National 6 (Spotlight Weekly)

Red Alert

Lack of awareness and unhygienic drinking water and food affects more than two thousand people causing deaths of over a dozen across the country

By THAKUR AMGAI

Teku hospital : Under stress

Do you know the name of any disease that can be largely prevented just by drinking safe water? Can you imagine that such a disease claims lives in dozens? But this is what has happened here. It is an irony that while doctors are on the verge of finding medicine to cure dreaded diseases like AIDS, people are dying of diarrhea in Nepal.

With the advent of summer and rainy season, incidents of diarrhea have increased throughout the country. The highly populated and poorly sanitized capital city, the Kathmandu Valley, has been the hardest hit by the outbreak of diarrhea.

With over 70 patients, on average, reporting to the hospital everyday, Shukraraj Tropical and Communicable Disease Hospital in Teku - the only communicable disease hospital of the nation - is facing immense pressure. On 21 May, the hospital, which has the total capacity of 100 beds, was flooded with 108 diarrhea cases. The patients were compelled to stay in the corridors and verandah for the treatment due to lack of beds.

In the last couple of weeks, the country has witnessed over 2000 cases of diarrhea. According to Epidemiology and Disease Control Division (EDCD), half a dozen patients have already died. Moreover, other reports suggest that the number of deaths could be well over a dozen.

Dr. Mahendra Bista, the director of EDCD, informed that by May 25, the number of reported cases of diarrhea were 1100 in Teku hospital, 32 in Bara, 75 in Jajarkot, 171 in Dhading, 450 in Dhanusha, 65 in Kapilbastu district and around 8 in Kanti Pediatric Hospital, Kathmandu. He also said that 2 people in Dhanusha, 2 in Dhading and 1 in Bara have succumbed to death. The reports of diarrhea cases have also come from other districts. Reports from the national radio say that 2 people have died in Sindhuli and 1 in Mahottari district.

In the capital, the limited manpower of the Teku hospital has been facing tremendous pressure. According to Dr. Shiva Shankar Jha, Director of Teku hospital, although the number of patients visiting the hospital at present is beyond its capacity, the hospital is trying its best to cater to all patients. Dr. Jha also informed that he had urged other hospitals of the valley to provide support by treating some of the diarrhea patients themselves. The hospital has less than 180 staffs with only about 15 medical officers.

The average number of diarrhea cases in the previous years during rainy season, which normally begins from mid July, used to be 30 to 40. However, this year, not only the number has more than doubled, the outbreak has started quite early as well. There is a fear that it could only be a prelude.

Impure drinking water is the major reason for most of the diseases including diarrhea.

According to doctors, 60 per cent of the diseases are water-borne. In addition to the water, the epidemic could also be a result of eating stale and unhygienic food at open eateries. Food materials decay faster in higher temperature and this year the temperature had reached a very high level. The obstruction in the collection of garbage because of the strikes and bandhs last week also played a major role in the outburst of the disease. Because of the high temperature as well as rainfall, the rate of decay of garbage accelerated spreading harmful pathogens.

Following the outbreak, various measures have been taken to contain it, which could otherwise take a form of epidemic. Suspecting drinking water as the major cause, the EDCD wrote letter to Nepal Water Supply Corporation (NWSC). It has also collected water samples from 25 places around Kathmandu including Bagbazar, Naikap and Kirtipur. Although Dr. Bista, refused to publicize the test results before submitting it to the Health Ministry, it has been understood that the water tested has been found to be contaminated. Likewise, the spread has taken an ominous turn after results of samples taken from 20 patients tested positive for cholera. Officials are still keeping tight-lip over this issue saying that they are conducting more tests to verify it.

On its part, the NWSC has increased the amount of chlorine used to purify water. Whatever the tests show, the General Manger of the NWSC, Kaushal Nath Bhattarai said, “Our water supply is as per the WHO standard and it is totally drinkable.” However, he conceded that at some places like Chhetrapati, Bangemudha and Keltol water was found to be contaminated. “We have immediately stopped the supply at those places and are supplying water through tankers in those areas,” he said. He clarified that the contamination is not at the water reservoirs, but due to the leakage of sanitation pipes. “The sanitation pipes goes along with the water supply pipes and there might have been some leakage. Moreover, during the dry season, people use water pumps to get more water and the leaked sanitation pipe could have entered the water supply pipes because of high pressure.”

The water supply infrastructure of Kathmandu Valley is very old. There are many leakages. And the drinking water is easily contaminated by the sewage and other stuff from the sanitation pipes. Bhattarai also informed that such pipes are under going maintenance.

The EDCD and Teku hospital have also urged the Kathmandu Metropolitan City (KMC) and other concerned agencies to help them keep the situation under control. The state owned media as well as the community F.M. radio stations have been broadcasting awareness raising messages about diarrhea. The KMC has launched various awareness raising and treatment campaigns. It has launched camps at different places for preliminary treatment and raising awareness.

With the increased publicity campaigns, particularly in Kathmandu Valley, people have started taking special care in food and sanitation.

Doctors say that water boiled for up to five minutes is safe to drink. Likewise, in summer, eating of stale food should be avoided and vegetables and meat should be cooked properly before eating. Hygiene should also be maintained. One should always wash one’s hands properly with soap and water before and after every meal and after going to the toilet. Doctors also advise against eating outside at open eateries, as there is no efficient mechanism to check the quality of food and water provided by them in Nepal.

Likewise even after getting it, diarrhea can easily be cured at home. Diarrhea causes loss of water and mineral salts from the body. 90 per cent of diarrhea can be cured by re-hydration. By drinking domestically made drinks like jeevan jal and other liquid food, the loss of water from the body can be replaced.

Diarrhea and cholera used to be major killers in Nepal many years ago. Epidemics of cholera and diarrhea used to kill tens of thousands of people in the past. In fact, despite the very high birth rate the population of Nepal was severely affected by deaths due to cholera and diarrhea till 1930s. Even as late as 1990, 2000 people had succumbed to death from diarrhea out of 100,000 cases reported.

Of late, the situation has improved a lot. These years, it is just a few dozen deaths and few thousand cases. The 20 cases of cholera that was reported by the national health lab is said to have been discovered after 11 years.