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Indian Journal of Community Medicine

Concerted health efforts prevent and contain diseases after floods disaster in Varachha zone of Surat

Author(s): Bansal RK, Tripathi VS, Desai VK, Singh A

Vol. 32, No. 3 (2007-07 - 2007-09)

LETTER TO EDITOR

Year : 2007 | Volume : 32 | Issue : 3 | Page : 232-233

Concerted health efforts prevent and contain diseases after floods disaster in Varachha zone of Surat

Bansal RK, Tripathi VS, Desai VK, Singh A
SMIMER- Surat & Commissionerate of Health, Gandhinagar, Gujarat, India
Date of Submission 23-Jan-2007
Date of Acceptance 18-May-2007

Correspondence Address:
Bansal R K
SMIMER- Surat & Commissionerate of Health, Gandhinagar, Gujarat
India

Source of Support: None, Conflict of Interest: None
How to cite this article:
Bansal RK, Tripathi VS, Desai VK, Singh A. Concerted health efforts prevent and contain diseases after floods disaster in Varachha zone of Surat. Indian J Community Med 2007;32:232-3
How to cite this URL:
Bansal RK, Tripathi VS, Desai VK, Singh A. Concerted health efforts prevent and contain diseases after floods disaster in Varachha zone of Surat. Indian J Community Med [serial online] 2007 [cited 2007 Nov 30];32:232-3. Available from: http://www.ijcm.org.in/text.asp?2007/32/3/232/36844

Sir,

This communication describes the combined impact of the 36 health-relief teams and the routine govt. and municipal health services deployed in Varachha zone of Surat city, catering to approximately 1.1 million people during the floods on August 7, 2006, when the city was submerged and inundated with unprecedented mud, silt and water. During the floods, residents waded through flood waters, slush and mud - often with naked feet with potential risks of outbreak of diseases.[1] These teams comprised of medical college faculty and state functionaries. Their activities were directed towards preventing outbreaks and deaths from water-borne diseases such as cholera and other gastrointestinal infections and vector-borne infections such as leptospirosis, malaria, dengue and chikungunya. They reported on active and passive disease surveillance, solid waste disposal, slush removal, water logging, vector breeding, chlorination and safe water supply, removal of animal carcasses and rotting cereals and other materials, safe housing to the Surat Municipal Corporation (SMC) and health care provision.

In immediate post-floods period, the concerns were to primarily prevent water-borne diseases by restoring water supply, chlorine tablets use, IEC activities including folk media for promoting safe water and safe food. Rotting carcasses, cereals and organic materials and also solid wastes were carted away by intensive 24-hour operations. Wet cereals were destroyed to prevent re-use. Quantitatively, this waste load was about that of an entire year. The risk of leptospirosis added urgency to our efforts of waste and slush removal and water de-logging.[2],[3] These activities were intensified in slums, shanty settlements and peri-urban areas such as Puna and Shimada villages, recently merged in SMC limits and lacking proper water supply, sewerage and storm water drainage systems.

A total of eight cholera cases were reported from 11 th to 16 th September. Subsequently, concerted efforts contained further cases and checked GIT infections. All leakages in water lines were rectified on a priority basis and water was supplied through tankers in interim. Leptospirosis cases were reported from 26 th August. These were immediately hospitalized, and active fever surveillance was conducted to search for additional cases. Fever cases detected in these ring operations were examined for malaria and put on doxycycline/ amoxicillin treatment, in addition to antimalarial and other treatment as indicated. Private practitioners were given free doxycycline for free supply to suspected leptospirosis patients. Free transportation and comprehensive treatment modalities including respirator facilities were made available. Government reimbursed treatment costs of critically ill patients on ventilator who could not be transferred to public health care facilities. The remaining patients were requested to utilize public facilities. Notification of suspected leptospirosis cases to municipal authorities was made mandatory.

The overall decline in morbidity and mortality from leptospirosis can be seen in [Table - 1]. It was seen that both leptospirosis deaths in the area had occurred before notification. It was also noted that disease severity had decreased in cases notified in the later periods. While the earlier cases were presenting with pulmonary involvement, later this had shifted to milder hepatic and renal involvement; and some of these were already on doxycycline prophylaxis. Relief and sanitation workers were given doxycycline prophylaxis and protective wear. We kept a constant vigil for rat falls, flea indices and testing of rat viscera and human serum samples. Helpfully, we evaded plague. There were false scares of Hantavirus.

Over the next 5 days, we focused on intensive anti-vector measures and strengthened surveillance and diagnostic capabilities for water-borne diseases such as hepatitis and typhoid and for vector-borne diseases such as malaria, dengue and chikungunya. All sewerage and drainage lines were flushed clean. Medical students and faculty conducted massive health educational campaigns. School authorities ensured that children wore full clothing and footwear and completion of cleanliness and anti-vector activities of premises before school's reopening. [Table - 1] shows a steady decline in the disease profile of the residents and demonstrates that when committed surveillance efforts are coupled with intensive curative and redress efforts, disease outbreaks can indeed be prevented. The current morbidity patterns now mirror the usual morbidity patterns of Surat city. These efforts and the subsequent surveillance have averted and thwarted further avoidable morbidity and mortality.

Acknowledgment

The authors are grateful to the personnel of the Government of Gujarat and the Surat Municipal Corporation for their dedicated efforts and the govt. financial support which has made this herculean task a reality. Our special thanks to the Chief Minister, Shri Narendra Modi, and his team, who were firm in their resolution that epidemics had to be prevented and contained in Surat city at all costs.

References

1. Moszynski P. Sudan floods bring threat of disease. BMJ 2003;327:357.
2. Easton A. Leptospirosis in Philippine floods. BMJ 1999;319:212. [PUBMED] [FULLTEXT]
3. Mumbai floods lead to disease outbreaks. BMJ 2005;331:420.

Tables

For larger view, please click on image

Table 1: Morbidity patterns from August 13 till September 11, 2006

Table 1: Morbidity patterns from August 13 till September 11, 2006

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