September 1, Kathmandu.
Doctors have stated that the risk of cholera, diarrhea, typhoid, leptospirosis, dengue, malaria, scrub typhus, and airborne infections spreading in flood and landslide affected areas has increased.
Doctors say that due to contaminated water, unsafe food, stagnant water, increased mosquito breeding, lack of sanitation, and displaced people having to live in one place, the risk of various communicable diseases increases after floods.
Dr. Sher Bahadur Pun, an infectious disease specialist working at Teku Hospital, stated that the risk of infection spreading indirectly is higher due to rats, insects, and other animals attracted to the carcasses of humans and livestock that died in the floods, rather than the direct spread of epidemics from the bodies themselves.
In a conversation with ICT Frame Magazine, he said that if bodies are not managed for a long time in flood-affected areas, rats and other creatures can be attracted to them, and diseases like leptospirosis can spread through infected rat urine and other means.
According to him, there is also a possibility of increased risk of vector-borne diseases.
He said, ‘Rather than sudden infection spreading directly from the carcasses, various types of animals, rats, or insects are attracted to the bodies of livestock and humans. Such things can put displaced people or individuals working there at risk. For example, leptospirosis can spread from the urine of infected rats. Similarly, vector-borne diseases like scrub typhus can also spread. When displaced people or individuals involved in rescue and management come into closer contact with such sources, there is a possibility of disease spreading.’
Dr. Pun stated that the understanding that infection spreads only from dead bodies after floods is not correct. He mentioned that if water, sanitation, toilets, food, and mosquito management are not properly handled in flood-affected areas, the possibility of infection spreading increases.
According to him, if there is a lack of safe drinking water, waterborne diseases such as cholera, diarrhea, typhoid, and jaundice can appear. Similarly, if floodwaters stagnate and create an environment for mosquito breeding, the risk of dengue and malaria can also increase.
He said, ‘If for some reason we cannot drink safe water or do not get it, problems like cholera, diarrhea, typhoid, and jaundice can arise. As water collects, an environment for mosquito breeding is created, which also brings with it the risk of malaria and dengue.’
Dr. Pun stated that recently, even before the floods, patients with diarrhea and fever were increasing, and the number of mosquitoes was also rising. Since dengue patients have also started appearing sporadically, he believes that health risks could become even more challenging after the floods.
‘Recently, even before the floods, patients with diarrhea and fever were increasing. Now, mosquitoes are also growing rapidly, and dengue cases continue to appear sporadically. The coming days are also challenging,’ he said.
He stated that since displaced citizens in flood-affected areas have to live in large numbers in temporary shelters, the risk of infection spreading will further increase if proper arrangements for toilets and sanitation are not made.
According to Dr. Pun, some individuals with infectious diseases may not show any symptoms initially. However, since the infection can be excreted through their feces and urine, in the absence of proper toilets and sanitation, the disease can spread to other people living in the same area.
He said, ‘In some infectious diseases, symptoms do not appear; a person may look fine, but the infection might be excreted through their feces and urine. Because of this, the disease can spread among the displaced people living there. Therefore, toilets are very important.’
He stated that if sufficient arrangements for soap and water can be made in flood-affected areas, the risk of infection can be significantly reduced. He suggested that special priority should be given to the habit of washing hands before eating and after using the toilet.
Special attention to children and pregnant women
Dr. Pun stated that special attention should be paid to the health of children and pregnant women during floods and disasters. He mentioned that even common infections can become serious in children, so attention should be paid to safe food, clean water, and personal hygiene.
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He stated that along with medicine, nutritious food and necessary health services should be provided to pregnant women.
He said, ‘For pregnant women, it’s not enough to only think about antibiotics. The nutritious food they need and the facilities that can be provided by healthcare should also be considered. Children should also be kept safe from infection and should not be given random food.’
He shared his experience of seeing more skin-related diseases and nutrition problems during floods in the Terai region in the past, stating that such problems should not be ignored in flood-affected areas even now.
Immediate treatment for patients needed
Dr. Pun stated that if any person in flood-affected areas shows symptoms of diarrhea, fever, or other infections, they should be immediately taken to a health facility for treatment. He suggested that sufficient medicine and healthcare workers should be deployed in the affected areas to prevent the spread of infection from one person to another.
‘There is a possibility of any disease emerging from there. Even if diarrhea occurs, immediate rescue and treatment must be provided to prevent the disease from spreading from that person. Medicines should be made available in various places as soon as possible,’ he said.
He stated that healthcare workers should be deployed based on the number of people displaced in the affected areas. He added that along with sending medicines and healthcare workers, the local environmental conditions should also be studied to manage necessary health services.
Coordination needed among three levels of government
Dr. Pun stated that effective coordination among the federal, provincial, and local governments is necessary to control health risks after floods. He also mentioned that the Nepali Army, Nepal Police, Armed Police Force, and other governmental and non-governmental bodies should coordinate to assess how much assistance is needed in which areas.
Adding to this, he said, ‘It would be even better if this work is done in an integrated and coordinated manner. Along with the three levels of government, coordination is also required from the Nepali Army, Armed Police Force, Nepal Police, and other bodies. It is necessary to assess how much assistance is needed in which place and manage accordingly.’
‘Health should not be neglected’
Dr. Pun stated that while food, shelter, and clothing are the primary needs of citizens during a disaster, health should also be prioritized. He believes that by adopting simple precautions in personal hygiene and safe food, many types of infections can be avoided.
‘The first priority may be food, shelter, and clothing, but that does not mean health can be neglected. If we only pay attention to personal hygiene and food, we can avoid most diseases,’ he said.
He stated that priority should be given to preventing mosquito breeding in stagnant water, arranging safe water, providing proper toilet facilities, making soap and water available, and ensuring timely access to treatment for patients.
Dr. Pun also suggested being cautious not to let regular health services decline while all state mechanisms are focused on search, rescue, and relief efforts due to floods.
He said, ‘The aim is to prevent another problem from arising due to reduced efforts in healthcare when our efforts are focused elsewhere because of floods and landslides. Everyone must remain vigilant to ensure there are no problems in affected areas and that communicable diseases do not spread in other areas.’
He stated that the potential risks of waterborne, vector-borne, and airborne diseases that could appear after floods should be estimated now, and necessary preparations should be made.
He stated that although natural disasters are unexpected, it is possible to prepare for the health risks that may arise afterward, so relevant bodies should immediately initiate monitoring and prevention work.
For More: Post Flood Infection Risk
