Monsoon is wreaking havoc in hilly districts, causing landslides and floods, sweeping away settlements in Baglung and Myagdi and killing dozens of people and rendering hundreds homeless. Earthquake victims have been living under tents even after one hundred days of deadly April/May quakes without hygienic food and sanitation facilities. While parts of far-western districts like Dhangadhi are submerged in floods, other parts of Tarai, Nepal's grain store and a mainstay of food economy, are thirsting for rains for paddy plantations. And now the threat of cholera outbreak! According to the Sukraraj Tropical and Infectious Disease Hospital (STIDH) dozens of people of Kuleshwar area in Kathmandu have been found infected with diarrheal diseases, raising suspicions of a cholera outbreak in the capital. These, it seems, are extremely vulnerable times for Nepal.Cholera is infectious and it can lead to death if untreated and is most common in places with poor sanitation. Poor hygiene and sanitation, with which earthquake victims are battling through in a number of earthquake affected districts, create fertile ground for cholera outbreak. Haiti offers a guide. Following the devastating earthquake of 2010, cholera killed about 9,000 Haitians and hospitalized hundreds of thousands, according to the US Center for Disease Control and Prevention. Haiti still sends thousands to hospitals every month. At least 150,000 cholera cases, according to one estimate, are reported to the World Health Organization each year. Nepal needs to be prepared to contain the contagion because a study carried out under the Ministry of Health and Population and Nepal Army Medical Corps back in May concluded that people of earthquake hit districts are vulnerable to various epidemics such as diarrheal epidemic. The MoHP, during its post-quake risk assessment in Kathmandu, Bhaktapur, Lalitpur, Gorkha, Dhading, Sindhupalchowk and Kavrepalanchowk districts, had found above 70 percent water samples collected from these districts unfit for drinking. Contaminated water, which is what most victims are forced to drink, is responsible for spreading cholera. This is no time to sit back and watch.
Apparently, the Sukraraj Tropical and Infectious Disease Hospital has been doing its bit to contain possible contagion. The hospital source claims to have conducted 'hanging drop test' of stool samples of suspected patients, and upon finding "positive" results, they have been sent to the National Public Health Laboratory for further test. This, we are afraid, won't be enough. The only infectious disease hospital of the country is often ill-equipped to administer the treatments on patients of infectious diseases. Other public health facilities are poor in handling such diseases—either human resources are not trained and skilled enough for the job or hospitals lack equipments for timely diagnosis. Our response to bird flu, swine flu and Ebola outbreak, has often been found wanting. Thus, while it is imperative for all to maintain personal hygiene (drinking only boiled water can help), the onus lies on the government to equip and prepare all health facilities so as to enable them to contain outbreak of any infectious diseases—which often raise specter during the monsoon. Let us not forget, people may be coming to terms with pains and miseries of earthquakes, but the possibility of infectious disease like cholera looms large.
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