Dr KR Jawaharlal has been working non-stop since November 11. Torrential rains had hit Tamil Nadu's Cuddalore district two days before. Lakes breached their banks and flash floods killed at least 27 people across the district. The rain continued even when flooding subsided and fields and roads remained waterlogged. With people out in the cold and wet, the prospect of disease and outbreaks of infections loomed large but Cuddalore’s medical officers didn’t miss a beat.
“We held 39 health camps on the first day, that is November 11,” said Jawaharlal who is the district’s deputy director of health. “More than 3,000 people attended the camp. We treated 90 cases of fever and 12 cases of diarrhoea, which is normal for this population.” Since then, the deputy director’s office has ordered more camps to be conducted in all affected villages and towns, especially susceptible slum settlements. On December 7, 92 camps were held in the district to look after 12,040 people. Through November and the first week of December, the district had already organised 1,599 medial camps.
“At health camps we give basic medicines like paracetamol,” said Kumaravel, the assistant surgeon at the government health centre in Chidambaram, who has conducted at least three camps in every flood-hit locality in the past month.
“In this rain, they may not be able to come to the [primary health centre to collect these medicines to so we take it to the camps in their area," he said. "Some patients are diabetic and hypertensive, have thyroid and heart disease. We make sure they have medicines even if they are stuck in the rain.”
A health camp a day…
Kumaravel said that at least two or three health camps are held every day based on where the need arises the most. Doctors from Cuddalore’s urban health centres have also been sending outreach teams to carry out blood tests and immunisations among the homeless and displaced flood victims.
The quick first response has worked well with no reports of infections or cholera, which can be devastating in post-disaster scenarios, being reported. But the doctors are still carefully treating and monitoring the increased cases of fever, diarrhea and upper respiratory infections – an uptick that is expected in the winter season.
“Usually, in 100 patients there will be about five diarrhoea cases. If it’s suddenly 15 cases on a day then we will suspect an outbreak and look at water sources in the area,” said Kumaravel, clear about the contingency plan.
Along with paracetamol, doctors have been making sure that patients with respiratory infections are getting their doses of amoxicillin or anti-histamines and that women have their necessary supply of sanitary pads.
The most common complaint has been that of intertrigo – sores that occur on moist skin infected by bacteria or fungus. “I have been walking around in all this water,” said Amudha, standing in queue at a health camp at Vaddaku main road in Chidambaram. "My feet are full of sores and I have come for the ointment."
She added: “Any medicine we need, we have been getting at the camps.”
Kumaravel and his colleagues have had to improvise when it comes to that ointment. “Sometimes there is a shortage of medicines," said the doctor. "Recently we had only paracetamol tablets because there was no syrup available. We had to manage. The ointment for fungal infections is difficult to get on some days. We began splitting the tubes into two and giving them out.”
While the doctors and nurses have been counseling camp attendees on proper sanitation and making sure they wash their hands, Jawarharlal has been appealing to non-government organisations and private corporations offering aid to send bottles of hand sanitizer. “Many of the flood hit areas don’t have clean water to wash their hands so why not give them hand sanitizer for the time being,” he said. “We will try it out in a small area and see if it is effective. If it works then we will distribute it to everyone.” Similarly, the deputy director wants consignments of mosquito bats to stave off dengue and other mosquito-borne diseases.
WhatsApp to the rescue
The efficacy of Cuddalore’s response to the health hazards in the flood aftermath has been, in no small measure, due to the messaging service WhatsApp. Jawaharlal said his mobile phone buzzes at least 1,000 times a day with messages from his superiors and subordinates.
“All the block medical officers are connected to secondary officers on their own groups – medical officers, pharmacists, district health missions and state health mission. Whatever I order, they will just transmit to their groups. Whatever message I get from the director or minister, within minutes I can send that,” said Jawarharlal.
Kumaravel has been doing his share on the mobile medium by sending photos the health camps conducted back to the deputy director. “Instructions from the deputy director or the block medical officer to distribute medicines or give sanitation instructions come through WhatsApp. It's the fastest and easiest way. We were using WhatsApp even before but it's especially useful in this flood time,” he said.
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“We held 39 health camps on the first day, that is November 11,” said Jawaharlal who is the district’s deputy director of health. “More than 3,000 people attended the camp. We treated 90 cases of fever and 12 cases of diarrhoea, which is normal for this population.” Since then, the deputy director’s office has ordered more camps to be conducted in all affected villages and towns, especially susceptible slum settlements. On December 7, 92 camps were held in the district to look after 12,040 people. Through November and the first week of December, the district had already organised 1,599 medial camps.
“At health camps we give basic medicines like paracetamol,” said Kumaravel, the assistant surgeon at the government health centre in Chidambaram, who has conducted at least three camps in every flood-hit locality in the past month.
Medicines being distributed at a Chidambaram health camp.
“In this rain, they may not be able to come to the [primary health centre to collect these medicines to so we take it to the camps in their area," he said. "Some patients are diabetic and hypertensive, have thyroid and heart disease. We make sure they have medicines even if they are stuck in the rain.”
A health camp a day…
Kumaravel said that at least two or three health camps are held every day based on where the need arises the most. Doctors from Cuddalore’s urban health centres have also been sending outreach teams to carry out blood tests and immunisations among the homeless and displaced flood victims.
The quick first response has worked well with no reports of infections or cholera, which can be devastating in post-disaster scenarios, being reported. But the doctors are still carefully treating and monitoring the increased cases of fever, diarrhea and upper respiratory infections – an uptick that is expected in the winter season.
“Usually, in 100 patients there will be about five diarrhoea cases. If it’s suddenly 15 cases on a day then we will suspect an outbreak and look at water sources in the area,” said Kumaravel, clear about the contingency plan.
Along with paracetamol, doctors have been making sure that patients with respiratory infections are getting their doses of amoxicillin or anti-histamines and that women have their necessary supply of sanitary pads.
The most common complaint has been that of intertrigo – sores that occur on moist skin infected by bacteria or fungus. “I have been walking around in all this water,” said Amudha, standing in queue at a health camp at Vaddaku main road in Chidambaram. "My feet are full of sores and I have come for the ointment."
She added: “Any medicine we need, we have been getting at the camps.”
Kumaravel and his colleagues have had to improvise when it comes to that ointment. “Sometimes there is a shortage of medicines," said the doctor. "Recently we had only paracetamol tablets because there was no syrup available. We had to manage. The ointment for fungal infections is difficult to get on some days. We began splitting the tubes into two and giving them out.”
While the doctors and nurses have been counseling camp attendees on proper sanitation and making sure they wash their hands, Jawarharlal has been appealing to non-government organisations and private corporations offering aid to send bottles of hand sanitizer. “Many of the flood hit areas don’t have clean water to wash their hands so why not give them hand sanitizer for the time being,” he said. “We will try it out in a small area and see if it is effective. If it works then we will distribute it to everyone.” Similarly, the deputy director wants consignments of mosquito bats to stave off dengue and other mosquito-borne diseases.
WhatsApp to the rescue
The efficacy of Cuddalore’s response to the health hazards in the flood aftermath has been, in no small measure, due to the messaging service WhatsApp. Jawaharlal said his mobile phone buzzes at least 1,000 times a day with messages from his superiors and subordinates.
Dr Kumaravel reporting health camp progress to his superiors via WhatsApp.
“All the block medical officers are connected to secondary officers on their own groups – medical officers, pharmacists, district health missions and state health mission. Whatever I order, they will just transmit to their groups. Whatever message I get from the director or minister, within minutes I can send that,” said Jawarharlal.
Kumaravel has been doing his share on the mobile medium by sending photos the health camps conducted back to the deputy director. “Instructions from the deputy director or the block medical officer to distribute medicines or give sanitation instructions come through WhatsApp. It's the fastest and easiest way. We were using WhatsApp even before but it's especially useful in this flood time,” he said.
