Mental Health in the Margins of Sindh

Ali Nawaz Rahimoo

Tharparkar: The desert region of Sindh Province is divided into two major arid zones the Thar and the Nara deserts. Together, they form the eastern extension of the vast Thar Desert shared with India, stretching nearly 300 to 350 kilometres from south to north.

The Sindh portion of the Thar Desert alone spans around 20,000 square kilometres, covering Tharparkar, eastern Umerkot, and parts of Sanghar District, notably the Khipro Taluka.

Despite its vastness, this desert belt faces some of the most severe economic challenges in Pakistan. Low per capita income, poor infrastructure, limited industrial development, and high climate vulnerability define everyday life.

Recurring droughts, water scarcity, and weak access to markets make livelihoods in Tharparkar, Umerkot, and eastern Sanghar deeply insecure. According to the UNDP Human Development Report 2021, poverty incidence in these areas exceeds 50 percent, with average household incomes well below the national poverty line.

Agriculture and livestock remain the backbone of the local economy, but without mechanization, value addition, or diversified industries, growth is stunted. Weak investment in education, healthcare, and roads only deepens inequality.

Read More: https://thepenpk.com/climate-disasters-are-here-are-we/

The Mental Health Crisis in the Desert

In a recent initiative delivered with support from psychiatric institutions, civil society actors, and local administrations, free consultations were provided to 4,570 patients—2,480 men and 2,090 women.

Clinical data revealed depression (34.7%) as the most prevalent disorder, followed by intellectual disability (11.9%), anxiety disorders (11.3%), epilepsy (9%), and somatoform/conversion disorders (8.6%).

Patterns varied by district. Depression was highest in Tharparkar and Umerkot, while Sanghar and Khairpur recorded higher levels of anxiety disorders. Women and adolescent girls faced greater risk, particularly due to poverty, early or forced marriages, and gender-based violence. UNFPA (2021) reported that 18 percent of Pakistani women aged 20–24 were married before 18, with Tharparkar and Umerkot among the worst-affected zones.

According to UN Women (2021), nearly one in four married women in Pakistan has experienced spousal violence—likely underreported in desert districts where stigma and weak institutions silence victims.

Educational deprivation reinforces this cycle. UNESCO and the Pakistan Institute of Education (2023) found that over 52 percent of girls aged 5–16 in Sindh are out of school, with female literacy in Tharparkar as low as 23 percent.

Suicide mapping by the Sindh Mental Health Authority (2016–2020) recorded 79 suicides in Tharparkar alone—48 of them women—alongside 64 in Umerkot and 66 in Sanghar. Adolescent girls emerged as the most vulnerable, often presenting with depression, trauma, and suicidal ideation, while men were more likely to report psychosomatic illness and substance abuse linked to joblessness.

Environmental Strain

The desert districts of Sindh sit at the intersection of poverty, climate stress, and weak infrastructure. Droughts repeatedly wipe out crops and livestock. Poor road connectivity isolates villages, while industrial stagnation means few alternatives to subsistence farming. High poverty rates—above 50 percent in Tharparkar—lock families into cycles of deprivation.

These structural challenges intensify mental health risks. Field surveys between 2022 and 2025 confirmed widespread depression, anxiety, and psychosomatic complaints. Symptoms such as chronic fatigue, insomnia, headaches, and body pain were common, but often dismissed as physical illness rather than signs of mental distress.

Read More: https://thepenpk.com/silent-science-of-womens-depression/

Suicide rates were highest in villages hardest hit by crop failure, water shortages, and long-standing poverty.

Healing Minds

The crisis cannot be solved by medical treatment alone. Mobile clinics, permanent care centres, and affordable, culturally sensitive services are vital to ensure that mental health support reaches people where they are. Equally important are awareness campaigns—in schools, villages, and on local radio—that dismantle stigma and encourage early intervention.

But mental health services must be paired with stronger livelihoods. With droughts now a recurring reality, investment in drought-resistant crops, improved livestock development, and vocational training for non-farm trades could stabilize incomes.

Women and youth must be at the centre of this response. Enforcing laws against early marriage, expanding access to education, and supporting women-led cooperatives can empower communities too often sidelined.

Addressing substance abuse is equally urgent. Targeted prevention programmes, rehabilitation services, and skills training can help young people break free from cycles of addiction.

Beyond Survival

The mental health crisis in Sindh’s deserts is inseparable from its poverty and climate vulnerability. Without a coordinated, well-funded strategy, communities will remain trapped in cycles of distress. A holistic approach—linking economic resilience, gender justice, education, and healthcare—is the only way forward.

Until then, the people of Thar, Umerkot, and Sanghar will continue to fight not only for survival under a scorching sun but also for peace of mind in an unforgiving landscape. The desert horizon, which now symbolizes struggle, could one day represent resilience—if Pakistan chooses to act.

The writer is a social development professional based in Umerkot, Sindh. He can be contacted on anrahimoo@gmail.com. 

The article is the writer’s opinion, it may or may not adhere to the organization’s editorial policy.