Indra Adhikari, Nepal Red Cross Society, in Kathmandu
In a huge effort to address increasing health risks in central and western Nepal, the International Federation of Red Cross and Red Crescent Societies (IFRC) and the Nepal Red Cross Society are appealing for nearly 740,000 Swiss francs (664,000 US dollars or 527,000 euros) in cash, kind, or services to assist as many as 189,000 people over the next nine months.
With the increase in temperatures over the past few weeks and a scarcity of safe drinking water sources, the number of diarrhoea cases is on the rise in remote areas of the country. There have been 17 deaths so far and 300 cases of infection officially reported to date.
"It's very hard to get food in Khalanga, and even more difficult to get medicine," said Nandakala Thapa, who is grieving the loss of her 20-year-old daughter. She died recently of diarrhoea just after getting married.
The Nepal Red Cross Society (NRCS) has been mobilizing volunteer teams to support the efforts of government authorities and humanitarian agencies involved in the water, sanitation and hygiene (WASH) cluster to undertake emergency hygiene promotion campaigns and preposition relief supplies.
However, to make a significant impact, these efforts will be scaled up, particularly in those areas of Nepal where NRCS is the only operational organization. Moreover, as the monsoon season is fast approaching, it is likely that a greater number of communities and districts are at risk of a rapid spread of diarrhoea, as has been seen in previous years.
"How can we wait for the outbreak of accute watery diarrhoea (AWD) to claim lives," asked Dev Ratna Dhakhwa, NRCS secretary general. "Our approach should be proactive rather than reactive. Our preventive actions should focus on saving lives and reducing human suffering before it’s too late."
International Federation and NRCS operations will ensure early and sustained action to prevent the further spread of diarrhoeal diseases and reduce the risk of potential outbreaks, which in 2009 claimed an estimated 371 lives and affected some 67,000 people. Efforts will be focused on emergency hygiene promotion activities, the prepositioning and distribution of diarrhoea prevention kits and the provision of safe water and sanitation facilities for the most vulnerable communities. This operation builds on the experience of NRCS in responding to last year’s diarrhoea outbreak, which emphasized the need to address the long-term chronic needs of communities to prevent recurrences.
In Nepal, health and hygiene services are not effective and, in many cases, are inaccessible to the man on the street. Medical personnel are often not available in remote locations, and because of geographical inaccessibility, it can be very difficult to deliver medical supplies.
Further complicating the health situation, local people in rural Nepal retain strong beliefs in traditional healing practices; and they often avoid seeking help from health workers.
Prevention based on experience
"Without delay, we have to launch water and sanitation campaigns and build latrines in each household," said Sanat Kumar Karki, president of the Nepal Red Cross Society in Jajarkot district. "We are hopeful that if the government and donors help us jointly in raising awareness among our people, the tragic events of the past will not repeat themselves."
In 2009, NRCS mobilized 1,720 volunteers to reach 1.2 million people during the last outbreak of diarrhoea. When visiting vulnerable households, they provided information on how to keep water safe, how to protect water sources from becoming contaminated, how to purify water, and how to prepare an oral rehydration therapy.
They also carried out street dramas and use various channels of mass communication, such as door-to-door visits, relief distributions, material distributions, wall painting, billboards in public places, and providing lessons in schools.