Communicable diseases under control but sanitation and hygiene shortages remain

Almost three weeks after a devastating quake hit Bam in late December, killing an estimated 30,000 people, the prevelance of communicable diseases has remained under control while serious sanitation and hygiene concerns remain in the southeastern Iranian city. The main issue that was of our concern was the health of the people [who] survived and the people that came to help the others to support the activities on the ground. In that context we were very concerned about communicable diseases," Bijan Hamidi, a medical officer responsible for the World Health Organization (WHO), told IRIN in Bam. Primary health care services were rapidly established after the 26 December quake and the authorities, including the Iranian Ministry of Health (MoH), got the surveillance system up and running soon after. "Now we have a good operational surveillance system and during the past 10 days there had been no significant increase in the incidences of communicable diseases and everything is under control," the WHO official said. The WHO in Bam said on Monday that according to independent reports from MoH health teams, the International Society of Red Cross and Red Crescent Societies (IFRC) hospital, a Saudi Arabian emergency medical facility and a third hospital had indicated no increase in the prevalence of communicable diseases. "This time of the year we don't expect such diseases like malaria to be of a major problem but this region is a hot area of the country," Hamidi pointed out, noting that the weather would get warmer in a couple of months and preventative measures should be in place to combat such diseases. According to the WHO, 30 cases of watery diarrhoea, one case of bloody diarrhoea, 105 incidences of ARI (Acute Respiratory Infections) and 35 cases of mental disorders were reported among 1,118 patients visited by the MoH health teams on Saturday while the incidence rate has been more or less steady over the past week. Meanwhile, no reports of hepatitis, brucellosis, malaria, TB, or typhoid fever had been reported. However, the problem of latrines and showers remained. "Although a lot of NGOs have announced their readiness to provide latrines, we are still facing significant shortages. Up to now 1,000 latrines have been established and 100-200 have been repaired, but more than 7,000 has been estimated as needed for all the population around the city," the WHO official pointed out. Meanwhile, more than 1,000 emergency toilets have been set up in the city so far. Also, provision of material by UNICEF to build 2,000 toilets rapidly is being negotiated. Ken Gibbs, a former UNICEF official and tropical medicine expert, told IRIN that the water and sanitation picture in and around Bam remained confused because people were constantly returning to the city after having fled the quake. "Showers are in very short supply and at this stage seem to be people's greatest priority because many have not had a bath since the earthquake. No water, how do you have a shower without water?" he asked IRIN, adding, however, that there had been enough water for drinking.