(formerly IRIN News) Journalism from the heart of crises

Diarrhoeal risk increasing, but no outbreaks yet

Water is only receding slowly and new rainfall is forecast for the next days. With no access to safe drinking water, many survivors are forced to drink from murky, brown water that carries the corpses of livestock and former neighbours.
International Federation

More than three weeks after cyclone Nargis struck Myanmar, killing some 78,000 people and leaving 56,000 others missing, health experts warn that the risk of diarrhoeal diseases will increase unless help is urgently provided.

Aid groups note that the rainy season set to begin shortly could exacerbate the spread of diarrhoeal diseases, including cholera and dysentery.

"It's certainly a very high risk and we all know that, because of issues of safe water," Maureen Birmingham, acting country representative for the World Health Organization (WHO) in Thailand, told IRIN in Bangkok. "It's one of the risky things we're watching for."

Diarrhoeal diseases were endemic in Myanmar before the cyclone, although there are no accurate figures about the rate of infection, the WHO reports.

To date, Myanmar's health officials have claimed the incidence rate is not higher than normal and no outbreaks of diarrhoeal diseases have been confirmed, said Birmingham.

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"We are definitely used to hardship"

Three-pronged strategy

In a bid to mitigate the risks, WHO and some 30 aid groups who make up the UN health cluster have launched a three-pronged approach, including surveillance, treatment and prevention.

As many as 17 regional surveillance officers, trained before the cyclone, have been deployed to affected areas to set up reporting sites.

This early warning system is the most effective way of monitoring the situation and watching for any sudden changes, said Birmingham.

Medical relief organisations are also focused on treating people with diarrhoeal diseases, most notably with oral rehydration salts.

WHO has distributed three inter-agency health kits, which each treat 20,000 people for three months, as well as diarrhoea kits, which each treat 100 severe and 400 moderate cases, and 100 adults and children for dysentery.

"One of the first things was to ensure that supplies were out there to treat people," said Birmingham. "Local medical staff know how to treat these diseases, because they are endemic in the area. The second thing is if there is some diarrhoea going on, we have to trace the cause."

Additionally, WHO and partner groups are focusing on providing clean water and sanitation to reduce the risk of further infections.

Issues of access

Yet aid groups hoping to reach Myanmar's badly affected Ayeyarwady Delta, remain concerned over a possible outbreak in areas they are unable to reach.

After an international donor conference in Myanmar on 25 May, Surin Pitsuwan, the Secretary-General of the Association of South East Asian Nations (ASEAN, of which Myanmar is also a member), which is leading the aid effort, reaffirmed the organisation's commitment to the international humanitarian aid effort.


Photo: International Federation
Myanmar Red Cross volunteers loading water storage containers onto a truck. Families can use these along with water purification tablets to have clean drinking water

"The UN Secretary-General, the chair of ASEAN, and myself, have asked for the full participation of aid workers in the relief effort for the victims of cyclone Nargis," Surin told reporters in Bangkok on 27 May.

"Other priorities have been put on hold. We are responding as an international community to accomplish this very important task for the time being. We are trying to open up roads, access, and space for the international community to have access to monitor and to deliver the necessities that would need to sustain, to revive, and to recover. To save the victims who are still waiting for our help."

Surin added that a rapid emergency assessment team from ASEAN would be deployed after training in Jakarta on 28 May.

The UN estimates fewer than half the 2.4 million people affected by the category four storm on 2 and 3 May have received emergency assistance.

The decision by Myanmar's senior general Than Shwe to allow aid workers into the country after meeting Ban Ki-moon last week could help medical teams reach the most vulnerable people.

Yet some relief organisations on the ground complain that authorities have requested two days' notice before they move into the delta, and sometimes they are only granted 24-hour access.

ag/ds/mw

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