Re: Diarrhea outbreak in Nepal: Toll close to 100 in Jajarkot
Re: Diarrhea outbreak in Nepal: Toll close to 100 in Jajarkot
http://www.reliefweb.int/rw/rwb.nsf/db900SID/JBRN-7U6HNV?OpenDocument
'Diarrhoea' outbreak fatally troubled Nepal
Source: Nepal Red Cross Society
Date: 21 Jul 2009
Indra Adhikari, Communications Director
Kathmandu, July 21 - In the last three months, 'diarrhoea' claimed at least 200 lives in a couple of districts in the mid-western part of Nepal, and over 5,000 people are still under treatment and supervision at health camps. Majority of them are women and children. After observing the situation, Prime Minister Madhav Kumar Nepal vowed a package to support the families of the deceased and ordered the local authority and organizations to make the response against diarrhoea more effective in a comprehensive manner.
According to the regional health directorate in Surkhet Jajarkot, Rukum, Dolpa, Surkhet, Dailekh , Salyan and Rolpa districts have been widely affected by the epidemic. Of them Jajarkot, where the diarrhoea actually out broke in the third week of April, lost 143 people and about 2000 people are sick of diarrhoea. Rukum, the neighbouring district, also has more than 500 sick people 33 died of diarrhoea. Rolpa the least affected district also has 34 patients and 1 case of death. Nonetheless, about 3,140 people are recorded sick. Sometimes, record keeping has also been difficult as individual patients not accessing the health camps are not recorded properly. Communication is not working in all the affected areas including majority health camps.
Initially, the problem was limited to Jajarkot only and limited response could control the situation. But as the monsoon begins, the situation has developed more serious. It spread to neighbouring districts and the area which came under the control of health response also has recurring of the situation. In addition, the government is still not sure if it is limited to diarrhoea though the sample collection for testing in Kathmandu already begun. Different organizations have also involved in this process but logistically, the affected areas are not easy to access by any mode of transport except air.
Even if it is cholera, the situation could have come under control if the preventive measures were effective. Because of poor knowledge of personal and environmental sanitation and thereby the worse health and hygiene practices, the health situation of people have become very much critical.
At the local level, response activities are coordinated by the local official of the government, where the Local district Officer, Nepal Police, Nepal Army, Red Cross, Political Parties, Journalists, I/NGOs and OCHA are participating in with their capacity.
Health Response Updates : As per the DPHO report health camps are established in 18 different locations in Jajrkot District to provide the treatment to the diarrhoea patients. To target the preventive measures DPHO has been disseminating the messages on the health and hygiene through the regional FM radios. Health staff are mobilized to make people aware of the hygiene practices and in Bhagawati VDC political parties are supporting in the household visit campaign.
Nepal Army has conducted health camps in 6 VDCs, MoHP health (supported by Nepal Medical Association) teams deployed in 13 VDCs, each team has one doctor and 3 paramedics. The teams are stationed in health posts, sub-health posts and PHC. Nepalgunj Medical College deployed 2 medical teams. All the affected areas are very remote and houses are scattered, therefore awareness raising and delivery of supplies is very difficult.
Meanwhile, a team of doctors and technicians lead by WHO are collecting the samples. Due to the logistics difficulties the samples has not reached to Kathmandu.
Inspite of all the efforts poured down there, the communications constraints have impacted the flow of information from the health camps. The health workers deployed in the field do not have survival kits. Awareness on the preventive measures is not effective as they were expected.
The Prime minister has directed the local officials to improve the coordination mechanism and made appeal to all the NGOs and INGOs for their extensive involvement in controlling the outbreak. He has also vowed to support 10 thousand rupees to the family of deceased and fifteen thousand rupees to the very poor ones.
Female Community Health Volunteers (FCHVs), local teachers, clubs are being mobilized for the preventive measures. The DDC Social Mobilizers are also mobilized to support the preventive measure campaign.
WASH Response : UNICEF, NEWHA, CONCERN and NRCS are supporting the WASH response.
Nepal Red Cross Society response :
NRCS has become a part of the response mechanism in the district and central level. It has provided 100 blankets, 100 tarpaulins and 50 stretchers, information, education and communication (IEC) materials to the affected Districts. The Red Cross volunteers in the affected districts are mobilised for public awareness on water and sanitation. The NRCS supplies are transported to the districts with the support of Nepal Army.
Likewise, NRCS has deployed a response team of 3 members (a medical doctor, a nurse and a watsan expert) in Jajarkot. The team has provided technical support to the district chapter, assess the current response and further need. It has provide clinical management support in some areas, analysed the gaps, coordinated and worked closely with District Public Health Office/WHO/UNICEF and other relevant organizations for logistic support, IEC and volunteer mobilization.
For, awareness campaign, NRCS Rukum district chapter distributed 30,000 copies of IEC materials through 15 volunteers in five affected village development committee that are exposed to and prone to expose diarrhoea. Likewise, in coordination with the district public health office, NRCS district together with water and sanitation sub-division office, has distributed 500 bottles of water guard, 5,000 tablet chlorine, 200 bottle piyus (water purifier) and 2 cartoons of jeevan jal in those communities. Moreover, RC volunteers have been greatly involved in managing the sick people and their carers.
The NRCS Rukum District Chapter is working with Save the Children and Child Workers in Nepal (CWIN) to support the District Public Health Office and assisting with medicine delivery, community awareness raising and distribution of tents and other logistics for caring patients.
NRCS is standby to support stretchers and additional blankets and tarpaulins to facilitate the health camps. The SWISS Red Cross has supported NRCS Jajarkot district chapter one hundred thousand for volunteers' mobilization and other emergency support. It is in a position to support medicines if required.
District disaster relief committee, Jajarkot has reported that around 3 tons of medicines received at the Chaurkhari Logistics Centre out of which 2 tons is distributed to the health camps and 1 ton medicines is in stock at Chaurkhari.
Nepal Telecom has committed to distribute telephone services in the health camps from Monday onwards.
The distance between Chaurkhari, Rukum and DHQ of Jajrkot and the poor communication are the big logistics constraints. The service providers and volunteers are facing greater problem with the food, hygiene and accommodation. The bad weather in Jajrkot has also affected the operation of the helicopter for logistic.
In order to improve the response mechanism, the DDRC is meeting on weekly basis and the WASH and Health meeting will be everyday until the situation comes to normal.
