SEVEN people dead and over 19,000 treated in one week. That was the diarrhoea situation in Bangladesh as of May, 4 according a New Age report. A common waterborne disease, diarrhoea, usually becomes widespread in our country twice a year — during summer and monsoon and worsens in case of are flood, cyclone or drought. This is an ailment we should have learnt to handle successfully a long time ago considering that it costs almost nothing to fight it. Instead, while the health sector faces innumerable other serious challenges, diarrhoea continues to not only persist but also kill.
   Despite being a comparatively less complicated disease to contain, not only in Bangladesh but throughout the world, especially in the developing nations of Asia, Africa and Latin America, diarrhoeal diseases fall among one of the highest killers of children. Every year 1.8 million people die from diarrhoeal diseases (including cholera) while 90 per cent of them are children aged under 5. After acute respiratory infections, it is the second leading cause of death among children, according to Rehydration Project, a non-profit organisation. Approximately, 70 per cent of these deaths are caused by dehydration — the loss of large quantities of water and salts from the body. As the human body needs water to maintain enough blood and other fluids to function properly when the body loses substantially more fluids than one is taking in, the body becomes dehydrated.
   True, as of today, no ‘cure’ for diarrhoea has been invented – a drug that would stop the disease, safely and effectively within a few hours. However, the huge number of deaths occurring every year could be prevented by a method that is cheap, safe and so simple that it can be learned and used by anyone and everyone. This treatment is called oral rehydration therapy and it was in the International Centre for Diarrhoeal Diseases Research, Bangladesh, in the late 1960s, that the ORT concept was developed and the correct oral rehydration salts mixes – a precisely mixed solution of sugar, salt and water – were clinically tested. This breakthrough, described by the British medical journal, The Lancet, in 1978 as ‘the most significant medical advance in this century’, made the ICDDR,B the leader in the field.
   Diarrhoeal disease is attributed mainly to unsafe water supply, inadequate sanitation and hygiene. Regrettably, we, as a nation, have failed miserably to ensure these basic amenities to its citizens. With each year, as the population increases, especially in the cities (the capital Dhaka is now home to more than 10 million people, a large section of whom are deprived of most if not all the facilities required to lead a healthy life), so deteriorates and intensifies diarrhoea outbreak.
   According to the Directorate of General of Health Services control room, in 2007, 537 people died and more than 23 lakh people were contracted with the disease. This year, even at the onset of summer, the situation appears grim. Since January, more than two lakh people contracted diarrhoeal diseases while 38 people died in the month of April alone.
   As is usually the case with almost all predicaments and ailments, it is mainly the poor and people from lower-income brackets that have become the main victims of diarrhoea. While the lack of access to, and awareness of, safe drinking water, poor sanitation and hygiene have always been the major reasons for the spread of diarrhoeal diseases among the poor, this time around another factor has been added. The ever-increasing food prices have driven more and more people to seek cheaper food, which is often contaminated, contributing to the increasing number of diarrhoeal patients.
   As the water table goes down at this time of the year, water supply to city dwellers in particular also drastically falls. As the dry season has set in, an acute water crisis is witnessed in different parts of the country, especially the crowded metropolis Dhaka. According to a New Age report of April 28, the Dhaka Water Supply and Sewerage Authority can supply only about 170 crore litres of water a day against the demand for over 210 crore litres. The long queues of men and women, water vessel in hand, waiting for their turn to collect a few pints of safe drinking water from the community tap is enough to tell the story of safe water scarcity. The supplemental arrangement of supply through mobile water tanks is rarely seen. WASA also blames load shedding for the supply deficit. Water crisis is quite common at this time of the year, but that is no reason the crisis should be explained away as a seasonal phenomenon. In fact, the crisis seems to be getting acuter from year to year as the authorities are doing nothing to prove that they are learning from experience.
   The population of the city currently stands at 10 million and keeps increasing. The yearly increase in the demand for water is estimated to be from 5 to 7 per cent. Supply is not increasing sufficiently and it is alleged that in recent years there has been hardly any initiative to increase the supply. As a basic need and in order to fight diarrhoea, water should receive far more attention from the authorities than it is getting at present. The relevant government ministries and agencies, like WASA, will have to acknowledge the plight of the city dwellers with due seriousness and do something tangible about it on an emergency basis.
   According to the World Health Organisation, improved water supply and sanitation reduces diarrhoea morbidity by between 6 and 25 per cent and by 32 per cent respectively. But there are a huge number of floating people with no fixed dwelling in the major towns and cities of Bangladesh, who are likely to be amongst the most deprived in urban areas in terms of basic facilities and health indicators and more importantly, common victims of diarrhoea. There are no reliable estimates on the total number of homeless people who live on the streets of Dhaka and in smaller cities and towns of Bangladesh but the number could easily exceed a few million. This floating lot who rarely have access to pure drinking water, sanitation and hygienic atmosphere contribute significantly to increasing the number of diarrhoeal patients.
   As for sanitation, about 60 million people in our county are still out of sanitation coverage. Even though the government claims that 85 per cent of the families across the country have so far been brought under the coverage of sanitation, the task still remaining ahead in this country of 150 million people is not easy. Most of the people in rural and slum areas cannot afford to install sanitary latrines. As a result, they defecate out in the open, mostly near water sources thereby creating serious risk of contracting diarrhoea. Even in the urban areas, especially in the slums and habitats of low-income groups, open latrines can be seen near canals or other water bodies increasing the number of diarrhoea patients by leaps and bounds.
   That the authorities concerned don’t take the outbreak of diarrhoea with due seriousness becomes evident as almost every year during this time there are severe shortage of oral saline and water purifying tablets. If these are not in short supply, the prices charged are twice that of normal. According to a New Age report on April 29, this year too some price manipulators and middlemen have indulged in making profit out of the deals and the same old ‘syndicate’ is at work. According to the same report, wholesalers in Mitford, the capital’s major drug market, were selling SMC’s saline at Tk 65 per packet (consisting of 20 small sachets), though the maximum retail price is Tk 60. What is even more disturbing is fake oral saline is being sold and there doesn’t seem to be any monitoring on the part of the authorities concerned either to check the prices of these lifesaving products or to dragnet the malpractice being carried on in this sector.
   True, diarrhoea is a common phenomenon likely to occur during this time of the year and the government can hardly be blamed for its outbreak. But the authorities concerned can no way shrug off their responsibilities in ensuring such basic facilities as supply of safe drinking water and create awareness to contain this life threatening disease. Until and unless adequate resources are mobilised and an all-out effort is made to ensure for the citizens the amenities they require to lead a safe, clean and hygienic life, the increasing number of diarrhoeal patients in each and every health centres throughout the country will continue to be a testimony of the abject failure of the government.