Authorities in Kerala, which was ravaged by its worst flood in a century, have shifted their attention to handing out medicines and disinfectants to fight diseases in the hundreds of relief camps that have sprouted across the state.
Prevention of water-borne diseases is typically the biggest challenge in any region that tries to recover from the damage of floods. The probability of the outbreak of disease is very high because July and August are the peak months of infectious diseases, said health secretary Rajeev Sadanandan.
The government is aiming to respond effectively if epidemics do break out, he told CNBC-TV18 in an interview by email.
Q. What is your assessment of the ground situation in terms of the potential outbreak of infectious diseases? A. The probability, as after any flood is high, especially as July, August is the peak of Dengue, Leptospirosis and viral fevers. This year we also had a chickenpox outbreak. In the initial days, all would be careful to follow the health advisories. Five days after the peak flood we have not had many incidents. But later, when the vigil is down is the time to be careful.
We are not taking any chances. An officer has been posted in every affected district, whose only task is to look out for diseases and alert the Rapid Response Teams.
Kerala has been every effective in doing this as demonstrated by the rapidity with which the public health system responded to an unknown virus, which turned out to be Nipah. We will soon hyper chlorinate all water sources and keep testing them. The mosquito population would also be closely watched and managed. But the key will be surveillance and rapid response if there is any outbreak.
Q. What challenges are you facing in maintaining overall hygiene and food hygiene at relief camps? A. The sheer numbers which leads to overstretching of facilities especially sanitation. People live in close proximity and could be infected by a person during the incubation period. Q. Now that the water levels have receded, Kerala is focusing on rebuilding and rehabilitation efforts. What is the focus of your department in these efforts? A. On the infrastructure front, we have lost 18 buildings, 59 need major repairs and 69 need minor repairs. The first priority is to construct or restore them and replace the damaged equipment. On the health front, our focus will be on preventing complications of non-communicable diseases.
In most developed countries, the incidence of severe complications such as cardio vascular diseases, post traumatic stress disorders (PTSD), depression, nephrological complications had gone up after natural disasters. We expect a similar scenario here.
Our aim is to watch for this and respond. We are working with the National Institute of Epidemiology to do this. We are also working with NIMHANS to ensure psycho-social support to flood affected populations to reduce PTSDs.
Q. The magnitude of the floods is unprecedented. So should the people expect, or be worried, about the outbreak of diseases too in proportions that the state has previously not encountered? A. We are prepared. But epidemics are capable of springing nasty surprises. Our aim is not to get caught out and be agile enough to respond effectively if epidemics do break out. Q. Does the state have adequate medical supplies to tackle the outbreak of diseases as well as for prevention such as tetanus booster shots? What is the government doing to muster medicine and medical equipment supplies? A. We have enough and more for the current level of consumption. But it will go up at least by 40 percent as diseases will increase in number and severity and many persons who would have gone to private sector would now turn to government hospitals due to economic impact. So demand would go up. To a limited extent donations would help. But once that is finished state would have to use their resources to fund additional drugs in addition to the destroyed equipment.
Finding funds for that in Kerala's already stressed fiscal system will be difficult. The development of health infrastructure of the state may have been put back at least three years.
Q. Is there anything that is worrying you — say chances of outbreak of diseases, inadequate medical supplies, insufficient manpower etc? How prepared are you to deal with the situation?
The fund crunch will hit us badly. As drugs are rapidly consumed, it may become difficult replenish them.
At present we are following conventional public health actions, only trying to ensure that there is a zero failure rate.
Q. These are early days, but are there any lessons that Kerala can offer other states that encounter such natural calamities?