BARISAL, 28 November 2007 (IRIN) - Diarrhoea continues to remain a source of concern in cyclone-affected parts of southern Bangladesh, with private TV channels showing patients receiving intravenous saline fluid in the districts of Borguna, Patuakhali and Bagerhat.

Two weeks after Cyclone Sidr slammed into the country, Bangladesh health officials report just over 300 cases, but no reported deaths.

While health experts believe large-scale outbreaks can be contained, the risk of that changing is undeniable.

"Waterborne diseases like diarrhoea, typhoid, dysentery, and acute respiratory tract infections like pneumonia are common after natural disasters like floods and cyclones," Mohammad Abdul Baset, health director of Barisal Division, told IRIN, adding that children were more susceptible to diarrhoeal attack than adults.

"There is enough supply of oral re-hydration saline, intravenous fluids, water purifying tablets (WPT), antibiotics and safe drinking water," he said.

"It has not taken a severe shape," an army doctor working with a medical relief team in Morrelganj sub-district of Bagerhat echoed, stressing preventive efforts were now under way.

Situation "manageable"

Such sentiment was shared by others involved in the relief effort who described the situation as "manageable" - provided prevention efforts were maintained.

"We need to ensure safe drinking water at household levels," Paul Edwards, chief of the water and environmental sanitation section of the UN Children's Fund (UNICEF) in Dhaka, the Bangladesh capital, explained.

"Transporting water in bulk will not ensure safe drinking water at the family and individual level. People still need storage devices," he said, describing the availability of small containers like jerry cans as particularly important.

Ten thousand jerry cans from UNICEF stocks have already been dispatched, with another 110,000 ordered, he said.

Meanwhile, the military and non-governmental organisations (NGOs) were continuing their efforts to supply WPT and bottled water to those affected to meet the rising demand.

Polluted water

"There are not many diarrhoeal patients at the moment, although experts are expecting probable outbreaks in the coming days," A. H. Taufique Ahmed, UNICEF's divisional officer for Barisal, told IRIN, citing a number of risk factors.

Many water points like tube wells, ponds and dug-wells in the affected areas have been fully or partially destroyed, while rotten carcasses of animals and fish have contaminated many of the ponds where people draw their water.

"The entire water system in the region has been polluted with pathogens," Ahmed said, adding, however, that there was no need for immediate worry.

"The government has enough buffer stock of oral re-hydration salts [ORS], intravenous fluid, water purifying tablets and medicine in stock," he assured.

According to the UN Rapid Initial Assessment Report of 22 November, focusing on nine of the worst affected districts, the pre-positioning of essential drugs and medicines, including WPT, had proven a major advantage in terms of preparedness and response.

Distribution of medicines

However, Shubhankar Das, a local journalist-cum-aid worker, was less than confident.

"Yes, there is enough supply of ORS, WPT and medicine, and we should not panic over any major outbreak of diarrhoea. But that does not guarantee that these will reach the needy in time," Das said.

"Nothing good will happen unless the attitude of government officials, particularly of health officials at the district and sub-district levels, is not changed from bureaucratic to people-friendly," he said.

"Stocks of medicine do not prevent diseases. There has to be proper and timely distribution of ORS, WPT and other medicine," Das maintained.

More than 3,000 people were killed and millions more rendered homeless when Cyclone Sidr slammed into southwestern Bangladesh on 15 November in what has been described as the worst natural disaster to hit the impoverished nation in more than a decade.

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