Fear of disease outbreak

There are mounting fears that the 7.8-magnitude earthquake that struck Nepal on April 25 could lead to the spread of serious diseases like cholera, dysentery and other water-borne maladies due to contaminated water, poor sanitation and a lack of proper medical infrastructure.

The massive earthquake - the worst to hit the landlocked South Asian nation in more than 80 years - killed more than 7,500 people and wounded over 14,500, according to government figures. The death toll is likely to jump once relief teams reach mountain villages flattened near the epicenter.

The UN estimates eight million people - nearly a third of Nepal's population - may have been affected by the earthquake across 39 of the country's 75 districts, with at least two million people needing tents, water, food and medicines over the next three months.

In a DW interview, Sophie Cairns, senior life sciences analyst at global analytics firm IHS, explains that even prior to the earthquake, Nepal was home to inadequate health facilities and access to treatment. The situation is now even more desperate as around 90 percent of health care facilities outside the main cities are reportedly not functioning, thus putting many in the quake-struck areas at serious risk of contracting infectious diseases.

DW: What is the prevailing health situation in Nepal's quake-hit areas?

Sophie Cairns: At the moment, ten days after the initial earthquake in Nepal, the country finds itself slipping into an increasingly dire health situation. Even prior to the earthquake, Nepal was home to inadequate health facilities and access to treatment.

The situation is now even more desperate: according to the WHO, 90 percent of health care facilities outside the main cities are not functioning. There have already been reports of diarrhea outbreaks and respiratory infections, and people in quake-hit areas are considerably more at risk due to lack of shelter, sanitation or treatment.

What are the potential health risks faced by the people in the earthquake-affected regions?

The main risk is the rapid spread of infectious diseases. Unsafe water can foster the spread of gastrointestinal diseases such as cholera, which is endemic to Nepal, and insect-borne diseases are also a risk as night temperatures grow warmer. Respiratory and eye infections are also a potential challenge.

What kind of medical aid is being provided in these areas?

International organizations such as the World Health Organization (WHO) and UNICEF are coordinating with the Nepali government, while a wave of assistance has also come from foreign aid agencies. Despite the damaged infrastructure, aid groups have been working flat-out to provide sanitary water, vaccines and hygiene kits to local residents.

What serious diseases are Nepalis currently facing in the aftermath of the quake?

The main worry is cholera, which is transmitted mainly by faecal contamination of food and water and as I mentioned is endemic to Nepal. The last major outbreak was in 2009, affecting over 300,000 residents. There have been reports of residents being forced to defecate in the open, which increases the risk.

What is the likelihood of such diseases spreading?

There are several contributing factors which increase the likelihood of the spread of serious diseases. Lack of safe water supplies and lack of sanitation are the immediate risks which must be addressed in order to control potential outbreak of infectious disease.

While it is difficult to quantify this risk, there is also the additional challenge of the approach of the bad weather season after late May. Inclement weather may well exacerbate the health risks and present considerable obstacles to relief efforts - it is a ticking time bomb.

Does Nepal have the necessary means to take care of these problems?

Not even close. Outside Kathmandu, Nepal's rural areas have limited healthcare infrastructure, which will be further stretched by the effects of the earthquake. There is also a risk of disruption to pharmaceutical production - domestic production meets around 50 percent of local demand - which means access to medicine may be severely hampered.

On an economic level, Nepal's lower-income citizens are particularly at risk of utter impoverishment as they are forced to pay for catastrophic health expenses out of pocket.

More generally, damage to roads and Nepal's only international airport is resulting in fuel shortages and limited electricity.

What role could international aid organizations play in mitigating these health risks?

International aid is absolutely crucial in providing emergency relief to local residents in the form of cleaner drinking water and sanitation. While the eventual scale of relief required is beyond calculation at this point, the immediate provision of disinfectant kits, emergency shelter and water purification tablets for example, go a long way in reducing the threat of a large-scale disease outbreak.

Sophie Cairns is a senior life sciences analyst at IHS, a global analytics firm.