DHAKA, 1 May 2008 (IRIN) - Diarrhoeal diseases have broken out across Bangladesh as temperatures soar and sources of safe drinking water dry up. Since 21 April at least 10 people have died. Thousands of others languish at home or in hospitals, but no one knows the real statistics.

Diarrhoea is a waterborne disease that the government says kills an estimated 25,000 people annually, mostly children.

Hospital sources say hundreds of people with diarrhoea and dehydration - mostly children - are arriving at hospitals across the country daily. As of 30 April diarrhoeal diseases have been reported in 49 of Bangladesh's 64 districts, with over 18,000 people affected over the past 10 days.

According to the Bangladesh Ministry of Health, over 4,000 new patients were admitted to government hospitals in 49 districts on 26 April alone.

Some 556 patients were admitted to the International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR, B) on 25 April, followed by 602 the following day. On an average day 180-200 diarrhoea patients are admitted to the facility.

In Chittagong, the commercial capital and the country's second largest city, over 5,000 patients reported to various government hospitals in the city's 14 sub-districts from 22-30 April.

Actual figures much higher

"These are officially recorded figures. The actual number should be 5-8 times more than that," said Motasim Billah, who runs a medical clinic in Dhaka.

Official figures included only those cases reported to government hospitals, while most of the diarrhoeal diseases occur in remote villages where no government facilities exist, he explained.

"Even in urban and peri-urban areas, where people are supposed to be aware of the harm that diarrhoea inflicts upon its victims, especially children, only a few take their patients to hospitals, and only when the patient is severely ill. Most of the diarrhoeal cases are managed at home," said Fazle Rabbi, a doctor at ICDDR, B.

"The reason for the sudden spike in diarrhoea cases is the very high temperatures and this is coupled with a lack of safe drinking water," he explained.

Azharul Islam Khan, head of the short-stay unit at the ICDDR, B, said 60 percent of those who reported to the hospital required admission. Others were given outpatient treatment and counselling.

Poor suffer most

Health experts said the poor and people from lower income brackets were the main victims of diarrhoea as a result of a lack of awareness about safe drinking water, poor sanitation, and the fact that rising food prices were driving more and more of them to seek cheaper food, which is often contaminated.

"Poor people are consuming stale and rotten food due to rocketing food prices and drinking unsafe water," said Habiba Khatun, assistant director of disease control at the health services directorate.

"Low-income people who rarely have access to pure drinking water and hygienic conditions are contracting the disease," said Jahangir Hossain, a scientist at the clinical sciences division of ICDDR, B.

Rahmat Ali Mia, 24, an umbrella repairer in Dhaka who was admitted to the ICDDR,B, said he contracted diarrhoea after consuming food and water from a street vendor the same day.

"I was hungry and could not wait to wash my hands. The food was cold and there were flies around," Mia said, adding that the water he drank afterwards at the open-air eatery may also have been contaminated.

"They say the water they serve is from tube wells. Who knows how honest they are?" asked Mia lying on his bed, receiving intravenous fluid from a stand nearby.

Twelve-year-old Jainal Abedin was admitted to the ICDDR, B on 26 April with severe dehydration. He had had a glass of melon juice from a street vendor the previous afternoon.

"He returned home with severe stomach pains. He went to the toilet more than 20 times and then fainted. We took him to the hospital at 3.30am," said Jainul's mother.

The diarrhoea cycle

"The number of diarrhoea patients peaks in May. From now on we expect the number of diarrhoea patients to keep increasing each day," said Iqbal Hossain, an associate scientist at the ICDDR,B.

In Bangladesh diarrhoea hits two peaks, one in April-May and the other in September-October.

Though health experts do not consider the present situation an "epidemic" or "critical", they advise people to be cautious and observe better hygienic practices.

"To prevent diarrhoeal diseases during the hot spell, families must maintain their personal hygiene - that includes the washing of hands after using the toilet, giving fresh boiled water to children and feeding children hygienic food," said Khan of the ICDDR, B.

sa/ds/cb

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