Management of Diarrhea Epidemic in Mid and Far Western Nepal – RVWRMP Response
Date:12 May 2010

RVWRMP agreed on April, 21 2010 to allocate NPR 100,000 to each of its working districts to be used in emergency response for management of diarrhea epidemic as seen most relevant in each district. RVWRMP District Management Committee (DMC) in each district will decide the most effective use of the fund and will act accordingly. The Project Support Unit (PSU) supports districts by providing mass awareness materials and additional human resources as requested.

This year the epidemic has already started. So far Bissalla VDC (Dailekh), Belapur VDC (Dadeldhura) and Baitadi have been reported by various public medias. Hence, there is an urgent need to address the diarrhea epidemic as an Emergency Action and Preparedness in addition to the RVWRMP normal operations in ensuring safe and sustainable drinking water and improved sanitation in 52 VDCs in ten districts of Mid and Far Western Nepal. RVWRMP is an active member in district WASH committees also during the times of an emergency.

Each year diarrhea epidemic kills many children, women and others in Nepal. Last year more than 300 deaths were reported in Jajarkot VDC (Mid West) whereas the epidemic was spread to the VDCs of the RVWRMP project areas as well in Baitadi, Dailekh, Dadeldhura, Doti, and Bajura district.

Immediate objectives of the RVWRMP emergency response are to: -

• Support and treat the people where diarrhea is epidemic in project areas – emergency actions to save lives of the victims such as distributing oral rehydration salts.
• Aware people and beneficiaries of RVWRMP through mass awareness campaigns – hygiene and sanitation campaigning is part of the RVWRMP project activities
• Involve in joint action of concerned district under epidemic control and management activities which is coordinated by the WASH committee and team in each district: solidarity on joint action to preserve the life of people.

The allocated fund can be utilized in each district, as is most appropriate and as decided through close coordination with the other WASH stakeholders, for rehydration salts, transportation of sick people and materials, chlorine and other water treatment solutions, and mass awareness campaigns through radio, local news papers, posters.

Suggested activities: -

• Each district will initiate the diarrhea epidemic management and preparedness meeting with WASH committee or other stakeholders in the district as soon as possible.
• Each district will verify the situation of epidemic and risk areas and make a plan accordingly based on decisions and understanding made in the district meeting.
• Plan will be finalized in DMC and will be forwarded to PSU.
• DMC will send a letter to aware the concerned VDC and UCs to take the precaution and implement the water safety measures urgently.
• Support and organize mass awareness campaign on hand washing, water safety, water treatment & handling, rehydration solutions, use of latrine, household and community level cleanliness among the others.
• Each district will procure chlorine or other water treatment chemicals locally to ensure that these are delivered in timely manner. At the same time their correct use must be guaranteed; in this regard oral rehydration salts are recommended as there have been reports on incorrect use of chlorine solutions resulting in more health complications rather than improvements.
• Mobilize radio FMs and local printing media for mass awareness and messages.
• One of district RVWRMP staff will be contact person in the district for immediate actions in emergency, coordination and communication in the district.
• Follow up the operation, maintenance and water safety plans which have been prepared during the post construction training of the Water Users Committees (WUC). Focus is to prevent such epidemics. UC & VDC also are responsible to organize mass awareness activities. Support and encourage them to be active.
• In case of patient management and medicines it should be handled by medical personnels only. In such situation, seek the support from DPHO and Health Post.
• Assess the situation of all RVWRMP work VDCs and other close by VDCs.