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Making Bharat Swacchh & Diarrhoea-free

“If we remove the garbage littered around us, keep our surroundings clean, prevent open defecation, it will help us eradicate diarrhea from our midst and keep Bharat Swacchh.. Diarrhea is easily preventable,” points out epidemiologist Dr. Dipika Sur, referring to India’s Swacchh Bharat campaign.

New Delhi, Feb 21 (GnY News Service): An Interview with Dr Dipika Sur, Scientific Director, PATH India. Dr Dipika Sur is an epidemiologist and one of India’s foremost medical researchers who has specialized in diarrhea and enteric diseases. She is also Secretary General of the Indian Public Health Association (IPHA).

The government is promoting Swacchh Bharat in a big way. This is very much in line with the theme of the World Public Health Conference you are hosting in Kolkata- Healthy environment, healthy people. In what way can the Swacchh Bharat campaign, in your opinion, help control diarrhoea?

Diarrhoea and enteric diseases are caused by contaminated food and water. Since Swacchh Bharat is aimed at maintaining cleanliness, it should definitely help. Every year, more than 7 lakh children die of diarrhoea the world over. If we remove the garbage littered around us, keep our surroundings clean, prevent open defecation, it will help us eradicate diarrhoea from our midst. Diarrhoea is easily preventable.

How far is climate change, erratic weather and rainfall patterns contributing to diarrhoea and enteric disease?

Diarrhoea is a disease very dependent on the weather. Sudden spurts in rainfall and temperature are conducive for the virus, which needs the right environment to multiply. Summer and monsoon are the seasons we need to be particularly careful in the tropics. Hence, there is clear contribution to a disease like diarrhoea.

Dr Dipika Sur BIG

G’nY file photo

WHO keeps mentioning breastfeeding as one of the best ways to prevent diarrhoea. One does understand that breastmilk can prevent disease and bring up healthy children. But given the fact that most mothers are malnourished, anaemic and weak at childbirth in India, can breast-milk always prove a solution?

Whatever be the status of the mother’s health, the breastmilk remains the same. It is God’s gift to all humankind, I must say. The nutrients in the mother’s milk remain the same; and so do the qualities of rendering immunity to the child. The quantity may differ; thus, you can have a mother who produces a lot of milk, while another does not produce anything at all, or only a negligible quantity. But a malnourished mother‘s health can get terribly affected when she nurses her little one, unlike that of a strong, well-nourished mother.

Of the three clinically known cases of diarrhoea, that isacute watery diarrhoea ,acute bloody diarrhoea or dysentery; and persistent diarrhoea-what is most common in India?Are there differences between the kind encountered in Indian children, and those in Ethiopian or Kenyan children?

In India, acute, watery diarrhoea is the commonest type. This is the commonest all over the developing world, where water and sanitation are a major problem. Since this type is very contagious, and spreads through contaminated water, it can affect a large number of people in no time. Bloody diarrhoea or shigella spreads through contaminated food. Hence, it will affect only the one consuming such food.

Generally, ORT (oral rehydration therapy) is the first step to stop diarrhoea. Yet, contaminated water in slums is the single-most reason behind the disease. Can boiling of water, even if it be contaminated, control the problem?

Preparing of ORT ought to be done after boiling the water. We recommend rolling boil for at least 10 minutes, if we intend to use the water for ORT. If water is extremely bad, as during a natural disaster, we recommend using chlorine tablets to disinfect the water. But remember, ORT is not the treatment for diarrhoea. ORT is to prevent dehydration, and hence death. Dehydration due to fluid loss is the major cause of death in any diarrhoea. The disease is in itself,self-defeating. For treatment, we have a couple of vaccines that are already in the market. But the prices being prohibitive, the Government has yet to introduce it in the healthcaresystem.

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