Militants blow up a an electricity sub-station, causing tube wells and the water supply to be disrupted; people resort to using dirty water and then fall sick. This, in a nutshell, is what has happened in parts of Swat Valley in North West Frontier Province.
Thousands have descended on Saidu Teaching Hospital (STH) in Swat District complaining of diarrhoea, stomach ache and vomiting over the past few weeks.
Over 2,000 have visited the hospital since 2 October, amid rumours that cholera had erupted in Saidu Sharif, capital of Swat District, about 3km from the city of Mingora, where the grid station was blown up by militants.
Swat Valley has been no stranger to militants, arson attacks and indefinite curfews in the past year, say local residents and observers.
"It's not cholera," said Mohammad Khan, medical superintendent at the 500-bed STH near the River Swat. "It is acute watery diarrhoea which is also known as gastroenteritis and the media is misinforming people," he said.
The first day, he and his team treated over 700 patients. "We are trying our best but we will not be able to carry on if the numbers increase," Khan said.
Most patients are sent home after simple re-hydrating treatment. So far there have been two deaths. Treatment, which includes intravenous drips and antibiotics, is dependent on a steady supply of medical stock.
The World Health Organization (WHO) has sent cholera kits (also used for treating gastroenteritis) for 2,000 patients and samples are being collected to rule out cholera.
Photo: Zofeen Ebrahim/IRIN
|With water supply disrupted people started fetching water from streams, which are extremely contaminated, according to officials|
Water supplies affected
The militants’ action has left Mingora and nearby towns without electricity for over two weeks.
"The power breakdown meant tube wells stopped working and the city water supply got disrupted. People started fetching water from streams which are now extremely contaminated," said Khan.
"People think because they are using running water, it is clean. What they fail to understand is that they wash their clothes, bathe and even defecate in the same water they use for drinking. Even untreated sewage finds its way into these streams," said Owais Yaqoob, a doctor at STH.
Though the number of patients at the STH has come down to 258, doctors like Yaqoob warn against complacency: “The worst is still not over and more needs to be done," he said.
"A worrying aspect is that gastroenteritis seems to have spread to other areas and that is not good news… It means that it is infectious,” said Yaqoob who is treating patients coming in from far-flung areas like Kabal and Char Bagh.
|A worrying aspect is that gastroenteritis seems to have spread to other areas and that is not good news… It means that it is infectious.|
The executive district health officer in Swat, Bakht Jamal, is trying to promote preventive measures that people can take. He is mobilising the mosques, and vehicles are making announcements through loudspeakers at street corners telling people to boil water and wash hands with soap before eating, and after visiting toilets.
Meanwhile, Médicins Sans Frontières (MSF), a non-governmental organisation which has been working in the conflict zones of Matta and Kabal in the past year, and has established small medical units in these districts, has hired three generators which are running tube wells on a rotational basis in Mingora city so people can access clean water. WHO teams are also distributing chlorine tablets in Mingora.