Chennai Floods: The worst might be over, but keep diseases at bay with these health tips

People have been wading through water over several days, so the number of water-borne, vector-borne, person-to-person communicable diseases are those that the state government, NGOs and volunteers working in the field need to worry about.

• People wading through waterlogged areas during the flood

Throughout history, disasters, both natural and man-made, have a strong relationship with disease outbreaks. This is often related to the displacement of people and has been known since the age of Pericles and the plague of Athens in Ancient Greece during the Peloponnesian wars. This has played out again and again since then, including in major wars, but this association is now seen commonly after natural disasters like floods, tsunami, volcanic eruptions, drought and earthquakes.

The disaster in Tamil Nadu due to the recent rains and floods is already seeing an outbreak of various diseases. The risk and magnitude of any outbreak can be assessed based on the diseases that are pre-existent in the community, the existing infrastructure, nutrition and health status, ability to restore safe water and drainage and availability of health care. Given that Chennai and other parts have seen tremendous waterlogging and people have been wading through water over several days, the number of water-borne, vector-borne, person-to-person communicable diseases and those related to the disaster, are those that the state government, NGOs and volunteers working in the field need to worry about.

Types of diseases likely to surface

Firstly, water-borne diseases that are likely to surface in Chennai now include viral gastro enteritis, cholera, typhoid, hepatitis A and E, leptospirosis among others. If people remember, there was a spike in cases of leptospirosis in Mumbai after the 2005 floods. Waterborne diseases can be mitigated here by ensuring that the water is drained out as quickly as possible in the city and safe drinking water is provided on a war footing.

Secondly, vector-borne diseases that are likely to emerge include dengue and malaria. Others like West Nile virus are also possible. These are primarily mosquito-borne, so stagnant water is a perfect breeding ground. Draining inundated areas in Chennai is key to control and moving people out of such areas is also helpful.

Lastly, person-to-person communicable diseases are usually related to overcrowding in close quarters. Diseases like influenza and upper respiratory infections tend to spread faster this way. This was, in fact, the leading cause of death in those displaced by the 2004 tsunami in Aceh and the 2005 earthquake in Pakistan. Measles outbreaks have also been documented in these conditions. In Chennai, there are reports of chicken pox outbreak in a relief camp. This also needs to be addressed quickly.

Other diseases are related to the disaster itself, and this includes tetanus, skin problems, including allergies and fungal infections. There have been rumours about dead bodies and the risk of transmission of diseases - these are overhyped, and there is yet to be any documented outbreak in the setting of the floods.

Prevention and tips on health safety

Prevention and mitigation of these diseases, in Chennai, Cuddalore and other areas, needs a multi-pronged strategy. Obviously, drainage of the water and establishment of safe water and food services is key. People should not remain marooned, but staying too long in relief camps puts them at risk for other problems. The earlier the situation improves and the earlier that people can return home, the safer it is from the infection point of view. People should avoid wading in water, if feasible.

Safe water can be achieved by boiling water for a full minute. If there is visible contamination, bleach (1/4 to 1/8 teaspoon to a gallon or 16 cups of water) can be useful. Reverse osmosis systems are also an option. Food safety is key, and the role of food handlers in the propagation of diseases is often forgotten. Aid workers should stay away if sick, and should wear gloves when handling food. Vaccination against tetanus, typhoid and influenza seems prudent. Mosquito prevention measures are useful, but these need to be used through the day.

Don’t medicate unnecessarily

At this point, abuse of medications, especially antibiotics, is a problem. Most patients do not need any. Establishment of appropriate primary care system with doctors trained in disaster-related disease management will go a long way in containing the situation. Studies have suggested that a single dose of doxycycline may be an option in reducing the risk of leptospirosis in those wading through water. It is only required for those with infections like typhoid. In general, the alarm symptoms that require immediate medical attention include:

1. Diarrhoea/vomiting and not passing urine

2. Fever with shaking chills

3. Jaundice

4. Fever lasting more than 3 days

5. Breathing difficulty and shortness of breath

6. Illness in people whose immune system is not normal- like kidney failure, transplant

Dr Subramanian Swaminathan is MD AB Infectious Diseases, Consultant, Global Hospital

Chennai rains: Narendra Modi mocked and Jayalalithaa heckled after Chennai floods

Yet, within hours, Modi became the object of mockery on social media after his press office released a doctored photo of him inspecting flood damage. For both him and Tamil Nadu Chief Minister Jayalalithaa Jayaram, the image of strong leadership created by their publicity machines was undermined.

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One of India's most powerful politicians, a former movie star called "Amma" or "Mother" by her followers, is being heckled and abused for going missing in action after floods swept the capital of the southern state of Tamil Nadu, which she rules.

It's a salutary lesson for Prime Minister Narendra Modi, who at first drew nods of approval when he rushed to Chennai last week, promising to stand by its people in their hour of need.

Yet, within hours, Modi became the object of mockery on social media after his press office released a doctored photo of him inspecting flood damage. For both him and Tamil NaduChief Minister Jayalalithaa Jayaram, the image of strong leadership created by their publicity machines was undermined.

Until the floods that ravaged the city of 6 million, the lofty remoteness of Jayalalithaaadded to the aura around a leader with an almost hysterical following. Devotees of the 1960s screen idol have immolated themselves in her defence in the past.

Now, she faces a backlash from residents fed up with the sight of her image on billboards, aid packets and her own Jaya Plus TV channel. She has been since in public only twice during the crisis - once with Modi.

Angry youths heckled a state minister and officials in Jayalalithaa's north Chennai constituency, where people were sitting on the roadside amid sludge and mountains of garbage, their shanties swept away by the worst rains in a century.

"Forget about Amma coming here, there was no sign of the party cadres," said one of them, called Dorairaj.

About 280 people have died across Tamil Nadu since torrential rains on Dec. 1 submerged tracts of Chennai under up to eight feet (2.5 metres) of water, trapping people on rooftops with no communication.

There was further revulsion after a party legislator put up a poster of Jayalalithaa lifting a baby above the floodwaters, in a scene from a blockbuster movie. "Adding salt to the wounds," said one Twitter post.

Avadi Kumar, a spokesman of her ruling AIADMK party, said there was anger among the people but the administration was doing all it could to bring relief: "It is impossible to reach all areas immediately or be present everywhere at all times."

GOOD DAYS 

Modi's own promise to voters of good days to come for India is also starting to face disenchantment, 18 months into his five-year term, with key reforms stalled by bureaucratic inertia and political gridlock.

Ambitious initiatives, such as a "Clean India" campaign, have made little headway - even as Modi has built up huge followings on social media and addressed enthusiastic diaspora Indians at packed stadiums on his many trips overseas.

"If today he appears to have lost control over his own narrative, it is his own fault," commentator Tavleen Singh wrote in Sunday's Indian Express, urging Modi to hire a professional media team. Modi does not have an official spokesperson.

Jayalalithaa, 67, in the past considered as a possible prime ministerial candidate backed by regional groups, faces an election in Tamil Nadu next year.

Modi's nationalist party has little presence in Tamil Nadu, a state of 70 million. It would rather the iron-fisted Jayalalithaa stays in power, believing she is more inclined to back his reform agenda in parliament than her rivals.

But there are concerns around her health and that she may have to curtail her campaign.

Earlier this year a higher court acquitted her in a graft case for which was briefly jailed which had caused an outpouring of anger from her supporters. Some lay down on roads and tried to persuade bus drivers to go over them.

"She is supposed to be a fantastic administrator. But this time there was no presence of government at all. Ordinary people did all the work that government and police were supposed to do," said S. Raja, one flood-hit resident of Chennai.

Chennai floods: Brand Amma could take a severe beating for inefficiency

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When Jayalalithaa was voted into power as the Chief Minister of Tamil Nadu, the expectations from here were high. People felt that she could undo all the wrongs done by the previous government focus on the people of the state. And she did. The Chief Minister of Tamil Nadu did everything from setting up Amma Canteens, Amma Water, Amma Cement to launching a state health scheme that provided plenty of free benefits for women and children.

But what happened during the rains and ensuing floods that hit Chennai and many parts of Tamil Nadu – especially over the week - is a completely different story. The state machinery that should have kicked into action immediately on December 2 in rescuing and providing relief to people seems to have gone missing in action.

TASMAC​ open despite the rains
While it was pouring incessantly with houses and buildings being submerged in three to five feet of water, the Tamil Nadu State Marketing Corporation liquor shops were fully functional. In fact, they even functioned under candlelight when power was out. Many of the inebriated men were found to be harassing women. Citizens were heard complaining about how this seemed to be the one state department that seemed to functioning extremely efficiently during this horrific time in the city. Many people have requested that the TASMAC shops be shut for a few weeks till the city returns to normalcy.

Amma stickers on relief items
While thousands of people were trying to get one meal a day and struggling to rebuild their lives, many men who were allegedly AIADMK volunteers were busy sticking Amma posters on relief supplies that were being distributed - not by the state - but by ordinary citizens. People on Twitter alleged that trucks carrying relief supplies were being allowed to pass through to areas only if the items had Amma posters on them. The efforts of good samaritans were seen to be hijacked by partymen who had nothing to do with the massive relief efforts undertaken by the public. There was outrage on social media and even on the ground by people over this act​.

Citizens perform relief and rescue operations
Citizens of Chennai came together and mobilised relief and rescue efforts. Today, Facebook, Twitter and WhatsApp are filled with groups who are diligently working 24X7 mobilising relief supplies and teams to distribute them. Volunteers have come out in thousands to help Chennai and Cuddalore. People in other states are collecting relief materials and sending them by the truckloads. The big question being asked where are the partymen to help people and where is the state machinery on the ground? A state minister and partymen who visited parts of North Chennai were heckled when they finally did turn up to see the ravaged area.

In lieu of all this, Brand Amma could take a severe beating and have an impact on the impending elections in 2016.

Nestle supplies Maggi noodles to rain-hit Chennai

After remaining at loggerheads with the government over ban on Maggi noodles, Nestle India was on Sunday listed among the top suppliers of food and beverage products for people affected by heavy rains in Chennai.

Among other products, Nestle has also supplied the 'two-minute' Maggi noodles to the Tamil Nadu government towards the relief operations.

In a statement, Minister for Food Processing Industries, Harsimrat Kaur Badal said that the industry should ensure that there is no shortage of milk, packaged food articles and bottled water for the people of Chennai.

"It is time to stand up and make exemplary contribution for the flood affected people of Chennai who have been patronizing food brands and products manufactured by the industry," she said.

The Ministry of Food Processing Industries said it is coordinating with all food processing companies for supply of packaged milk, packaged food and bottled water and also listed out names of eight companies who have made available supplies of food and beverage products to the Tamil Nadu Government at Nehru Indoor Stadium in Chennai.

The list of seven such companies included Nestle India on the top with supplies of 10 MT of noodles, 5000 litres of tetra packed milk and 50000 pouches of coffee.

"Further additional quantity approximately 25-30 MT of noodles, about 8 MT Munch and Sunrise Biscuits 800 Kgs is also being supplied," the Ministry statement said.

Nestle's Maggi noodles were banned by the central food regulator FSSAI and various state food departments over alleged presence of lead and taste enhancer MSG beyond permissible limits, but the ban was later lifted after orders from the courts. The product was recently relaunched.

Besides, ITC has supplied 6 truckloads consisting of 3163 boxes of biscuits. MTR has supplied about 14128 ready-to-eat food packets and another quantity of 35000 ready-to-eat food packets will be delivered by Monday.

Britannia has supplied 3 truckload of 345 boxes of biscuits today and remaining 2 truckloads of food items. They have also been requested to supply additional quantity of milk produce and some bread.

Coca Cola India has supplied ready with 50000 one liter water bottles, while Pepisco has supplied 12000 one liter water bottles and arranging transport to supply today.

Parle is arranging to send 3 truckload of Parle biscuits, it added. 

Telecom department changes verification process of new mobile connections

All mobile service providers will now be following a new verification process of new mobile connections. The telecom department’s access service cell, which is a competent authority, has ordered all the mobile service providers to follow the alternative process to existing process issued for verification for new mobile connections.

The alternative process covers service providers having service authorisation licenses, including CMTS, UAS, and UL (AS). Under the new process, the entry of various fields in customer applications form (CAFF) should now be made electronically instead of manual writing. In addition, the photograph of the customer should now be taken at Point of Sale (PoS) itself and the same should be populated in the CAF instead of pasting the photo in the existing process.

Further, the scanned imaged of the Proof of identity (PoI) and Proof of Address (PoA) documents furnished by the customers should be embedded in the CAF.
TelecomTalk has reviewed the order letter, titled “Customer application form embedded with photograph and scanned images of Proof of identity (PoI) and Proof of Address (PoA)”. The letter also says that the copies of PoI and PoA documents submitted by customer should also be attached and maintained along with CAF as in the existing process.

“It shall be ensured that the scanned images of PoA and PoI/ photographs captured at PoS should not be stored at PoS terminal to avoid any misuse of the same,” the letter read.