We must be prepared for the possible onslaught of communicable diseases in quake-hit regions this monsoon. A recent study of water samples collected from these regions—carried out under the aegis of the Ministry of Health and Population and Nepal Army Medical Corps—has produced some alarming results. Seventy-four percent of the collected water samples were found to be unfit for drinking. Moreover, the study uncovered a higher-than-normal presence of the larvae of Aedes mosquito in water samples from Kathmandu Valley. These mosquitoes are responsible for dengue and chikungunya fevers, both of which can be deadly in later stages. According to epidemiologists, diseases with short incubation period are seen in the immediate aftermath of big natural disasters. This is already happening in Nepal. For instance the Sukraraj Tropical and Infectious Disease Hospital at Teku, Kathmandu, the only hospital of its kind in the country, is already starting to see cases of Shigella dysentery, an acute form of diarrhea. Doctors at the hospital expect the appearance of cholera, another potentially deadly disease with short incubation.After the onset of monsoon, doctors fear the appearance of diseases with long incubation periods. These include typhoid, Hepatitis A and E, chickenpox and measles. All those living in earthquake-affected regions should boil their potable water. This will significantly reduce the chances of contracting water-borne diseases like cholera and dysentery. Much harder will be checking the spread of air-borne ones (chickenpox, measles). The only way to avert a pandemic of these highly contagious diseases is through high surveillance so that early cases can be isolated and treated. But the best solution is surely to keep them out, which is why it is so important to make the quake-affected people resilient against them. It won't be easy for those who have lost their homes—and hence are forced to live in tents or other temporary constructions, which they may have to share with six to seven other families—to maintain their hygiene. The cholera outbreak in Haiti (after the devastating 2010 earthquake) is instructive. Once cholera was spotted, the virus spread like wildfire among the 150,000 Haitians living in makeshift camps that had no water and sewage systems. More than 8,000 Haitians have since been killed by cholera.
With our rickety health infrastructure, it will be difficult to halt the spread of potentially catastrophic contagion like cholera and dengue once they are spotted. The country does not even have a stand-alone 'isolation unit' were initial cases can be treated in isolation. Providing safe drinking water and building hygienic toilets in temporary settlements should, as such, be high on government priority. So many precious lives were lost in the Great Earthquake, and many of them could have been saved if national building codes could have been enforced. Proper sanitation could, similarly, save countless lives. It is thus important that the bureaucratic hurdles for deployment of healthcare and sanitation workers in quake-affected regions are minimized and the government works closely with WHO and other international health bodies to reduce the looming risk from communicable diseases.
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