Some of the highest temperatures seen in the last decade and severe power cuts are putting pressure on water supplies, exacerbating the diarrhoea situation.
More than 1,000 diarrhoea patients a day are seeking help at Dhaka specialist hospital for diarrhoeal diseases (ICDDR, B): Its capacity is being pushed to the limit as it can only accommodate 350 patients at a time.
The city experiences outbreaks every year, but this one is looking particularly bad. According to the ICDDR, B, 19,000 patients were admitted in March 2009 compared with 7,890 in March 2008. In April 2009 some 23,000 were admitted compared with 13,932 in April 2008.
Over half of those needing treatment at the ICDDR, B are children.
The death toll from the recent outbreak is 37, with most dying on the way to treatment centres, according to sources at the Directorate General of Health Service (DGHS).
"The scorching weather has given rise to a shortage of safe drinking water, which is the primary cause of such a high number of patients. If the weather continues… the number of diarrhoea patients will continue to increase,” Shahadat Hussein, head of the Longer Stay Unit at ICDDR, B, told IRIN.
Piped water is the primary source of safe drinking water in Dhaka but in the slums, where over 1.3 million of Dhaka’s residents live, only one in four households have any form of safe drinking water connection (Bangladesh Bureau of Statistics, 2005).
Symptomatic of the seriousness of the situation is the fact that the Department of Health has ordered all health care centres in Dhaka to provide round-the-clock services.
Health Minister A.F.M. Ruhul Haque also announced the opening of temporary treatment centres across the capital, but by 4 May, just one such centre at Mirpur Ayurvedic College had opened.
According to Dhaka Water and Sewerage Authority (WASA) sources, power cuts of 8-12 hours a day are affecting water pumps and resulting in water shortages.
|The ICDDR,B has erected tents in the parking lot to cope with the overflow|
Dhaka’s slum-dwellers are being forced to use contaminated sources of water - rivers, ditches, ponds and puddles. Even water supplied by WASA is often murky and foul.
According to Azharul Islam Khan of ICDDR, B, the sweltering heat has also led people to buy cheap sherbet drinks made with contaminated water.
ICDDR, B doctors said most patients were from the lower income groups, and many had no permanent residence, or safe water supply.
Whilst boiling the water would help stave off infection, the fuel required was expensive and kept mainly for cooking by slum-dwellers (who make up nearly 30 percent of the city’s population).
Poor sanitation in many areas combined with the hot weather was making matters worse.
“E. coli bacteria and rotavirus are primarily responsible for diarrhoeal infections... The heat helps pathogens proliferate faster than cold conditions,” ICDDR, B’s Shahadat Hussein told IRIN.
“We are dealing with both kinds of infection in this recent outbreak. Rotavirus infection is predominant among children, while E. coli is the primary suspect for infection among adults,” he said.
He told IRIN the more severe cases of dehydration were treated with intravenous rehydration and Oral Rehydration Therapy (ORT) accompanied by zinc supplements. Less severe cases, in addition to ORT, were given liquid food.
Diarrhoea is one of the primary causes of child death in Bangladesh. According to research by the UN Children’s Fund (UNICEF) in 2004, 36,000 children under five 5 die of diarrhoea every year.