In developing countries like Pakistan, there is a lack of implementation of the environmental laws to manage discharges of untreated effluents, loaded with heavy metals, into freshwater. To evaluate the potential human health impacts from exposure to such polluted water, this study assessed the concentration of six heavy metals (i.e., Zn, Fe, Pb, Cu, Cd, and Mn) in the surface water in lower Sindh, Pakistan. Water samples were collected from eight locations around Kotri barrage at Indus River both during pre-monsoon and monsoon seasons to determine the temporal variations of the concentration of heavy metals. The concentrations of heavy metals were then compared with the drinking water quality guidelines of the World Health Organization (WHO). It was observed that in most cases, the concentrations of metals were significantly higher compared to WHO guidelines during the pre-monsoon period. To determine the potential human health risk associated with the exposure of heavy metals, both oral hazard index (HI_oral) and dermal hazard index (HI_dermal) were estimated. The results indicated that during pre-monsoon, HI_oral was higher than the threshold limits at every location, while HI_dermal was higher only at three locations. Nonetheless, during monsoon, these indices were within limits. It suggested that the health of the people dependent on these freshwater streams in the study area is at considerable risk. Finally, the findings of this study recommended the enforcement of the laws in its true spirit to regulate effluent discharges into these streams in order to avoid health vulnerability of millions of people.

This article explores the water policy narrative in Pakistan, and identifies its historical trajectories and influences, as well as the impact of the global agenda setting of water for 2030. For this purpose, water sector reforms in Pakistan are examined as a case study. The National Water Policy (NWP) 2018 and Participatory Irrigation Management (PIM) reforms are critically evaluated and loopholes identified, in terms of both theoretical aspects and constraints in their practical implementation. The overall analysis reveals that the engineering narrative is dominant in policy circles and large-scale infrastructure construction is seen as an exceptional measure to overcome the current loss of storage potential due to sedimentation. On the other hand, the adoption of the Integrated Water Resource Management (IWRM) framework reflects the desire of state institutions to imbue water policy reform with international credibility. The IWRM framework has been adopted as isomorphic mimicry to appease international financing institutions and donors. PIM reform is thus far from delivering the desired results due to ideological battles among new (i.e., the Participatory Farmers Institution) and traditional bureaucratic irrigation institutions. As adopted, the global agenda setting of water, in the shape of IWRM, is a repackaging of existing activities, and prevents alternative thinking in the setting of water priorities according to developmental needs.