Cholera outbreak in rain-hit areas: three die, 24 confirmed cases

Out of the 283 suspected cholera cases in rain-hit areas of Sindh, 24 have been confirmed positive and three people have died to the disease so far, the World Health Organisation (WHO) said in its report issued on Sunday evening. The report stated appalling figures of the people affected by different diseases in the disaster-hit areas. The WHO Disease Early Warning System (DEWS), set up during last year’s floods, stated that a total of 1,734,929 consultations were reported, out of which acute respiratory infections had the highest proportionate of morbidity with 19.4 percent, followed by skin diseases (18 percent ), suspected malaria (10 percent ) and other acute diarrhoea (11 percent).
“Between a month’s period (August 16 to September 15) the DEWS detected 225 alerts, out of which 42 were confirmed outbreaks and the Rapid Response Team responded to all reported outbreaks within 48 hours and among these, 35 were attributed to acute watery diarrhoea,” the DEWS said in the report. “In the last few days, the WHO distributed health kits, essential medicines and medical supplies to cover the needs of a population of about a quarter million,” the report quoted WHO representative Dr Guido Sabatinelli as saying.
“With health stocks pre-positioned in Hyderabad and Sukkur, the WHO can still serve other 200,000 people. We hope that the donor response to the emergency appeal will be generous in order to fully respond to the health needs of the flood affected population,” he added..
The WHO has been leading the delivery of health services to flood-affected people in country, as part of a coordinated UN humanitarian response, with national and international organisations.
The WHO also plays the role of coordinating the health response through the health cluster, along with the National Health Emergency Preparedness and Response Network (NEHPRN).
While families are still recovering from the 2010 floods, over seven million people have been reportedly affected by the 2011 monsoon floods in Sindh, half being females, according to the National Disaster Management Authority (NDMA). An estimated one million homes have been damaged or destroyed and over 30,000 villages partially or totally inundated. The government has so far set up thousands of relief camps that offer shelter to approximately half a million vulnerable persons who not only lost their homes, but also their livelihoods.
Based on the initial assessment carried out by the provincial Health Department, in collaboration with WHO and NEHPRN, up to 33 percent of basic health units have become non-functional.  A total of 11 percent of the rural health centres are unable to provide health services to the flood affected population due to inaccessibility or damage to the infrastructure. Essential emergency obstetrics care services have been disrupted. There are acute shortages of basic newborn kits and essential drugs for caesarean-section and assisted delivery. The WHO, in collaboration with humanitarian partners, has been providing and coordinating timely, effective health services to the most vulnerable as well as curtailing epidemics. However, as the emergency escalates, so do the needs and much more resources are required. The flood-affected communities are in dire need of the international community’s support.
In a recent survey on the nutritional status of children under five years of age in district Tando Mohammad Khan, it was found that five percent of children suffered from severe acute malnutrition (SAM) whereas 16 percent suffered from moderate acute malnutrition. The situation is expected to worsen due to insufficient food supplies and unsafe drinking water. Children with SAM have a 10- to 20-fold risk of dying compared to well-nourished children. SAM can be a direct cause of child death, or it can act as an indirect cause of death by dramatically increasing case fatality in children suffering from common childhood illnesses including diarrhoea.
This is particularly heightened in conditions of poor sanitation, hygiene and poor provision of health services.  The WHO supports life-saving interventions such as nutrition stabilisation centres (NSCs) in Taluka Hospital Kotri that provide services to children suffering from SAM with medical complications. More NSCs are being established by the WHO in 16 more districts of Sindh.
Currently, the WHO-supported NSCs are functional in Jamshoro, Matiari, Ghotki, Lakana and Hyderabad. The urgent priority districts include Kamber Shahdadkot, Thatta (Sajawal), Tando Allahyar, Mirpu khas and Tando Mohammad Khan.   There is also an urgent need to put in place nutrition surveillance system which is being supported by the WHO in collaboration with the provincial Health Department to continuously monitor and respond to the developing life-saving needs.
The maternal newborn and child health (MNCH) services in at least 40 percent of health facilities are currently disrupted, including in Nausheroferoze district where the situation is critical. WHO MNCH officers in districts Badin and Tharparkar took the initiative to join hands with the Health Department where emergency medical relief camps plan were worked out with the district. The WHO, in close coordination with the government and other health partners, distributed 1,340 disposable delivery kits. Despite the problems of accessibility, to date, a total of 19,687 children have been vaccinated against polio and 18,437 against measles.
According to the report, the WHO environmental health team delivered 1,173,000 aqua tabs, 30 laundry soaps, 909 Lifestraw family filters, 4,018 jerry cans, 917 hygiene kits and 4,400 information, education and communication material. A total of 60 pillow tanks with a 5,000 litres capacity have been dispatched. The medical and WASH supplies distributed in the flood-affected districts are adequate for over a quarter million population coverage. The WHO environmental health team in collaboration with the PCRWR Badin has been providing environmental health support to Badin district where four reverse osmosis plants were installed to purify contaminated water.