Chapter 1
Box 1.4 Orissa – from cyclone to suicide

Within days of super-cyclone 5B striking the India state of Orissa, government health officials, NGOs and the media were all warning of a looming public health crisis. The tidal surge and heavy rains that accompanied the cyclone caused massive flooding, contaminating thousands of tube wells, swamping crops and killing hundreds of thousands of cattle.

Human and animal corpses littering the affected areas were thought to pose a major health hazard and it seemed likely that a cholera epidemic could claim more lives than were lost during the cyclone itself. Why the predicted epidemic never materialized is still open to question. After the cyclone, people had no choice but to draw water from contaminated sources. In some coastal areas the cyclone destroyed 99 per cent of the coconut trees – but they provided a good supply of green coconuts which served as a valuable source of clean water and nutrients for many who had little or no access to food.

While access to clean drinking water was an acute problem, many knew to boil water before consumption. Comprehension of public health issues, particularly among Orissa’s coastal population, has been boosted by the long-term presence of many aid organizations. Following the disaster, mobile clinics reinforced hygiene awareness.

Within days, supplies of water treatment chemicals such as halogen tablets were being distributed as an integral component of most relief distributions carried out by the government and NGOs. Such a rapid and widespread intervention certainly reduced the incidence of water-borne diseases. Water surveillance, epidemiological monitoring for communicable diseases, and a massive programme to clean wells were undertaken. While a small number of cholera and measles cases were reported, these diseases are considered endemic to the coastal region. The initial increase in hospital admissions occurred mainly in bigger towns such as Paradwip and Cuttack where unsanitary, overcrowded conditions led to increased cases of diarrhoeal diseases.

However, longer-term public health impacts of the cyclone may be less obvious and more serious. Endemic poverty in Orissa means people spend four-fifths of their income on food, leading to ‘starvation debts’ which have forced mothers to sell their own children in order to survive. And around half all Indian children under five are malnourished. Add to this fragile situation a devastating cyclone, and the principal public health crisis – and challenge – becomes food security.

Vandana Shiva, director of the Research Foundation for Science, Technology and Natural Resource Policy in India, argues that commercial exploitation makes matters worse. Sea water swept 20 to 30 km inland because coastal mangrove swamps, which previously acted as a brake on storm surges, had been slashed to make way for shrimp farms. Floods wiped out seed stocks as well as the immediate standing crop. “The corporations are trying to make the crisis an entry point for hybrid seeds,” alleges Shiva. Hybrid seeds deliver one great crop but are useless if replanted, she claims. The capital needed to buy new seed annually, plus the herbicides essential for hybrid varieties to survive, is locking farmers into debt. Unable to afford either hybrid inputs or food produced elsewhere, many farmers are taking their own lives. “The epidemic of suicides in India I see as a public health crisis,” maintains Shiva.