Floods are devastating but its aftermath can be just as deadly. Even as homes and properties remain submerged, the threat of the outbreak of diseases, many of them life-threatening, looms large. Once the water recedes, laying bare a trail of devastation, water- and food-borne diseases rear its ugly head with a ferocity, which, if unchecked, can claim many lives.

This vulnerability stems from the lack of access to clean drinking water, unavailability of hygienic food and from the displaced huddling together under makeshift shelters, exposed to a rapid transmission of communicable diseases.

This potential fallout, however, is scarcely new for the Ministry of Health (MoH) and its subordinate units. It has plenty of experiences responding to disease outbreaks after flooding—be it in July 1993 or the 2008 Koshi Floods—where hundreds of people were taken ill. Yet, each time a flood strikes and people are displaced, MoH’s lax response draws sharp criticism. 

“It is a shame that we are back to square one, even though we know that the monsoon wreaks havoc every year,” said Dr Laxmi Raj Pathak, a public health expert who led the MoH’s response during the 1993 and 2008 floods.

Last week, torrential downpour triggered floods in many parts of the country. In the aftermath, the Ministry of Home Affairs estimates that 140,000 households have been directly affected by the rain-induced disaster. By Wednesday, 123 casualties had been reported, while 35 people are still missing. The loss to cattle and livestock is yet to be assessed.

In a week after the disaster, potential health risks are already surfacing. On Monday, over 35 Musahar people were taken ill in Bhangaha village of Mohattari district that was severely affected by floods. People were found to have suffered from diarrhea and dysentery given their compromised hygiene and sanitation. In Jhapa, too, flood victims have started falling sick from viral fever. Health officials reported that viral fever cases were particularly high among the people who lived in settlements near the Kankai and Biring rivers. 

Health workers on the ground have reported that a majority of the people displaced by the floods lack clean drinking water. All of the displaced are living in close proximity, increasing the risk of rapid transmission of diseases like influenza, diarrhea and dysentery. Consumption of unhygienic food and open defecation has increased the risk of cholera and typhoid fever as well.

“Pregnant women and children are the most vulnerable during any disaster. Compromised nutrition to both these groups will have a far reaching impact in the development of the both unborn and the children,” said Dr GD Thakur, former chief of Epidemiology and Disease Control Division.

Studies across the world suggest that even common diarrheal cases in children, if unattended, will impact their physical and mental growth, and should it prolong, might even lead to death.

Experts suggest that MoH should adopt a multi-sectoral approach while responding to the flood affected districts. “Multiple factors including the unavailability of clean water and food have its repercussion on health. Yet providing these goods do not fall under the purview of the Health Ministry. So the ministry should reach out to concerned line ministries to make available sustained health services on the ground,” said Dr Pathak.

Government officials maintain that they have ensured a proper stock of emergency drugs in the health facilities in affected regions, while health workers have been instructed to provide round the clock services. “We have already deployed four expert teams to the ground to coordinate the effective delivery of health services. The teams have been sent to Biratnagar, Rautahat, Janakpur and Nepaljung, respectively,” said Health Minister Giriraj Mani Pokhrel.

What remains to be seen is if the authorities have learned from previous outbreaks and can provide swift and efficient interventions to those most in need. Large swathes of the Tarai have faced tremendous losses from a natural disaster; a human-induced one can and must be averted.