The Indian monsoon brings with it cyclones and flooding. Fearful and battered communities are left to cope with vector-borne diseases; an ever-present threat of drowning, electrocution, snakebite, poisonous insect bites, respiratory diseases and of late COVID-19, owing to crowding.
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Cyclone Michaung that swept through the coastal districts of Tamil Nadu and Andhra Pradesh earlier this week left thousands marooned for several days. Rescue work is underway in Chennai, Tiruvallur, Kancheepuram and Chengalpattu districts that were in the path of the cyclone. Neighbouring Andhra Pradesh has started assessing the damage and will soon start taking preventive health issues.
Tamil Nadu’s Director of Public Health issued a pre-emptive four-page instruction to health officials across the State to prepare for the emergency. Floods disrupt access to food, water and safe shelter and jeopardise the community’s ability to access healthcare services. Contaminated water which is all around after flooding is responsible for vector-borne diseases such as cholera, typhoid, and malaria. After the cyclone and rains died down, the State government also commissioned mobile medical units. The units, which include a doctor, staff nurse, a sanitary inspector and an assistant, will function all day in the urban health centres for at least a week.
The World Health Organisation states (on its website) that being prepared for the challenges such an emergency poses reduces the magnitude of the physical and human costs. Ensuring that the affected get food; restoring primary care services, putting together mobile health teams and outreach, and conducting epidemic surveillance helps.
Acute diarrhoeal diseases and cholera can be prevented by ensuring safe water and sanitation. Those with severe symptoms will need rapid treatment with intravenous fluids and antibiotics. In localities that have a high risk of cholera, improved sanitation and oral vaccines have helped. Since most people show only mild to moderate symptoms it is often missed. Some are infected but do not develop any symptoms and the bacteria is present in faeces for as many as 10 days after infection. This could potentially infect others. Untreated acute watery diarrhoea and dehydration can cause death.
