War on Diarrhea : A Battle to be Won
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War on Diarrhea : A Battle to be Won

Camps have been set up in cyclone-affected Kolkata to treat diarrhoea and waterborne diseases caused by lack of proper sanitation.


By Dr Jorge G Caravotta

SUNDERBANS, West Bengal, India, 31 July, 2009 -- When Cyclone Alia hit the Bay of Bengal more than 80 percent of the fragile homes in the area were totally destroyed. The storm broke through the weak embankments built a century ago by the British, flooding rice paddies, devastating crops and forcing families to seek shelter at higher ground.

“We ran taking all our most essential things. We were very afraid and we dropped most of the things to keep our hands free to take our children who were getting overpowered by the wind,” says a villager who fled with his family when the storm hit at midday on 25 May.

“It was terrible. In just 15 minutes everything was flooded. … Water was up to our necks.” With a lack of human resources and guidelines, the natural disaster completely overwhelmed local health facilities. Disease surveillance was weak at facilities and in medical camps, leading to difficulties in the rapid identification of disease outbreaks.

A life-threatening situation

Since the cyclone hit, 100,000 diarrhea cases, resulting in 31 deaths, have been reported by the government in South 24 Parganas and North 24 Parganas. Severe watery diarrhea with vomiting and cramps is life threatening. If not treated, patients can lose up to one liter of water per hour.

Patients with severe dehydration can die as quickly as 6 hours from the onset of symptoms. Overstretched health facilities often fail to meet sanitation conditions to create a safe and clean environment for the wellbeing of patients, relatives and health personnel. A lack of hygiene and sanitation make people more susceptible to diarrhoeal diseases and needs to be tackled to decrease infection.

Helping the most vulnerable

Children and pregnant women are particularly vulnerable.

“Now, children under five are affected by cholera … making the fight even more difficult,” said Dr G.B Nair, Director of the National Institute of Cholera and Enteric Diseases (NICED) in Kolkata, the capital of the state. About 900 medical and paramedical personnel have been trained on diarrhea management guidelines and disinfection procedures, said Kaninika Mitra, Health Specialist in UNICEF’s West Bengal office.

UNICEF is partnering with the National Rural Health Mission, NICED and the Integrated Disease Surveillance Program to strengthen antibiotic protocols, epidemiological surveillance and diarrhea control.

Sustainable Efforts

UNICEF and NICED have trained fifty doctors from the Kolkata Medical College in case management, disinfection guidelines and preparation of safe and clean water.

At present, 300 government medical teams are operational in the field to work at health facilities and with communities. More than 50 engineers from the Public Health Engineering Department have been oriented on the proper disinfection of tube-wells, said Shyam Dave, UNICEF WES Specialist. Bleaching powder also is being distributed to affected communities to prevent the spread of diarrhea.

“We need to make sustainable efforts at community and facility levels to support the children and woman of the river island communities in their fight against cholera and acute diarroeal diseases,” said Dr. Henri van den Hombergh, UNICEF India Health Chief. “It is a fight that can be won.”


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