Ashok Kumar was impressed to hear that an international relief agency had been distributing aid in such a remote place. But the awe lasted only a few moments, as he soon learnt from locals they were selling medicines at double the price of pharmacists in district headquarters. He was not surprised. After all, he had already seen a health assistant drunk as a skunk at midday blabbering foolishly at the locals who came to seek advice for their children, children with sunken eyes and hollow cheeks and very loose bowels, who would probably die soon.
Kumar had also seen people cut their nails with a sickle and children in the second grade who could not tell a Rs. 100 note from a Rs. 10 note. He hoped to see at least a toilet in the area during his eight-day stay. He did not. This was Dailekh.
“We had to wake up in the darkness of early morning to go toilet in the fields, and had to be careful not to step on places where others had already relieved themselves. When it rained, the human manure flowed around, and we could see how easy it was for the various water sources to get contaminated and why people fall sick so frequently. We only had to look at the thick gravy-yellow sludge in the low-lying puddles near the fields to realise how backward these places really are,” Kumar, one of the volunteers recently back from the diarrhoea-affected districts in the Mid-West, described the situation thus.
According to the World Health Organisation, 94 percent of all diarrhoea cases are caused by poor hygiene and sanitation. Despite this sound warning, the volunteers who went to the region felt that the state has focused entirely on the curative part of treatment, and not at all on the preventive aspects.
“There are mule-loads of medicines and Jeevanjal, but the government has still not realised that those wouldn’t be needed in the first place if people were made aware of simple things such as washing their hands and not drinking water directly from the Bheri River. They will be sick again, and more medicines and more mule-loads of Jeevan Jals will be needed,” Thurba Moktan, another volunteer, said.
Each one of the 63 volunteers who went to the diarrhoea-affected districts of Rukum, Surkhet, Jajarkot and Dailekh had a similar story to tell. The volunteers were part of Paschim Paaila, a campaign that began in the first week of July during the National Youth Assembly, where Roshan Raj Shrestha of UN-Habitat had told the participants about the Mid-West epidemic. Soon after, participants started discussing it at informal meetings. They wanted to do something more helpful than simply discussing the problem, and arranged for representatives from donor organizations to be present at the meetings.
Within three days, an assessment team was sent to check the ground reality. Soon, the 63 were already working in the remote Mid-Western districts, at least Rs. 650,000 in cash had been collected, and 20,000 bottles of chlorine solution to disinfect drinking water had been produced by the volunteers.
Of course, there were problems, but none too great. A government director in Surkhet helped coordinate with the government. Sheer determination on part of the volunteers allowed them to cover large distances on foot. They also had to watch out themselves, as Dushala Adhikari, one of the volunteers, fell sick after sipping water from a stream. She contracted diarrhoea, but recovered within a day.
Adhikari, in retrospective, feels her illness reflects the entire issue. “I contracted diarrhoea on the way and recovered within a day, while people around me were dying of the same disease. People ask how can anyone die of diarrhoea in the 21st century. They do not realise that those who are dying are not living in the 21st century. They are 300 years behind us in terms of resource and awareness.”
The movement is still not over. There are more teams who have been readied to go, and the campaign has received help from other organisations. But what matters most, even now, is that this is not the first, nor will this be the last, diarrhoea epidemic to hit Nepal’s remote districts. The problem needs to be tackled at the very root of the issue, beginning from awareness about the disease to tackling illiteracy and poverty. Until then, an organism that only irritates people in urban areas will keep killing thousands in villages.