Summer scares Water and food-borne diseases

Summer scares Water and food-borne diseases

MAY 06 - 

Summer has arrived in Kathmandu. With the temperature rising, fruits stalls have cropped up on road-sides, selling fresh juice and cut fruits. Ice cream parlours and cold-drink stores are crowded as well. Although the city’s road expansion drives have made the roads here dustier, people still flock to street-side food offerings. But there are consequences. Just a few weeks ago, we had lots of patients coming in for check-ups related to allergies and coughing provoked by the dusty streets. More recently, however, we’ve seen more and more cases of diarrhoea and abdominal pain, with or without vomiting—symptoms suggestive of gastroenteritis. Cases of typhoid are also on the rise, and sure to worsen with the advent of the monsoon. These food and water-borne diseases, after all, always pose a threat to people in summer months in a country like ours where conditions of food hygiene and water sanitation leave a lot to be desired. 

Drinking water is indispensible for human existence. But the Kathmandu Valley suffers major crises when it comes to its drinking water supply. Nearly all the surface and ground-water sources have been exploited, and the growing imbalance between supply and demand has led to shortages and intense competition that has further resulted in the pollution and qualitative degradation of drinking water in the Valley—a grave public health issue. The Valley has, in fact, earned the unfortunate moniker of being the ‘typhoid capital’ of the world. 

Diseases caused by contaminated water are among the 10 most prevalent in Nepal. These are largely caused by micro-organisms present in human or animal faeces that find their way into our bodies via the mouth (orally). This may happen through drinking from a contaminated water source (water-borne), but more often, faecal-oral diseases are spread through other routes as well—hands, clothes, food, or materials used in cooking, eating or drinking. These diseases are highly infectious, and can spread from one person to another. And the only way to prevent this would be to maintain high standards of hygiene and sanitation. 

The main water-borne/faeco-oral diseases in Nepal are typhoid fever, giardiasis, dysentery, diarrhoea, hepatitis and worms. These diseases are responsible for much morbidity and mortality in the country every summer. Diarrhoea, for instance, which refers to the passing of three or more loose stools per day, can lead to severe dehydration and the patient may need to be resuscitated in a hospital setting. Then you have typhoid, characterised by high-grade fever, vomiting, with or without diarrhoea; if it is not detected and treated in time, it could lead to complications like ulceration and bleeding in the intestine and perforation. Giardiasis, on the other hand, comprises of diarrhoea, loss of appetite and abdominal discomfort. If left untreated, it colonises the duodenum—the first part of the small intestine—and causes chronic mal-absorption. Meanwhile, hepatitis, commonly known as jaundice, is caused by the Hepatitis virus A and E, and can at times be very serious and life-threatening. Dystentry is what we define as the passing of frequent loose stools mixed with blood, and is associated with abdominal cramps. Treatment with appropriate drugs along with correction of dehydration is the usual line of management. And finally, we have the various types of parasitic worms that might cause pain in the abdomen and diarrhoea. The ova of these worms generally enter the human body via contaminated green vegetables, food and water.

Ultimately, lack of proper hand hygiene, use of contaminated sources of drinking water, and consumption of uncovered food with flies hovering all over—these are some of the causes of the increased incidence of the above-mentioned diseases in our country. In the absence of proper water supply, and proper monitoring of water at the government level, we need to be vigilant ourselves with regards to the water we drink and the food we eat. We should avoid buying from open food and fruit stalls that function on a limited supply of water of doubtful quality. We need to be sure about the quality of our water at the source and also in storage vessels. And flies are another of our worst enemies; all our food should be protected from them as far as possible. One of the easiest and cheapest ways to keep safe from water/food/fly-borne diseases is to revert to chlorinated drinking water. We should also remember to drink more water in general as a rule, as well as adhere to proper hand washing principles. And more emphasis certainly needs to be put on the availability and maintenance of toilets in Nepal. Only then can we be assured of a disease-free summer, and indeed good health all-year round. 

Dr Neopane is a Senior Consultant Physician at Norvic International Hospital

Source: The Kantipur Daily