Bihar floods: Pregnant women are most vulnerable as risk of disease looms

By the afternoon of September 1, four women had given birth in the Primary Health Centre at Patori block in Samastipur district of Bihar. The four of them and their infants shared two beds uncomfortably.

Three of them were affected by the floods in the area and had waded to the centre for help.

The health centre serves 20,000 people in five panchayats in the area. However, it just has six beds.

It is an imposing structure as it is set to be converted into a sub-centre – one step away from being a full-fledged district hospital – with 75 beds. However, the upgradation is still going on. With construction still in progress, the health centre’s floors were coated with construction dust.

Also in the ward was Kanchan Devi, 22. She was pregnant with her first child and was due in two weeks but had to be brought to the Primary Health Centre as she was in a lot of pain. When floods hit her village of Banghala in Patori block, Kanchan Devi did not leave her home, leaving her vulnerable to infections.

Sanju Devi, the accredited social health activist from her village, who tracked her pregnancy, had accompanied her to the primary health centre.

“The water was upto here,” said Sanju Devi, gesturing toward her stomach. “The road was broken. She was in a lot of pain, so I had no choice but to bring her here”. It took them more than an hour to cover the 10-12 km distance to the centre.

While Kanchan Devi writhed in pain, 22-year-old Soni Devi lay in a foetal position on one of the beds with her newborn. Her water bag had broken while she was wading through the floodwaters to reach the road where she could catch a rickshaw to the primary health centre. A resident of Hasanpur Surat village at Patori block, she delivered her fifth child at noon on Thursday.

Next to her was another first-time mother, Pushpa Kumari, 20, who had walked in waist deep water for nearly an hour to reach the health centre.

A resident of Sangrampur village, Pushpa Kumari had had a traumatic labour. “Bachdani fat gayi thi (Her uterus had torn),” said Kiran Devi, her worried grandmother. Premsheela, the accredited social health activist who had accompanied Pushpa Kumari to the centre, explained that the young mother-to-be suffered cervical tears during labour. The young mother looked pale and exhausted.

“We always have about four or five women delivering at any given point of time,” said Dr Jabaharlal Sahu, the medical superintendent in-charge of the primary health centre.

But why do they not have more beds?

“We have only six beds in total,” said Dr Sahu. “It has always been the case.”

The shortage of beds also meant that a woman who has given birth is not permitted to stay in the health centre for too long. Thus all the women who had delivered so far were supposed to go back home in the evening.

This worried Pushpa Kumari’s grandmother. “This girl is bleeding,” she said, “and they are talking of discharging her in the evening. How will she wade through water to go home in this state?”

Government relief

Two weeks ago, when the Ganga started flooding in 12 districts of Bihar – Begsarai, Bhagalpur, Bhojpur, Baksar, Katihar, Lakhisarai, Munger, Patna, Purnia, Samastipur, Saran, Vaishali – the State Health Society arranged for a survey of pregnant women in these areas and referred them to hospitals.

“This has been complied with in nearly roughly 100% of the cases,” said Jitendra Shrivastava, health secretary, Bihar. “We have had a record number of referrals this time.”

So far, the government identified 2,233 pregnant women of whom 828 were hospitalised, and 717 have given birth. The government also announced that it was giving eggs, milk and bread to pregnant women. Bihar Chief Minister Nitish Kumar also announced that women who delivered baby girls in relief camps would be given a sum of Rs 15,000, while those who delivered baby boys would be given Rs 10,000.

The state government had set up relief camps across flood-affected districts where flood-affected people were provided with freshly-cooked food. The state also set up health camps in 410 places, where nearly 2.6 lakh patients had been treated so far.

On Thursday, at north Dhamaon panchayat in Patori block, the medical officer, Dr Neel Kamal, had seen over 100 patients suffering from either diarrhoea, fever or skin rashes, among other diseases. The doctor had antibiotics, paracetamol and halogen tablets (used to purify water), and a few other essential medicines at his disposal.

Going home

Owing to the flood waters receding, several flood-relief camps in Bihar closed on Saturday.

After staying for a little over a week in a relief camp on Sonpur road in Vaishali district, the residents of Shahpur Daria village returned home. They were provided with food at the relief camp but were living under plastic sheets held up by poles near the road.

Back home, many houses were made of mud. While the water had receded, some houses had collapsed while others were damp. The homes of many people this reporter met were full of slush. The houses opened out to fields, which still had flood water.

“We have not got bleaching powder from the government,” said Dharamnath Rai, a daily wage worker in the nearby Gol Bazaar. “No government person has entered this village yet.”

The villagers complained that there were also many more rats and mosquitoes as compared to the time before the floods.

In a press release, the government said that state health officials were using bleaching powder, gamaxine powder (to kill rodents and other pests) and powdered lime to prevent diseases from spreading.

“We have to remember the immensity of the area also,” said health secretary Shrivastava. “We do not concentrate on small places. There is spraying across the entire state. Our aim is to decontaminate water sources – mainly wells and spray it around the cattle area. We cannot spray it around houses. We have apportioned a certain number of bags of bleaching powder.”

This reporter saw a sprinkling of bleaching powder outside a few houses.

Shahpur Daria village does not have any toilets, and villagers usually defecate near the river. However, after the river swelled up, they had to defecate just behind their houses, which is extremely unsanitary and makes them vulnerable to diseases.

Picking up the pieces

Sickness had also struck the residents of the village. Two-year-old Gulshan had been suffering from fever from the time his family fled their flooded home and took refuge at a relative’s house nearby.

“I borrowed Rs 10,000 from the relative we were staying in for his treatment,” said his father, Police Rai, who works as a daily wage worker with a sand mining company. “The doctor gave him a sui [injection] and the fever has come down now.”

Daily wage labourer Kamleshwar Mahlo too borrowed Rs 10,000 for the treatment of his three-year-old son Rauki Kumar.

“He was vomiting, and had big boils on his body,” said Mahlo. “I sent him with a relative to Patna. He is getting treatment from a private doctor.”

Some villagers had been bitten by animals such as pigs and dogs, and had approached private doctors for treatment.

Shrivastava claimed that the government had planned to send mobile medical camps to such areas, adding that these would refer serious cases to government healthcare centres. The government, he said, also had ASHA kits to distribute in all flood-affected areas in the state, which contain essential medicines such as oral rehydration solution sachets, paracetamol and soframicin ointment for skin infections.

The villagers were extracting water from hand pumps in the area, but did not have enough dry wood to boil it. Some villagers had lost their chulhas (hand-made mud stoves) to the floods.

Food was scarce, with many villagers complaining of an increase in the price of rice in the market. It has risen from Rs 22 per kg to Rs 28 per kg, said the villagers.

“I came home from work, and nothing was cooked,” said Dharamnath Rai. “We have to eat chivda now with some jaggery.”

Kamleshwar Mahlo’s mother, Lakshmidevi wept over their lost possessions, especially their stock of rice and wheat. They were barely eating.

“Look at our chulha,” said Lakshmidevi. "It has still not been lit."