Recent floods in South Asia have devastated parts of northern India, Nepal and Bangladesh. Millions of people have been affected and hundreds of thousands displaced. In a number of areas, the monsoon rains are said to be the worst in years. Authorities and local aid organisations have been working hard to cover most of the current needs in the affected areas by running clinics, distributing basic relief items and getting ready for potential outbreaks. Considering this strong local response, MSF teams in Bangladesh, India and Nepal are now in an assessment stage. In India and Bangladesh, there is no need for MSF to assist with the medical response for now. In Nepal, a team is assessing the situation. Reaching the affected communities is a logistical challenge. Many roads have been cut off by the floods and it is very difficult to reach these areas. Therefore, MSF has decided to focus on the most remote areas that are not yet covered by other relief organisations. MSF will continue to monitor the situation and may decide to intervene on a larger scale after the waters have receded. When people return to their homes, hygiene may be very poor, increasing the risk of disease outbreaks.

INDIA

MSF teams are monitoring the situation and assessing needs in the northern states of Assam, Uttar Pradesh, and Bihar. In Assam, where MSF was already running a malaria project, seven million people are affected in 26 districts. In Uttar Pradesh 20 districts are flooded. Two million people are affected, and 65 have died. So far, rescue and assistance operations have been carried out by the authorities and local organisations, who have distributed shelter, water and food. The government has started to distribute chlorine tablets and bleach, to decrease the danger of contamination via polluted drinking water. So far no outbreaks have been reported. People have sought refuge with their families, in government camps or in improvised tents on higher ground. The water has started to recede, which enables people to return to their homes. However, this increases the risk of disease outbreaks. MSF assessed some flooded health centres, but the staff had moved to buildings on higher ground to continue their work and they were coping with the situation. So the MSF team decided to focus on more remote areas in the coming weeks. In the northern state of Bihar, it has been very difficult to get accurate information on the situation in the areas affected by the floods. In order to get a clearer picture of the needs, an MSF team went to the flooded areas to assess the situation. A number of local organisations are currently working in these areas. Darbhanga seems to be the most affected district, but has received the least amount of assistance from authorities or other aid organisations. After the flooding, between 1,000 and 1,500 people gathered in a makeshift camp in Darbhanga City. But there has been no rain over the past week and these people are now starting to return to their villages. Two MSF mobile clinic teams will provide primary health care and humanitarian assistance to displaced people and villages cut off by the floods. It is estimated that these teams will continue working for two months. MSF will also assess East Champaran district, where there seem to be no other aid organisations. Another MSF team has been assessing Saharsa district. The government and other organisations are working in Saharsa and there is no need for MSF's assistance at this time. However, MSF will continue to monitor the risk of outbreaks of waterborne diseases in the next few weeks. In Supaul district, which is on the border with Nepal, it took the team seven hours to reach the most remote locations by boat. The team will relay its findings shortly. In Bihar, it is estimated that water levels in some places will take two to three months to go down. Therefore there will be a high risk of outbreaks of waterborne diseases in the coming weeks. Since there is no epidemiological research centre in Bihar, the situation needs to be closely monitored.

BANGLADESH

Two teams are assessing the situation in the capital, Dhaka, and the north of the country. The diarrhoea hospital in Dhaka has admitted five times the normal number of patients. MSF is following developments at the facility. The teams are preparing for developments after the waters recede. The water and sanitation situation is expected to deteriorate, which will increase the chance of disease.

NEPAL

In the coming ten days teams will assess three districts in the southern Terai region.

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