Floods are an essential component of the ecology of agricultural system and fisheries. It provides the necessary nutrients for agriculture, irrigates and fertilises floodplains and fills water storage. Nutrients are also added to rivers and lakes, improving the quality of fishes that can be consumed. There may be a relocation of fishes and organisms living in water bodies. Floods are usually welcomed as seasonal events assuring good agricultural activities but, when scaled above an unexpected level causes demographic hazards, shifting the paradigm from prosperity to destruction in no time.
Disastrous floods have a significant impact on the lives of people, especially on public health. The potential for disease outbreak is always present after a flood disaster. Therefore, important health drive initiative needs to be taken, mainly after the flood water recedes, to curb the spread of diseases, especially communicable diseases.
The recent Kerala floods have claimed over 370 lives and displaced over 1 million people (Livemint, 2018). The State’s Public Health Department has taken a health drive initiative to prevent communicable diseases. The initiative is a 30-day action plan with the objective of conducting a study of vector density and observation of larvae, deployment of flogging squads in the affected areas, collection and identification of mosquitoes, insurance of blood, stool and rectal swab testing with water-borne diseases, conduct medical camps and work on effective utilisation of the services of laboratories for confirmation of diseases, ensuring safe drinking water by cleaning the source of potable water, distribution of chlorine tablets, removal of dumped waste and disinfection of the area along with many other measures.
These health drive initiatives are pivotal in preventing any outbreak of diseases. Let us also look into an account of such initiatives taken by the other Indian States after extreme flooding.
Flooding in Chennai back in 2015 was a colossal disaster claiming many lives. Fears of disease outbreak and epidemic loomed over the state of Tamil Nadu, but the spread of such diseases was curbed with 24x7 fever surveillance programme and large-scale medical camps held after the flood. According to a report, ‘Chennai Floods 2015. A Rapid Assessment’, published by Interdisciplinary Centre for Water Research Indian Institute of Science, Bangalore, the programme monitored all communicable diseases which helped bring down the number of cases related to communicable diseases. , says the report. The timely actions by the Department of Health and Family Welfare, Tamil Nadu, averted widespread transmission of diseases in the extended metropolis area in the post-flooding period. More than 2000 sanitation workers from all over Tamil Nadu was deployed.
The report, ‘Chennai Floods 2015. A Rapid Assessment’ also mentions that 108 ambulance service was deployed for round-the-clock operation and by December 26, 2015, 216 camps, 92 mobile medical teams were functional in Chennai, the State Government also ordered 2000 tons of bleaching powder to be spread on the streets after the drying of the water. The dosage of chlorination was increased for achieving better disinfection not only at the source but also in case of contamination in the distribution network. The chlorine level at the source and the supply end was regularly monitored. Many medical camps were put in place to provide better health-care. The prompt actions undertaken by various organisations prevented the outbreak of epidemics.
The Mumbai flood in 2005 was another huge calamity, and their strategy was to provide care and treatment at the doorstep so that the number of cases developing full-blown leptospirosis, burden on the hospital services and morbidity and mortality could be reduced. Human resources and materials were deployed at the three tiers of the public health system with greater emphasis and providing primary care. The teams conducted health camps close to homes in the areas of maximum water-logging and in those that were recording maximum cases in previous seasons. The services at the secondary level hospitals ensured that standard treatment protocol was followed. At the tertiary level, a separate round the clock “fever casualty” was opened. The services of trainee doctors and undergraduate students were also utilised. The healthcare provided through the organisation of health camps and upgrading management at hospitals helped combat the diseases leading to reduced incidents of illnesses, such as fever, which might have been related to leptospirosis.
Uttarakhand also feared the start of an epidemic during the flash flood in 2013. At least 128 people reported of carrying water-borne diseases, such as high fever and gastrointestinal infections, in Guptkashi village, according to National Disaster Response Force (NDRF). A high-level team comprising of doctors and specialists were sent to the affected area to review public health measures. The district units of the Integrated Disease Surveillance Programme (IDSP) conducted health surveillance in all affected areas. Eight additional teams were also kept on standby, ready to move to the concerned district at short notice. Further, a specialised team was deployed to extricate dead bodies and cremate them, whose decay seemed to be the cause for contamination of water.
The outbreak of epidemics and the spread of communicable diseases after flooding is always anticipated and feared. Therefore, prevention of diseases is key to maintaining public health. Health and cleanliness drives should be conducted in the flood-affected areas regularly. Communicable Disease Management programs, which should have surveillance and immunisation components, are integral parts of disaster response. Emphasis should be laid on strategising the prevention of communicable diseases, especially during the pre-disaster phase. Formulating policies with a focus on the identification of essential risk factors must be undertaken. Emergency response plans should be put into action with well trained and informed public health workers to identify the dangerous disease and to manage and provide treatment on the spot effectively. Assurance of safe and clean drinking water and disinfecting flood-affected areas should be the top priority. Thus regular awareness programs should be conducted to equip the people to cope with disasters such as flood, to attain minimum damage.
Sharma, N. (2018, August 18). Kerala plans to hold health drive to check communicable diseases: K.K Shailaja. Retrieved from https://www.livemint.com/Politics/wpF6H08r8IBGineh3ZpPzM/Kerala-plans-to-hold-health-drive-to-check-communicable-dise.html
Narasimhan, B, et al. (May 2016). Chennai Floods 2015. A Rapid Assessment. Indian Institute of Science, Bangalore.
Kshirsagar NA, Shinde RR, Mehta S. Floods in Mumbai: Impact of public health service by hospital staff and medical staff. J Postgrad Med 2006; 52:312.4
Babaie J, Ardalan A, Vatandoost H, et al. Performance assessment of communicable diseases surveillance in disasters: a systematic review. PLoS Currents. 2015;7
Tiwari D, Mohan V. (2013, June 26). Uttarakhand floods: Epidemic looms as people complain of fever and diarrhoea. Retrieved from https://timesofindia.indiatimes.com/india/Uttarakhand-floods-Epidemic-looms-as-people-complain-of-fever-diarrhoea/articleshow/20770540.cms
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