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South Asia Floods Displace Millions, Spark Fears of Widespread Disease

By Emily Wax
Washington Post Foreign Service
Sunday, August 5, 2007

NEW DELHI, Aug. 4 -- Every year when the monsoon rains pound South Asia, many of the poor children in Anouradha Bakshi's educational program become too sick from waterborne diseases such as diarrhea, typhoid and cholera to attend classes.

She fears this year will be far worse, with nearly 20 million people already displaced by severe flooding across northern India, Bangladesh and Nepal.

"What we'll see now is a lot of illness, especially in the many slum children who don't have a change of sheets or clothes, let alone access to clean drinking and bathing water," said Bakshi, whose nonprofit group Project Why helps families who live in shanties.

The monsoons, which batter South Asia from June to September, have killed an estimated 1,000 people, destroyed crops and cattle, and submerged tens of thousands of homes, hospitals and businesses. The number of people displaced by the heavy rains and violent winds is the highest in nearly a decade, officials say.

Regional authorities and health experts fear a looming health crisis as waterborne diseases take hold when the water recedes. Stagnant water leads to bacterial diseases that can cause acute respiratory infections, dysentery, rashes, fevers and a host of other illnesses, health workers said.

Some officials worry that the number of deaths could exceed the toll in 2005, when the worst flooding in nearly a century claimed at least 1,023 lives in Mumbai and other parts of western India and thousands of people contracted waterborne diseases.

Heavy rains have caused massive flooding in northern and central China, the United Kingdom and the United States. Last month Japan suffered its worst typhoon in decades, and in June a cyclone affected 2 million people in Pakistan.

But medical experts say South Asia often faces the most deadly health risks from severe weather because of weak or nonexistent sewer systems, poor access to drinking water and the massive number of people who live in low-lying areas along rivers. Many urban drainage systems are choked with garbage and plastic, and overflow with steaming raw sewage after even light rains.

"I always see so many children coming in with boils on their feet, since they have been forced to bathe in dirty water and they sometimes live very close to flooded garbage dumps," Bakshi said. "There is a larger issue here in that there still is no housing policy for the poor in India, and there is no proper sewage or drainage systems in most of the country or in many parts of South Asia."

The worst flooding this year has taken place in India's northern states of Uttar Pradesh and Bihar, both heavily populated and impoverished, and Assam.

"Water, basic hygiene and sanitation is an apocalyptic issue in South Asia," said Marzio Babille, chief of health for the U.N. agency for children, UNICEF. "There has been some progress. But it's way too little to cope with the enormous pressure of environmental factors and climate change that is needed."

Prolonged exposure to stagnant water, he said, "could be extremely dangerous to poor communities who are already at risk for bacterial diseases including shigella, dengue fever and polio, which can be spread by contact with infected feces."

The Indian government and UNICEF have started to distribute hygiene kits, clean-water tablets, plastic sheeting and mosquito nets, Babille said. Helicopters have dropped food for 2 million people in eastern Uttar Pradesh, the Associated Press reported.

"There have been a lot of lessons learned from previous disasters including the tsunami and the flooding in Mumbai in 2005 to get things done right away," Babille said.

In Bihar, where it has rained for 20 days straight, hundreds of water pumps have been submerged in rural villages, forcing communities to search for clean water, officials said.

"This is the worst flooding I've seen in the last eight years, and there's a real fear that with flooding this size that illness can spread," said Manoj Srivastava, director of disaster management in Bihar. "Rarely have people seen this many days of incessant rainfall. There is a great effort underway to prevent disease."

Indian and UNICEF health workers will be dispatched to disinfect water, clear garbage and animal carcasses and spray insecticide to prevent mosquitoes from breeding, Srivastava said. Two Indian Air Force helicopters are being used for rescue and relief efforts.

In Bangladesh, thousands of families have fled their homes in search of higher ground. An estimated 41 of the country's 64 districts have been affected by the floods, aid workers said. Nearly 1,000 cases of diarrhea have been reported, and the United Nations has started distributing oral dehydration salts and water purification tablets.

In southern Nepal, flooding and landslides have displaced thousands in the countryside, and bridges and roads have been washed out. Many villages remain cut off by high water, according to officials from the Ministry of Home Affairs and the Nepal Red Cross Society.

There have been hundreds of cases of fever, acute respiratory infections, diarrhea, waterborne diseases and snakebites in at least five districts. Thousands of farms have been destroyed at the peak of rice-planting season in the Terai region, the breadbasket of the country, the officials said.

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