As floodwater recedes, disease risks to be a worry for Maharashtra

Western Maharashtra was struck by severe flooding in the last week of July 2021. Some 213 people died and thousands are in need of rehabilitation. As floodwaters slowly recede, the spectre of multiple disease outbreaks loom large over the region, healthcare workers have warned.

Districts affected included Ratnagiri, Raigad, Sindhudurg, Satara, Sangli and Kolhapur. Pune and Thane were also affected. The Maharashtra government has announced an immediate relief Rs 10,000 for each individual affected in the floods.

“Relief camps were mostly set up in schools, with around 200-300 people sharing two toilets. These conditions are a breeding ground for diseases,” Dr Milind Bhoi, a doctor who runs the Bhoi Foundation non-profit and volunteered in Satara district, told this reporter.

Vinay Dubey, a relief worker and social activist working in Ratnagiri district, said locals had to use portable bathrooms because the toilets in the relief camps were blocked with mud.

“Yet, the number of these portable bathrooms was not enough, leading to people resorting to open defecation, which is a direct risk for several bacterial and worm infections,” he added.

He noted that there had been a huge delay in cleaning flood-hit areas after the waters receded. “This means there are bodies of dead animals lying on the roads. Imagine the diseases that will happen because of this,” he said.

Floods have accounted for more than half of India’s disasters since the 1990s, according to an analysis by the United Nations Office for the Coordination of Human Affairs.

Research based on floods across the country have highlighted the severe short- and long-term health consequences of flooding, ranging from stunting and malnutrition in children to infectious diseases to mental illnesses like stress, anxiety and depression.

“As water in flood-hit areas is contaminated and sanitation is a problem, we are looking at a rise in water-borne infections like diarrhoea, cholera and leptospirosis,” Bhoi said.

Several medical teams shipped doxycycline and paracetamol tablets to flood-hit regions last week to prevent diseases like leptospirosis and gastroenteritis. Chiplun, the worst-hit town in Ratnagiri, received over 25,000 tablets according to a report in the Times of India.

The Maharashtra health ministry had also ramped up the supply of novel coronavirus disease (COVID-19) vaccinations to flood-hit regions in an effort to prevent co-infections like Covid-19 and malaria at once.

The immediate health concern, however, was fungal infections affecting citizens across flood-hit districts, according to Dr Aatif Mohimtule, a doctor volunteering in Khed, Ratnagiri.

“There’s a huge amount of wet mud and sludge left behind after the water receded, which mostly caused fungal infections,” he said.

Flood-hit areas had received supplies of syrups for children, tetanus shots, bandages, ointments, etc. But Mohimtule said they were facing a severe shortage of medication for skin fungal infections, which was the immediate need of the hour.

Dubey added that there was very little access to clean water, which meant that people were relying on Bisleri bottles. These can be unaffordable to citizens from lower-income stratas.

Several relief workers also complained of a mismatch in the amount of amount of medical supplies coming in and the amount needed on the ground.

They attributed this to a lack of communication and chaos. There was also no coordination between non-governmental organisations and municipal-level relief work.

“Though we have received some help from the Khed city mayor, most of the relief work is being done by non-profits, with little communication between us and government workers, who have their own rules to follow,” Dubey said.

Amita Dhumal, the deputy collector of Ratnagiri, said non-profits were involved in talks about flood relief interventions and that there were continued attempts to coordinate with non-profits for emergency relief work.

Yet, doctors and relief workers predicted that these relief measures were ultimately temporary, leaving people in flood-hit regions to suffer long-term health problems without adequate medical assistance for complications.

“I’ve worked through the disasters like floods and earthquakes before. Everyone shows up to help when the disaster strikes but work still needs to be done months after. Unfortunately that’s never the priority,” Bhoi said.

He said he had gone to Satara with psychiatrists in order to offer grief counselling to several individuals who had lost their loved ones to the flood. “Can you imagine grief-counselling being a one-time thing?” he asked.

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