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
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