THE Tamil Nadu government, which was criticised for its lackadaisical handling of the floods in Chennai, embarked on a massive health-care and sanitation exercise to prevent any disease outbreak, deploying all the resources at its command.
“Nothing is more important than a decisive intervention of the government at this critical stage, which was missing during the floods,” said a volunteer of a non-governmental organisation involved in rescue and rehabilitation efforts. Though viral infections were reported from different parts of the city, and fever, diarrhoea and skin diseases emerged as common ailments among flood victims, the situation as such was not alarming.
“As of now, no major outbreak of any disease has been reported,” said Health Secretary S. Radhakrishnan. The primary concern of the State Health Ministry is to check and stop the transmission of viruses. In such urban catastrophes, infection control is very difficult as water becomes contaminated. “We have evaluated the situation and prepared a comprehensive health and sanitation contingency plan. A communication link with various line departments of health and family welfare and also the Chennai Corporation has been established for a coordinated effort,” Radhakrishnan said.
The havoc wrought by the floods across the city is a critical reason why such a massive exercise will be of importance, although an expert in community medicine said that despite the widespread destruction, less than 2 per cent of the victims might need medical care.
Preventive care against disease outbreak with incubation periods of four to six weeks becomes important. “We have to take into account the internally migrated flood victims who could carry viruses from one part of the city to another. Hence, we need to conduct medical camps across the city, which is an enormous exercise,” Radhakrishnan said.
The effort has led to greater and uniform availability of medicare in all parts of the city and in districts hit by the floods. Sathiyan (55), who lives adjoining the Cooum river in Pudupet in Chennai city, told Frontline that a medical camp for around 500 flood victims was organised on December 6 and medicines were distributed free of cost. A spokesman for the Health Department claimed that 200 mobile health teams were formed during the first spell of floods in November, which was later increased to 1,715 after the December 1 floods.
According to Radhakrishnan, some 3.5 lakh persons made use of the health camp facilities every day. “Cases needing referral are sent to the government hospitals. The Tamil Nadu Medical Services Corporation, which procures medicines for government hospitals, has kept ready three-and-a-half months of stock of life-saving medicines worth Rs.90 crore. The State government has also issued a public health advisory. Health awareness campaigns have been launched in the affected areas through 100 autorickshaws,” he said.
Health inspectors and village health nurses, numbering around 1,000, have been deployed in affected areas for house-to-house visits and to distribute basic medicines, bleaching powder and chlorine tablets. Nearly 2,000 tonnes of bleaching powder and 1 crore chlorine tablets are being distributed to houses in the rain-hit areas of Chennai, Cuddalore, Villupuram, Tuticorin, Kancheepuram and Tiruvallur districts. Each household will be given half a kilogram of bleaching powder for sprinkling on the ground and 20 chlorine tablets to purify water.
An expert team of public health officials from the World Health Organisation and the State government’s Health Department, under the guidance of Dr Kulandaiswamy, Director of Public Health, is closely watching the city to nip in the bud any rise in the incidence of fever and diarrhoea.
“Preventive tetanus vaccination for relief workers and those exposed to injuries and vaccination for measles for children are being carried out. Skin infections like dermatitis are being reported, besides conjunctivitis and ear, nose and throat infections,” said a doctor on duty in a camp in the Kotturpuram neighbourhood.
Nearly 4,000 persons, including doctors, nurses, pharmacists, and laboratory technicians, have been mobilised for this mammoth task. Besides, private hospitals empanelled in the Chief Minister’s health insurance scheme, private doctors and corporate volunteers are coordinating with the State government apparatus. “In the post-impact phase, i.e., four days to four to six weeks, the focus will be on preventing water- and vector-borne diseases and also addressing psychosocial impacts,” Radhakrishnan said.
“There is the possibility of diseases like cholera and diarrhoea spreading and of various types of infections increasing. The intake of safe and clean water at this time is very important,” said Dr P. Gugananthan, an expert in social medicine and a former health officer of the Chennai Corporation.
He insisted that drugs should be given out in these camps judiciously so that people are not rendered drug-resistant. The Tamil film actor R. Parthiban, who organised a relief and medical camp at Vadapalani, told Frontline that people came mainly for cough, sore throat and skin allergies. “Very few sought social and psychological counselling,” he said.
“We need mobile toilets very urgently,” a woman in Ashok Nagar said. With no toilet facilities, defecation in the open has increased the possibility of contracting infections. More sustained and concerted efforts are the need of the hour to tackle the threat of an epidemic outbreak. A medical emergency would only wreak havoc on a city already ravaged by floods.
Ilangovan Rajasekaran
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