They waded and stumbled through waist-deep muddy water and slush for hours to reach a relief camp in Pandalam, in rain-ravaged Pathanamthitta district, Central Kerala. Dr Bijin Joseph, a specialist in family medicine, along with his medical team of 16, with three doctors, eight nurses and four pharmacists from KIMS hospital in Thiruvananthapuram, wanted to push on.
The raging waters of the Pamba prevented them from progressing further and fishermen warned them against attempting anything foolhardy. Instead, they promised to bring patients to their camp.
Thiruvananthapuram, Kerala 20/08/2018:: Medicine collecting from Medical college and SCT at the Corporation office on Monday..........Photo:S_Gopakumar.
“It was pouring. I can never forget the sight of 500 people, young and old, huddled in that camp, because we have never seen a calamity on this scale in Kerala. While the youngsters were actively organising things at the camp, many senior citizens were completely in a state of shock. Many had seen their lives being washed away by the water — houses and all their possessions. It was traumatic for all of us too. We were on our feet from 10 am to 9 pm on some days. Our immediate concern was for patients who were on daily medication: those who had diabetes in need of insulin, those with hypertension and cardiac problems. Then there were many, specially young children, with cold and fever,” recalls Bijin. Through the six days, the team also worked in camps in Ranni, and Seethathodu, both in Pathanamthitta.
- Since volunteers and residents were forced to live in waterlogged areas and walk through flooded places, rat fever or Leptospirosis is a worry. All those who had to work or live in such conditions are given Doxycycline as a prophylactic medicine.
- Snake bites are common in floods when the water recedes, so it is best to wear thick rubber gloves, gum boots and use mechanised equipment to clean houses and buildings.
- Keep the skin dry to avoid skin infections and fungal infections. Consult a doctor in case of redness or itching.
- To clean wells, flush out as much water as possible. Then opt for a process of super-chlorination: use upto 10g of bleaching powder for every 1,000 litres of water (usually only 2.5g is used). Let it stand for an hour.
- Toll-free health line: 1800 1231454
In a relief camp in Seethathodu, he learnt that the area had experienced over 30 landslides in a week’s time. There were villages where houses were completely wiped out. The team had to treat fractures, cuts and bruises. “Two people had been killed and many families had their houses completely demolished by landslides and floods. They wondered what they had to return to,” narrates Bijin.
Meanwhile, a huge medical team set off from Thrissur Medical College to camps around Thrissur, in Central Kerala, under the leadership of orthopaedic surgeon Dr Santhosh Kumar, deputy superintendent of Medical College, Thiruvananthapuram, and vice-president of Doctors Without Borders in South Asia. On the team were Dr Mohammed Asheel, Dr Bindu DHS, Dr Rahul UR.
“A mobile medical unit consisting of a doctor, nurse, and pharmacist was put together and 30 such teams travelled in a bus around Thrissur. There were 30 such buses for offering medical assistance in the camps. Our priority was to treat patients in need of help and also prevent the outbreak of any contagious diseases (measles, chicken pox, typhoid, cholera, diarrhoea). Since thousands of people are living together, it is easy for a contagious disease to reach the levels of an epidemic,” says Santhosh. He also led a team to Wayanad, aided by an NSS squad from Delhi.
As the waters recede, there are bound to be manifold new issues in the days to come, says Santhosh, who has treated patients hit by various disasters in over 30 countries. “As the camps are being closed, the threat of an outbreak of contagious diseases has decreased greatly. However, since the water has still not receded in many places in Alappuzha and Pathanamthitta districts, and since people have begun to return to their homes, there are other problems to look out for,” he explains.
Kochi, Kerala, 16/08/2018: Fire and rescue personnel evacuate people from flooded houses in Eloor in Ernakulam on August 16, 2018. Photo : Thulasi Kakkat.
It is also at this stage of such a calamity that respiratory diseases must be carefully monitored. A simple viral infection that results in a cough or cold, can get escalated to become something more serious, like pneumonia.
An immediate concern is a spike or occurrence of rat fever, because of the lack of proper footwear, such as gumboots. Then there is the danger of snake bite and fatal injuries caused by electrical equipment damaged by the flood waters.
COIMBATORE, TAMIL NADU, 21/08/2018. Medicines sourced by the Drugs Control Department and Coimbatore District Chemists and Druggists Association being readied for despatch to Kerala on August 21, 2018. Photo: M. Periasamy
Since almost all the wells in these regions have been contaminated, all the sources of drinking water will have to be pumped, cleansed and super-chlorinated, before they can be used.
Even as the water is still going down, vector-borne diseases rear their heads. When the sun comes up and water starts stagnating, the whole life cycle of mosquitoes begins anew.
Based on his experience in working in flood-hit Philippines and Odisha, he says it would be best to use mosquito nets for protection or use mats and ointments to protect oneself from dengue and Japanese encephalitis.
The floods in Kerala are said to be the worst in a century, since 1924.
The doctors also point out the immediate necessity of organising psycho-social support groups to counsel many of the survivors of the flood. “The plan is to select about 200 volunteers and train them to identify, select and counsel those undergoing emotional stress or trauma. The best way is to have such trained volunteers at clinics, so that they can identify people in need of counselling,” says Santhosh.
As the State moves into the process of rehabilitating the survivors, medical practitioners gear up for more work, not letting the grief of their own losses come in the way of duty and service.
