After major floods, health problems like diarrhea, respiratory infections and skin problems are common. Médecins Sans Frontières (MSF) teams provide primary healthcare and distribute basic items to limit people’s exposure to cold, rain and contaminated water.  Floods caused widespread destruction in Bihar state, India, after the Kosi River broke its banks in Nepal in late August. Water flowed into a channel it had abandoned more than 100 years ago and flooded districts in Nepal and Bihar. A few weeks later, other floods, this time the result of heavy monsoon rains, caused major damage in the Mahanadi River delta, mainly in Orissa state. MSF is participating in emergency aid efforts with the Indian government and other nongovernmental organizations.
  Medical and material aid in Bihar MSF works in some of the districts most severely affected by the flooding, namely Araria, Supaul, Saharsa, and Madhepura. MSF mobile clinics provided basic healthcare, treating conditions like diarrhea, respiratory infections, and skin diseases. The organization has so far carried out more than 12,500 consultations in Bihar’s flood affected districts. MSF is also giving therapeutic ready-to-use food to the most vulnerable people, namely malnourished children and pregnant and lactating women. To prevent the spread of disease, MSF vaccinated more than 15,000 children against measles, and another 10,000 against polio from the end of September to mid-October. To prevent the spread of water-borne diseases, MSF is poised to hand out 800,000 water purification tablets. Although there have been no reports of epidemic outbreaks, the main cause of death is diarrhea. MSF is sharing data with the local authorities to help them be better prepared in case of an epidemic.  In some cases people have lost everything to the floods, so the teams are distributing packages containing basic items like blankets, clothing, bed nets, plastic sheeting, pots, pans and soap. Some 6,500 kits have already been distributed, and another 9,500 kits will be soon be passed out. More than 90,000 flood survivors could benefit from these essential items. More flooding in Orissa state Floodwaters have receded almost everywhere in the northeastern state of Orissa, including severely flooded areas like Khurda and Puri. Indian authorities and local organizations have quickly organized emergency aid in the form of clean water, food and shelter materials. Some of the affected people are returning to their homes, while others continue to stay with family. Some families are staying in partially-destroyed houses while they wait for aid promised by the authorities. Many farmers have seen their rice crops destroyed and will have nothing to harvest next January. Two areas are still partially flooded: the blocks of Delang and Kanas. An additional MSF team arrived to support aid efforts here on Oct. 5. Doctors on foot and in boats MSF has provided medical aid, and has distributed essential items to more than 1,000 families. Some villages are still inaccessible by road; MSF teams travel on foot or by boat to these isolated areas to provide medical care. Residents of other villages can go to health centres for treatment, but there are few qualified medical personnel — only five doctors for 22 centres. Many people have illnesses linked to the flooding. Respiratory infections and diarrhea are the most common. MSF is also working in health centres in Godisgoda and Indipur, which together serve about 25,000 people. In one week, more than 1,350 people were treated in these clinics.

Despite the measures taken by the authorities to treat water and reduce the risk of epidemics, bacteria can still propagate at the water points used by people for drinking, washing food and dishes, and watering animals. The MSF team is sensitizing the population about the appropriate hygiene measures to follow to avoid disease.

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