Planning for Health Precautions after Flood is as important as donations to manage Post floods health crises.
Thousands have volunteered for medical relief work in Kolhapur and Sangli Floods. Huge stocks of medicine also have been donated by doctors statewide. As the water recedes the biggest challenge would be epidemics of various diseases and infections flaring up in the unhygienic surroundings. But mere donations would not suffice in the successful management of the health crises and epidemics. Any natural calamity should follow epidemiological surveillance and planning not just of treatment but prevention of the epidemics and diseases. Not just physical but psychological rehabilitation of many who have lost their homes is a commonly neglected issue after such calamities.
Since historic time’s prevention of mortality due to epidemics and diseases after natural calamities have been a subject studied and stormed academically by Medical experts. This is to improve upon the medical response and minimize the mortality and morbidity. 2015 Chennai floods, very well managed in terms of health precautions after flood, medical relief work is a case study analyzed and some lessons were learned from this calamity to formulate some protocols, standard treatment guidelines for the management of Post floods epidemics. On the same grounds, Kolhapur, Sangli flood crises can be managed in a better way.
Presently the response to medical relief work in Kolhapur is emotional and it is bound to be. However, it needs to supplement with better planning to make it more effective. A fortnight from now will see a surge in cases of Gastroenteritis, Acute respiratory infections – pneumonia, viral upper respiratory infections, leptospirosis, dengue, Malaria. Skin infections like tinea are also expected. All these diseases can be widely classified as Gastrointestinal, acute febrile illness and Vector, rodent born infections. The classification is intended to simplify the tasks and train treating doctors and paramedical staff for the management of specific diseases of these three groups. Such broad classification is always required to categorize the huge number of patients at one time just by the symptoms as the dearth of time and resources is an issue in such situations. Not just treating but identifying the patient and initiating treatment on the first day of symptoms is a priority post floods to prevent the epidemics from taking roots. Also calling many patients at the same place is often a favourable thing for the spread of epidemics. Hence home to home surveillance and treatment is a better option. Also isolating infectious patients from relief camps and quarantine of healthy is an important aspect of the prevention of epidemics. Chennai floods were followed by disease-specific treatment stalls of these three disease groups and paramedical staff directed the patients to particular stalls after a home survey from the provided checklist of disease-specific symptoms. Also, a mobile medical unit and rapid response team to shift the patient to tertiary level hospitals for critical patients allotted to a definite geographic area is a must to reduce the mortality of serious patients.
Although treatment is an aspect it would be incomplete without administrative measures for safe and clean drinking water, cleaning the surroundings and piled up garbage, daily fogging for mosquito control and thymate spray for rodent control particularly rats. All this has to be started on a war footing and implemented with utmost efficiency in every nook and corner of affected villages. Remains of deceased animals are always a major source of infections after floods so clearing and the dead debris of such animals should be a major priority. A separate team has to be assigned the work to cremate the dead animals. Also, live animals mainly cattle are a source of epidemics. A veterinary team diagnosing and treating livestock is as important as the treatment of humans.
Emotional turmoil and mental blow among the homeless, those who had a wide escape and brushed shoulders with death, travelled through floods, lost loved ones is something which remains neglected after such natural calamities. Post-traumatic stress disorder is a major psychiatric condition to be dealt with in such situations. Although the role of psychiatrists, counsellors is pivotal but simple public remedies can be adopted. The catharsis of emotions in groups in the night in relief camps or villages, venting out feelings, talking to others can be primary and effective remedies to prevent panic attacks and post-traumatic stress disorders.
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Even the hospitals in Kolhapur, Sangli were submerged and couldn’t function to full capacity at present. Mahatma Phule Jan Arogya Yojana, the government insurance scheme is running successfully in the state. But the issue with the residents of the flood-hit region is they have lost their identity proofs in the floods necessary for enrolment of the scheme. If the state health insurance society goes the extra mile to ease the enrolment of such patients they can be very well absorbed in hospitals all over the state.
It is said in public health that a natural calamity changes your life even if you haven’t directly suffered in it. This is true for each one of us. If altruism is coupled with planning for Health Precautions after Flood, the epidemic and health crises post floods can very well be resolved.
Dr. Amol Annadate | reachme@amolannadate.com