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May 31, 2014

Increasing reports of enteric diseases outbreaks in Nepal

These days, we are frequently hearing news related to outbreak of waterborne illness, particularly acute watery diarrhea (in short AWD). Among all acute diarrhea l illnesses, CHOLERA  is notoriously known for its outbreak potential with high morbidity and mortality in the community. It is said to be the diseases of the impoverished, so this is more common in low income settings, where water and sanitation facilities are compromised. Notably, this disease is also common where there is natural disaster like earthquake & floods compromising the quality of drinking water e.g. Haiti. However, there is rise in outbreaks compounded by man made disasters like war leading to overwhelming refugees across borders e.g. South Sudan

All these news are very prominent in major international social media, but such similar outbreaks from Nepal does not get international coverage. There must be various reasons. I will not go into it. This year, there were many reporting of outbreaks related to enteric disease. One was from Biratnagar, eastern part of Nepal, where there was a large outbreak of viral hepatitis in the center of the city. This caused huge toll of morbidity and also some deaths. It is reported that the sample was confirmed to be hepatitis e virus (HEV). Similarly, another enteric illness has been reported from Rautahat and this is lab confirmed to be cholera. Few deaths have been reported with more than 600 people affected with the illness.

This shows that we have a long way to supply quality drinking water and better sanitation to the people. The provision of safe drinking water and sanitation is the basic human right. This is the duty of state. All these reflect poor governance and in nutshell, we can say "state has failed in providing basic amenities to the people". Irony, all these outbreaks are in majority, as of now, reported from cities, where these "untoward" public health disaster gets noticed by mainstream news media, (may be this can be generalized but, this is a general trend that i observe) while it is sad, these sort of outbreaks are rampant in rural parts of the country and gets rarely such coverage in the media. It is also the fact that rainy season has started, so we expect such public health occurrences will be more frequent in coming days. Therefore, it is the responsibility of the state mechanism to put  an efficient surveillance system in place, so all diseases of outbreak potential can be detected early and appropriate action taken place before it takes the shape of an outbreak.

Anuj in Himalayas

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