An interview with Dr. Binod Kumar who has been working on the MSF kala azar project in Hajipur since April 2008, and was among the first MSF teams to provide medical assistance to victims of the floods in Bihar.
What are the main medical problems you see in the camps?
We focus our medical activities on pregnant and lactating women and children under five. We see many cases of severe and acute malnutrition, diarrhea, upper respiratory tract infections and skin infections, problems linked to the contamination of water, cramped conditions and lack of hygiene. In some areas, diarrhea had become endemic. In Chuni or Sarsakla, for example, we took water samples and the tube-wells used by the population have been contaminated. We gave containers, water purification tablets and we had health promotion sessions to teach people how to use them so they can have clean drinkable water.
What is the people’s state of mind?
The population in this part of Bihar is very rural, and very poor. Now they’ve lost everything. They’re very anxious about food. We systematically treat those who need it with ready-to-use therapeutic food. In the camps we’ve covered, we’ve also provided plastic sheeting because people had been sleeping in the open, feeling hopeless and homeless. They say they have no clothes, and not enough food and they don’t know how long they will have to stay there.
What’s the situation in the camps?
It depends on the camps; some are being managed by the government and are rather well organized. In other places, people have settled in temporary settlements or along roads, wherever they could find dry land. These settlements can be far from any health centres or neglected because access is difficult. In Chuni, for example, several thousand people were rescued by army boats from the floods but the roads were destroyed or made impassable, which means they didn’t receive much aid apart from airdropped food packets. We had to use a tractor to deliver non-food items. Because the roads were so bad, it took a long time and was difficult but now we have covered the whole camp and everyone has received plastic sheeting, soap, containers and water purification tablets. We also continue to run mobile clinics regularly.
What are the risks of epidemics?
The risks are serious because the camp is crammed and the water contaminated. The water level has gone down, and when water becomes stagnant people’s health may deteriorate. When we reached Chuni an outbreak of diarrhea was just starting and three or four deaths were reported with hundreds of diarrhea cases. But we treated people immediately and the situation there is now under control.