Health workers at Nepal's Epidemiology and Disease Control Division (EDCD) in the Department of Health Services (DHS), are making preparations to control a diarrhoea outbreak, which occurs during the annual monsoon season between July and September in rural areas.
"We have our teams ready in the district, regional and central levels where all the medical stocks and staff have been already propositioned," Sagar Dahal, chief of natural disaster management of the EDCD told IRIN in Kathmandu, the capital.
In addition, it has placed more than 50 emergency health kits, provided by the UN World Health Organization (WHO), in strategic locations such as Nepalganj along the border with India, Biratnagar in the east, as well as Kathmandu.
"In case of emergency [if the epidemic is out of control], we have our kits ready to immediately run health camps in the affected areas," said Dahal.
Meanwhile, Rapid Response Teams (RRT) have been formed at the central, regional and district level. Health workers, who were provided training in emergency response, are now active and on standby in more than 30 districts in case of any outbreak, added EDCD officials.
A 12-hour hotline has also been established at the EDCD to provide emergency response if the health offices at the district level are unable to cope. If the situation deteriorates, the hotline will be a 24-hour service, Dahal added.
 Photo: Naresh Newar/IRIN  |
| Health officials in Nepal have already started to preposition medical supplies and health workers to prevent diarrhea deaths |
His office has just finished mapping diarrhoea-risk areas to assess which districts were most vulnerable by comparing the epidemic prevalence over the past three years. It found that 26 out of total 75 districts — most in the far west and mid-western regions - were considered high risk.
These districts had recorded three diarrhoea epidemics over the same three-year period.
An additional 34 districts were categorised as medium-risk areas while the remaining 15 districts were considered low risk.
But already this year there have been reports of people dying from diarrhoea in the far west and mid-west regions of the Himalayan nation.
Although only 13 dead were recorded in hospitals over the past 23 weeks, the death rate could be much higher as access to health services in the most remote areas is very limited, local health workers warned.
Over 7,500 cases in six months
In 2007, there were about 33,746 reported cases of diarrhoea, with 250 deaths, the EDCD reported. However, it believes the numbers could be significantly higher as these figures were provided only through 28 sentinel sites — the hospitals strategically located near the epidemic-risk areas. In the first six months of 2008, the EDCD reported 7,532 cases of diarrhoea, but these were only cumulative figures, with the actual number expected to be higher.
Most cases at the community level remain under-reported, say health workers.
Although diarrhoea is prevalent throughout the year due to poor hygiene practices, unsafe drinking water and poor sanitation, the situation is particularly bad during the annual monsoon period when floods and landslides damage water systems and contaminate drinking water.
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