Government must scale up health centres to contain cholera outbreak

As a deadly cholera outbreak hits tribal areas of Orissa, ActionAid is helping to check the spread of the virus by organising health camps and awareness drives with indigenous communities in areas adjacent to those already reeling from the epidemic.

Local groups report that more than 250 people have died of cholera in Koraput, Rayagada and Kalahandi districts of the state. Most of the victims are indigenous people. Different news reports quote the death toll listed by government officials between 146 and 197.

“If the government reveals the true figure, they would have to offer compensation to many more families,” says Bratindi Jena of ActionAid.

Opposition party leader Jaidev Jena has reportedly put the figure higher than 500.

The state government has announced compensation of Rs 10,000 to families of the dead.

Cholera virus has already spread from the worst affected blocks of Rayagada to neighbouring Gajapati district. Intake of contaminated water and rotten food is alleged to have led to the outbreak.

“Contamination of open water sources from faecal material is bound to increase the number of cholera patients,” says Dr. Unnikrishnan PV ActionAid’s Emergencies and Conflicts Advisor in Asia. 

Too little too late?

Orissa Chief Minister Naveen Patnaik says affected people are being treated by special medical teams at various government hospitals. Instructions have been given to district administrations in the region to disinfect all water sources.

But news reports say the state medical administration is facing an acute staff crunch.

Chief Medical Officer of Raygada district told a news channel that where four doctors are required in the community health centre only two are available. Also, six primary health centres have just one doctor.

Ambulances are also in short supply. Villagers physically carry family members who’ve taken ill and walk as many as 10 kilometres to reach the nearest hospital.

As rainwater slush from hilltops pollutes water sources during and after monsoon, cholera and diarrhoea outbreaks hit these districts every year. Nearly 50 lives are lost every year.

This year too post-monsoon reports of diarrhoea and cholera had started to trickle in from Rayagada, Koraput and Kalahandi six weeks ago but the government’s attempt to prevent and contain the diseases is limited and late.

Blame game

In media statements government officials are holding tribals responsible.

A medical officer told a news channel: ''The habit of the tribal people is irresponsible. They drink water from the nullahs and rivers and do not use tube well water.”

The fact is that several tube wells are ineffective in these districts. Those that do work, pour yellow and muddy water. Residents don’t have access to safe drinking water.

“There needs to be a shift in government culture of blaming tribal way of life for disease outbreak. And to accept responsibility for access to safe drinking water and public health facilities,” says Bratindi Jena.

ActionAid response

ActionAid has set up mobile health camps which have treated 4000 families of whom over 1600 patients were diagnosed with diarrhoea and gastroenteritis. These camps were held in three blocks – Lanjigarh, Kalyansinghpur and Bishancuttack of Kalahandi and Rayagada districts.

Oral rehydration solution (ORS) and halogen water-purification tablets are being distributed. Also, volunteers are raising awareness about the merits of drinking boiled water and avoiding open streams. Posters specifying do’s and don’ts are being put on walls of houses and hospitals.

Bleaching powder has been sprayed into 74 open wells in Rayagada and 63 wells in Kalahandi. Residents are being advised to drink water only from disinfected wells.

Swasthya Vahini (health drive) groups comprising tribal youth have taken up cleaning drives in 30 villages.

Immediate and long term needs

Government needs to repair all defunct tube wells, say aid workers. Water bodies – wells, ponds – need to be disinfected and more doctors, medicines, ORS and cholera vaccines are needed for people in affected and bordering areas.

Awareness about do’s and don’ts also needs to be stepped up among residents.

The government must repair wells and disinfect water supplies, scale up provision of doctors and nurses, maybe engage the army medical services and embark on a public information campaign using local radio and loudspeaker announcements if necessary.

Photo credit: ActionAid

Updated: September 10, 2007