In the post-flood scenario, Kerala is facing a unique situation wherein, more than communicable disease outbreaks, the Health Department is left to tackle a host of complications of chronic non-communicable diseases (NCDs).
“Morbidity due to NCDs is quite high in our population and post-floods, we found that a significant proportion of those in relief camps had been missing their daily medicines. Many of them could not recollect their regular medicines and had lost all medical records. The situation might have already put many at a higher risk of NCD complications. Already, several sudden or heart attack deaths amongst the flood victims have been reported,” a senior Health official said.
NCD complications set in slowly and many of them might be going unidentified even in medical camps.
In order to get a clear picture of the epidemiology of NCDs in the post-disaster scenario, the Health Department has now sought the help of National Institute of Epidemiology (NIE), Chennai, an agency of Indian Council of Medical Research, to conduct field-level epidemiological studies in all flood-affected districts.
“We’re looking at the possible complications of diabetes, hypertension, COPD, cardiovascular diseases, chronic kidney diseases and accident/injuries.
“The Health Department’s State-level advisory group on NCDs has now prepared a separate protocol for NCD treatment at primary care level, applicable in the immediate post-flood period and has distributed it to all districts.
“The field-level survey by the NIE team will give us a clear idea of the possible situation of NCD complications that we might have to handle, so that we can prepare short-term and long term plans to put people back on treatment,” he added. At present, in all relief camps, blood sugar and blood pressure of everyone are being checked daily. While all NCD drugs as per the new protocol are being distributed to people in medical camps, there have been complaints of shortage of NCD drugs.
This is primarily because many people who were being treated in the private sector and were on expensive drugs were refusing the the NCD drug protocol (generic drugs) of the Health Department, officials said.
The department plans to give for free, drugs to all chronic NCD patients for the next one or two months, till their situation normalises.
NCD drug stock
While the department has enough NCD drugs stock to tide over another two weeks or more, senior officials are hard at work to prevent a possible shortage of these drugs.
“We do not have any record on the impact of NCDs in a post-disaster situation anywhere in the country. But I suspect that the disease profile after floods in Kerala is more likely to be akin to the situation post-Katrina than post-Bihar floods. In the current scenario, we anticipate that the public sector will have to cater to a large section of NCD patients who were previously being treated in the private sector. In such a situation, even when we are holding our drug inventory level at 200%, we could be in for tough times,” the Additional Chief Secretary (Health) Rajeev Sadanandan, told The Hindu .
