Contaminated water and weak infrastructure leave thousands sick each year
KATHMANDU, JUNE 21
As the monsoon arrives, bringing relief from the heat, it also ushers in a surge of water-borne illnesses. Cases of diarrhea, cholera, typhoid, malaria, and dengue rise sharply during this season-particularly in densely populated and low-income areas where sanitation systems are inadequate and clean water is scarce.
"These diseases spike during the monsoon due to multiple factors," says Dr Pallavi Koirala, a community physician and former WHO consultant. "Floods cause sewage to mix with water sources, while poor drainage and waste disposal systems exacerbate the problem."
In cities like Kathmandu, where rapid urbanization has overwhelmed infrastructure, water pipelines often run alongside open drains. "In rural areas, people rely on rivers and springs, which become unsafe during the monsoon. Humid conditions also promote bacterial and viral growth in food," explains Dr Koirala.
Hem Raj Pandey, Section Chief of the Disease Surveillance & Research Section at the Epidemiology and Disease Control Division (EDCD), outlines their role: "We focus on public awareness, water quality guidelines, and coordination with local governments. When outbreaks like cholera occur, we supply testing kits, collect samples, and ensure rapid response-from diagnosis to treatment. Field teams provide data, which guides our health measures and medicine distribution."
Official data from Nepal's Department of Health Services (2022–23) shows rising cases: 95 confirmed cholera infections by September, and 56,000 dengue cases leading to 88 deaths-mostly among economically marginalized groups. "Public hospitals report accurately, but private facilities often underreport," Pandey shares.
Children, the elderly, and those in poor living conditions face the highest risks. "Children under five, pregnant women, the elderly, and slum residents are most vulnerable," says Dr Koirala. In some areas, shared water sources for humans and animals further increase infection risks.
The crisis extends beyond health, straining household finances. Families spend savings on treatment, lose income due to missed work, and frequently lack proper diagnoses. Women and girls, tasked with water collection and caregiving, bear a disproportionate burden. "In rural areas, late healthcare-seeking-due to distance, cost, or lack of awareness-worsens outcomes, raising complications and deaths," adds Dr Koirala.
Yet prevention is possible. "Boiling water, using chlorine tablets, handwashing with soap, and ending open defecation can drastically reduce monsoon-related diseases," says Dr Koirala.
