, dengue, and diarrhoea.

The unprecedented scale of the disaster – $30-40 billion in economic damage, 1,700 killed since mid-June, eight million displaced, and almost half the country’s farmland submerged – turbo-charged pre-summit calls for climate reparations. But there are far more pressing concerns in southern Sindh province, where access to assistance has been curtailed by the vast extent of the flooding, massive damage to health facilities, and a chronic lack of medical personnel.