I am making a few suggestions in the wake of monumental tragedy caused by floods in Kerala. Apart from whatever the administration is doing to contain epidemic of water borne diseases, stress should be on two very simple steps:
- The Kerala government could announce and initiate on a war footing ‘Operation Chlorine Tablet’
- The Kerala government could announce and initiate on a war footing ‘Operation Bleaching Powder’
These should be distributed at the relief camps/medical centers so that it reaches every household. If implemented these two steps alone could save thousands of lives in Kerala. The chlorine tablet would take care of the water being made drinkable; the bleaching powder would ensure that the surroundings are disinfected. These two steps are very cost effective & could be done even by financially strained municipalities.
Of course the services of WHO, UNICEF and NICD (National Institute of Communicable Diseases, Delhi) could be availed of, but their advice should be questioned on scientific grounds before their prescription is implemented on the masses.
These suggestions emanate through work in areas/situations where water borne diseases become imminent. I was a member of one of the first medical team which reached Indo-Bangla border in 1971 where almost ten million refugees had landed. The camp where I worked had housed twenty-five thousand refugees. The stress was on vaccination against cholera and typhoid, use of bleaching powder as a disinfectant and distribution of Sulfaguanidine tablets at our makeshift clinic. Those in severe dehydration were given intravenous glucose saline solution – which was always a scarce commodity. Since we worked during the months of June, July and August the monsoon rains as also the overflowing small nearby rivers played havoc in the spread of epidemic diseases.
During the 1988 cholera epidemic in Delhi half the citizens were vaccinated by the Rajiv Gandhi government even though WHO had concluded by then that vaccination is both useless as well as dangerous once the epidemic has started. Over 1500 people had died in this epidemic. It is well known that governments resort to mass vaccination since those in power want to appear to be doing something during the crises – and vaccination offers the best mask as if something effective is being done for the masses. Majority of the deaths had occurred because people were being shifted to infectious diseases hospitals whereas they should have been treated right at the local treatment centers at the relief camps.
(In recent years the WHO has again changed its stance and is now seen to be advocating cholera vaccination even when there is a full blown epidemic; perhaps the WHO, too, wants to be seen to be doing something just as politicians in power do worldwide.)
I had a chance to work among the tribals in Nilgiris in 1973 where Dr. Narasimhan Rao had devoted his whole life for the cause of the tribals. He impressed upon us through experience that where intravenous glucose saline solution is not available, one could directly inject green coconut water; all one needs is the intravenous tubing set. In fact this method is of use in remote areas of some countries along coastal areas. But its use is limited to severe dehydration cases.
Dr. P.S. Sahni is a member of PIL Watch Group Email: pilwatchgroup@gmail.com
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