That 12 cases of cholera have been reported in the valley in a little over a week is alarming
Since the first case of cholera was detected on June 19, the Kathmandu Valley reported its 12th case on Monday, with health experts warning that the valley could be on the cusp of a massive cholera outbreak.
One cholera case is already one too many, as every detection could translate into at least a dozen more infections in the community. Water and food contaminated with the bacterium Vibrio cholera is the cause of the disease, which leads to profuse watery diarrhoea and even death if not treated in time. The presence of e-coli and coliforms, which cause cholera, in the water samples taken from different sources at Baghbazaar, Dillibazaar, Budhanilkantha and Sanepa of the valley is an indicator of fecal pollution of the water people are using. According to the Epidemiology and Disease Control Division (EDCD) of the Ministry of Health and Population, the coliforms were found in the water distributed in the taps, wells, tankers and jars. Cholera is spreading fast and has also been confirmed in people residing at Balkhu, Koteshwor, Balaju, Kapan, Naikap and Thankot.
Cholera is not to be taken lightly, as it could lead to the death of almost half of all those infected if not treated in time. Excessive diarrhoea apart, other symptoms of cholera include constriction of the stomach, leg cramps, fatigue and vomiting. The disease occurs almost every year in the country with the start of the monsoon season in June. The Valley, because of its population density, is at high risk of cholera infection, abetted by its poorly managed drinking water, sewerage and waste management systems. Due to the heavy rains and flooding, there are high chances of leaking drinking water pipes being contaminated by sewage.
Since cholera has been reported from different localities of the valley, the authorities must act quickly to contain the disease at the source. This means, managing the sewerage, protecting the drinking water sources from getting contaminated, and detecting any new cases as quickly as possible. The public should, therefore, be made aware of cholera's symptoms, and anyone suffering from them should report to the nearest health facility at the earliest. Hygiene is the key to controlling its infection.
WASH (Water, Sanitation and Hygiene) practices, promoted by the World Health Organisation (WHO), such as washing hands with soap, drinking and storing safe water, drying dishes in the sun after washing them, using a latrine and keeping the household environment clean will go a long way in keeping cholera at bay. People must be asked to drink only boiled water and wash fruits with hot water or peel them before eating. Kathmandu has seen repeated outbreaks of cholera for decades, and the last serious outbreak was in 2016 when as many as 150 cases were reported. But with a cholera prevention programme that focussed on adopting safe water, sanitation and hygiene practices, the number of cases got reduced to just three in 2018. However, with 12 cases detected in a little over a week and increasing by the day, a massive outbreak of cholera looks imminent.
The government cannot be taking chances, and it might be rational to initiate a massive vaccination campaign against the disease at the earliest.
Crisis of fertilisers
Farmers celebrated the National Paddy Day today or Asar Pandhra across the country without chemical fertilisers in their hands when they need them the most at the time of paddy plantation. The farmers from across the country have taken to the streets, demanding supply of fertilisers without further delay. However, the government has not been able to meet the domestic requirement even though paddy plantation has been completed by almost half due to early onset of this year's monsoon. Timely rainfall is a prerequisite for timely paddy plantation.
However, productivity of the major crop will not increase if the farmers do not get fertilisers during the plantation season.
It may be recalled that the government had reached a memorandum of understanding with India in March to directly purchase urea and DAP from the Indian godowns. But the government seems to be unable to bring the fertilisers through the government-to-government deal due to logistic constraints.
Delayed supply of the chemical fertilisers will not contribute to increasing paddy productivity. Nepal annually requires 210,000 tons of urea and around 60,000 tons of DAP during the paddy planting season.
Shortage of fertilisers is a perennial problem that the government has failed to solve.
A version of this article appears in the print on June 29, 2022, of The Himalayan Times.
