After the floods, the threat of leptospirosis and other infections looms large in this Mumbai slum

On Tuesday last week, Malathy Devendra worried as water rushed into her house. Devendra, who lives in small house made of tin sheets in a slum in the Govandi suburb in Mumbai with her husband and six children, even thought that they might all drown. “The roof was leaking and water was entering the house from all four sides,” she recalled. “It was raining so heavily, that I thought that the roof would collapse.”

Lakhs of families live in such houses in Govandi. Their only protection against heavy rains, like the downpour on Tuesday, are blue tarpaulin sheets spread on roofs to stop water from seeping into the houses. But, that day, as the streets of Mumbai flooded, these homes quickly filled up with water entering through the doors and even seeping in through non-tiled floors.

In Govandi, flooding does not just bring rain water, but also sewage from overflowing drains and toxic runoff from the garbage dumping ground in neighbouring Deonar.

“We could see plastic wrappers [discarded in the garbage dump] floating in the water,” said Shabnam Qureshi, who lives with her son in a Govandi slum called Indira Nagar. “I saw so many centipedes and some other insects crawling in the house.”

The floor in Qureshi’s house is just a layer of mud on which the family lays mats to sleep. “The roof was leaking and water was oozing out of the ground,” said Qureshi. After the Tuesday rains, she placed paver blocks, normally used to pave footpaths in the city, as flooring.

Both Qureshi and Devendra and members of their families fell ill with fever following the rains on Tuesday. “I went to the municipality dispensary and my son took a paracetamol as he didn’t have time to go to the hospital,” said Qureshi.

Devendra borrowed Rs 200 from her neighbours to take her one-year-old son Yogesh to a private clinic. During the rains, Devendra’s children took shelter in the loft of the house even as water from the drain outside flooded the house below, submerging the family’s few belongings. “Yogesh was on the loft with all the children.,” said Devendra who was sitting on a plastic can placed in a pool of water that had not cleared since the rains. “His body was burning but we could not take him to the doctor.”

Devendra’s 14-year-old neighbour Sanah Parveen also fell ill with fever. “All the clothes were wet, we were wearing the same wet clothes throughout the night,” she said.

More rain, more disease

The municipality dispensary in Govandi’s Baiganwadi – the locality that also has Mumbai’s oldest and largest dumping ground – has seen more patients with complains of fever, body pain, skin infections since the rains last week.

“Most patients here have skin infections owing to the poor living conditions,” said Dr Suresh Uchale, medical officer of the dispensary. “There are also cases of viral fever, which are not unusual in monsoon.”

Health authorities and doctors in the area are, however, keeping an eye out for signs of leptospirosis infections. Leptospirosis is spread by the bacterium Leptospira that causes fever, headache, bleeding, chills and vomiting and, if not treated in time, can lead to liver and kidney failure and even death. The bacterium is often found in the urine of infected animals like rats, dogs, pigs, cattle, all of which are found in abundance in the Deonar dumping grounds. As rain water washes through the dumping grounds, seeps into Govandi’s slums and accumulates in its their streets, people wading through the water are exposed to the infected urine. Those with cuts or bruises on their legs and feet are especially at risk of contracting infection. When Mumbai flooded in July 2005, many parts of the city and adjoining districts witnessed similar waterlogging and there was a surge in the number of cases and deaths owing to leptospirosis.

Even before the rains and flooding last week, Mumbai recorded 27 cases of leptospirosis between August 1 and August 15.

Leptospirosis can be treated with antibiotics. But the Brihanmumbai Municipal Corporation’s health department is taking preventive measures and has issued a health advisory asking people to take a prophylaxis treatment against leptospirosis, which involves doses of the antibiotic doxycycline for those at risk of exposure and doses of azithromycin for pregnant women and children.

“The prophylaxis works best when given within 48 to 70 hours of the exposure,” said Dr Om Shrivastav, infectious disease consultant from Mumbai. “After that if someone has contracted the infection, they will start exhibiting symptoms and will have to be given the necessary [antibiotic] treatment.”

Since Tuesday, The city corporation has administered prophylaxis to 24,898 adults, 1,261 children and 74 pregnant women in different parts of the city who had waded through flood waters.

However, given that the efficacy of the prophylaxis is time bound, the civic body’s health department is struggling to deliver the treatment in Govandi. On Friday, more than 48 hours after the rains and flooding, Scroll.in visited many homes in Govandi where families had not been contacted by health workers for treatment. “We are trying to cover as much population as possible but it is impossible to cover the entire slum,” said a medical officer from the locality.

Leptospirosis is only one of the many risks from the toxic waters that have flooded Govandi.

“We don’t know the long-term health consequences of this toxic water entering the homes of this marginalised population,” said Arun Kumar, the chief executive officer of Apnalaya, a non-governmental organisation working in these slums.

No food, lower immunity

Already at risk for many infections, the residents of Govandi have also been left with depleted food stocks after the rains. The flood waters soaked the grains stories inside homes. “There was only one cot in the house,” said Laadli Parveen, a mother of four. “We all were sitting on the cot to save ourselves throughout the night. There was no chance of saving our grains.”

Devendra’s children went hungry on the night of the floods. “I had saved money to so I can buy food grains in bulk at a cheaper rate,” said Devendra. “All that is gone.”

She bought half a kilogram of rice the next day to feed her large family.

“The corporator comes asking for votes but he didn’t think of sending us some food that night,” said Qureshi agitatedly.

Several children in the area are already malnourished who are more likely to fall ill because of their low immunity. Health activists said the disruption caused by the rains has affected malnutrition control programmes being run in the slums. “Many children have been suffering from diarrhoea after the rains,” said Sunita Choure, programme manager at Apnalaya.

Meanwhile, the already poor residents of Shivaji Nagar are spending hefty sums of money to rebuild what they lost in Tuesday’s floods and protect themselves against other similar incidents. Jahira Banu took a loan of Rs 20,000 from a local money lender to plaster the mud floor of her house. “I first tried to fill the land with some sand, I purchased but the water still kept on oozing out of the ground.”

Banu, who does zari work, plans to pay her loan installments by stitching more. “I will have to work late nights but at least next time when it rains like this, our house will not be destroyed completely.”