Present Mid-Western Diarrhoea Epidemic and Solution: Through My Sight

• Phurba Sange Moktan

As nobody is unknown about the present situation of Mid-Western Nepal, daily diarrhoeal death news is also definitely not the new thing. Diarrhoea, which may not count as a disease in developed world, is causing more than 350 deaths in Nepal. What a pity situation. This might hurt anybody and obviously so I am.
As being the field volunteer of PASCHIM PAAILA (MISSION WEST) – A campaign for diarrhoea/cholera control program in Mid and Far Western Region in Nepal. I have seen and felt the problem and real scenario of Rukum district and I am sure no other districts have the different scenario and problems, which is mainly a public health problem due to drinking of contaminated water and poor hygiene sanitation, though different views are coming in media.
Through this article, I am not going to talk about drastic change, but only a small changes and attentions that may helps to enhance the effectivity and sustainability to control the present epidemic, which I have seen and felt during the due course of action period in Rukum – Mid western Nepal.
The present health scenarios of Rukum are seen as follows:-
1. The community people of Chaurjahari Area use to drink the water directly from the Veri River.
2. Rukum people use term KHOLA LAGYO (BHUT LAGYO) for diarrhoea and they don’t allow the sick people to drink water due to the false perception of further more diarrhoea.
3. Very poor hygiene behaviours can be seen in Rukum.
4. It became very hard to see latrines in Rukum district.
As we all know that diarrhoea is a very small social, financial and health problem but it is causing major damage in Nepal. Why? Is it only the unhygienic behaviours of people due to lack of education and awareness that causing the epidemic? I don’t think. But what I can see are, the problem of government who ignored the situation at the beginning periods and wanted to work later with only emotion but without proper planning and strategy, the problem of so called experts who criticizes too much in Kathmandu, but do nothings for epidemic areas, the problem of health staffs who attended the training in Kathmandu by ignoring the epidemic of their own area and the most major problem is the selfish attitudes of Health Minister who went abroad to collect money and experiences instead of collecting solutions in Nepal. Everybody is striking on the problems and problems but do not give attention to seek the effective solutions. This has also become a big problem.
Diarrhoea epidemic has not controlled yet. So, steps should be forwarded towards the prompt, effective and sustainable solutions. Some points to control for the immediate epidemic that I have seen are as follows:-
1. Though study and planning has been made, further more proper planning and sufficient study should be done about epidemic area.
2. Immediately effective coordination with the district health system should be strengthen in order to mobilize effectively the peripheral health institution up to ward level.
3. Well maintained coordination should be made for lodging, fooding, transportation, proper orientation and motivation of health team that are sent to epidemic area.
4. NGOs, INGOs and CBOs are also working in the epidemic areas. So, proper coordination and collaboration with positive response should be made with them by the government level and peripheral level.
5. During the mobilization of health team, combine approaches of curative, preventive and promotive health should be made in which curative camp can be placed at feasible site of the VDC and mass chlorination (i.e. source or, drinking water tank chlorination) and mass health awareness program by collecting the community people around the drinking water source should be done, which only be the effective approach for controlling the present epidemic.
6. Community people, youths, students and leaders should make to feel, “This is your problem and you only can control the problem. So, you have to come in front and participate and mobilize yourself to combat with the problem. We externals might just be the assistants. But if you want the sustainable change, you have to take leadership yourself.”
Whatever we discussed above is about the problems and solutions of the present epidemic but the problem might not last for just this year. Then, we have to think about to prevent the future epidemic as well. As we all know that this is a purely a public health problem, so that health preventional and promotional activities should be focused and carried out in coming days as well through the community participation and mobilization. And for that district health and public health system should be oriented, trained and strengthened instead of making dependent by centralizing to the Kathmandu.
At last, we all conscious Nepalese that we feel great sorry if someone die in our family and relatives. See, more then 350 innocent brothers and sisters had died in our country just between few months. Why are we just looking at the situation as merely a poor observer?
I request you all, who think yourself as a responsible civic of the nation, and this is an opportunity to serve the nation. So, let us raise our big hands. Then only, we can be proud to say, “I had also contributed during the Mid-Western Diarrhoea epidemic of Nepal.”
(- Writer is a Student of Public Health, final year (BPH, final year) and also a field volunteer of PASCHIM PAAILA campaign.)