Salman Saleem
Balochistan’s long-standing grievances and structural challenges have persisted since its annexation, leaving deep and lasting effects on its people. Political unrest continues to destabilise communities, particularly in conflict-affected areas. At the same time, weak institutions, poor social indicators, and repeated human rights concerns have compounded the hardship faced by ordinary citizens.
Despite its vast natural wealth, including copper reserves and flagship projects such as Saindak and Reko Diq, the province still struggles to provide even basic necessities. While many regions of the world addressed similar challenges during the twentieth century, their persistence in Balochistan presents a troubling picture that resembles a prolonged period of neglect.
Infrastructure and Road Safety Crisis
One of the most visible manifestations of this neglect is the province’s fragile road infrastructure. Poorly maintained highways and limited safety mechanisms have contributed to an alarming number of traffic accidents.
According to data from the Medical Emergency Response Center (MERC) 1122, between October 2019 and September 2025, more than 77,826 road accidents were reported across Balochistan. These incidents resulted in at least 1,743 deaths and over 103,900 injuries. Most accidents occurred on major national highways, including the N-25, N-50, N-85, and N-70, highlighting the scale of the crisis and the urgent need for infrastructure reform.
Growing Health and Cancer Burden
Alongside infrastructure failures, Balochistan faces a serious public health challenge. The province has witnessed a growing cancer burden, with breast cancer emerging as one of the most prevalent diseases among women.
Between 2020 and 2022, regional health records documented around 6,500 cancer cases. However, local estimates suggest that the province may be experiencing between 20,000 and 22,000 new cases each year. Limited healthcare facilities, delayed diagnoses, and lifestyle-related risk factors, such as tobacco use and poor nutrition, have worsened the situation.
Emerging evidence also points to environmental contamination as a contributing factor. Exposure to heavy metals, chemical residues, and improperly managed hazardous waste, including remnants linked to military activity, may be increasing health risks. However, the absence of comprehensive cancer surveys means official data for the period from 2023 to 2025 remains unavailable.
Lack of Healthcare Infrastructure
These trends underline the urgent need for public health interventions. Strengthened early detection programmes, targeted awareness campaigns, and expanded diagnostic and treatment facilities are essential.
Yet, the prospects remain bleak. Balochistan currently lacks a dedicated cancer hospital, leaving patients dependent on distant facilities in other provinces. As a result, many cases go undiagnosed or untreated, further deepening health inequalities.
Economic Marginalisation and Poverty
The hardships faced by the population reflect a broader reality of weak governance and institutional inefficiency. Extreme poverty, unemployment, and low household incomes continue to shape the socio-economic landscape.
Despite abundant natural resources, including natural gas, coal, copper, gold, marble, and gypsum, the economic benefits rarely reach local communities. Revenue generated through extraction is largely centralised, while only a limited share is allocated to the province. This allocation remains insufficient to address development needs or ensure economic stability.
As a result, local populations bear the environmental and social costs of extraction without enjoying its benefits. The absence of transparent revenue-sharing mechanisms and meaningful local participation has reinforced long-standing grievances and mistrust toward state institutions.
Water Crisis and Humanitarian Concerns
Adding to these challenges is a severe crisis in access to clean drinking water. More than 85% of Balochistan’s population struggles to obtain safe water for daily use. Even coastal cities such as Gwadar face chronic shortages, forcing residents to rely on distant, unreliable, and often unsafe sources.
Prolonged exposure to contaminated water has contributed to the spread of waterborne diseases. This reality stands in sharp contrast to Gwadar’s portrayal as a global investment hub, with projects valued at more than $62 billion. While development narratives promise transformation, many residents continue to search for something far more basic: a single drop of clean water.
A Province in Need of Attention
Balochistan’s challenges are not isolated incidents but symptoms of long-term structural neglect. Without inclusive development, institutional reform, and equitable resource distribution, these crises will continue to deepen.
Addressing them requires more than policy statements. It demands political will, transparent governance, and a commitment to ensuring that development benefits reach those who have remained on the margins for far too long.