Delay in delivery of aid adds to risk of epidemic in Burma

Two weeks after Cyclone Nargis, aid agencies warn that Burma (also known as Myanmar) stands on the edge of a “public health catastrophe.” Lack of access to safe water and sanitation, largely as a result of delays in mobilising a sufficient emergency response, means that the risk of epidemics of waterborne diseases is high.

More than 100 000 people are thought to have died as a direct result of the cyclone. Aid workers now fear a second wave of deaths from disease. Although the government has begun to ease its previous restrictions on aid workers and supplies entering the country, people who are experienced in natural disasters warn that the first days are crucial in preventing outbreaks.

“With the likelihood of 100 000 or more killed in the cyclone, there are all the factors for a public health catastrophe which could multiply that death toll by up to 15 times in the coming period,” said Oxfam’s regional director for East Asia, Sarah Ireland.

“In the Boxing Day tsunami 250 000 people lost their lives in the first few hours, but we did not see an outbreak of disease, because the host governments and the world mobilised a massive aid effort to prevent it happening. We have to do the same for the people of Myanmar.”

The United Nations Office for the Coordination of Humanitarian Affairs warns that relief is still coming far too slowly: “It’s still very much too piecemeal for our liking . . . One week on, we would normally expect to have far greater coverage. With this many people affected, everybody is very concerned. We do not want to see a second wave of tragic deaths caused by disease and starvation.”

The UK charity Oxfam said: “People’s resistance to disease is weakened daily because of lack of food and shelter and exposure to the elements and through drinking surface water that is more than likely to be contaminated with human and animal waste. This creates an effective breeding ground for diseases such as cholera, typhoid, and shigella.”

Merlin, one of the few medical agencies with a presence on the ground, had a network of 600 trained community health workers, but 50 of them are dead or missing, and much of their transport and equipment was lost to the storm.

Linda Doull, Merlin’s health director, said: “Without rapid medical aid, thousands of people will die. The immediate concern is clean water. In such hot temperatures and with so little food available, diarrhoea and dehydration kill quickly—and young children are the most vulnerable.”

As the flood waters recede, malaria and other vectorborne diseases are also a concern, as are snake bites and long term food insecurity resulting from the loss of the entire rice harvest.

Paula Sansom, Merlin’s emergency health manager in Burma, said, “Getting clean water to the hundreds of thousands of families stranded by the cyclone is our biggest challenge. A massive, comprehensive response is needed now. Diarrhoea has already begun to take hold, which without proper sanitation could infect entire communities. Heavy rains are also expected, which will add to the devastation. It is vital that we move now and move quickly.”