Cholera_-_India

Cholera- India Members of the World Health Organisation; Ladies and Gentlemen and Guests. An outbreak of cholera disease has occurred in the Bengal region of Eastern India and is spreading throughout the country at an alarming rate. Cholera is a water-based disease which can kill a person within days, if not treated. There are also signs of the unrelenting disease spreading to neighbouring countries such as Bangladesh, Pakistan, China, and Sri Lanka. Although Cholera is usually not life threatening, it appears the symptoms need to be examined so that this disease is either eliminated or controlled. Poor nutrition, poverty and contaminated food and water can cause severe forms of diarrhoea. Diagram 1 shows people typically affected by Cholera. Some are being treated to replenish their vital fluids. (Hayhurst, Cholera, 2001, p.4) Diagram 2 KEY INDIA Map Source: http://www.google.com.au/imgres'imgurl=http://volunteer-nepal.abroaderview.org/images/cholera_map_asia.gif&imgrefurl=http://www.mountainvolunteer.org/abou Most scientists believe the first major cholera outbreak, took place in eastern India in 1817, in a region known as Bengal. Life was harsh, villages were poor, many were starving and under nourished, as drought left much of the land cracked and useless. Hence, it was difficult to grow food crops. The water that could be scrounged was dirty frequently contaminated with garbage and human sewage. In these most vulnerable conditions the world was bound to see the outbreak of a deadly disease called Cholera. According to Hayhurst, “The Vibrio Cholerae Bacterium thrives in human faeces. And in the unsanitary conditions of early 19th century India Cholera found a welcoming home as faeces made it into the water supply and ultimately into the guts of those who drank the water or washed their food in it.” The following diagram (3) illustrates the Cholerae Bacteria. An outbreak of cholera usually occurs in the wet season where the water is easier to contaminate due to runoff into the city’s water supply. Cholera is a disease causing a serious diarrhoeal condition which can potentially cause death if no medical attention is readily given. Medicine and public health are unable to keep up with the consequences of greater globalization such as trade and transport along the river routes. Meanwhile in India the sick and hungry sought help, they have crowded into relief camps and cities spreading Cholera as they seek another campsite. Diagram 4 illustrates poor sanitation and polluted water contributing to the spread of Cholera. India is most prone to outbreaks of cholera because it is often regarded as the most common of the poorest country in the world. Sub- standard sanitation, as illustrated in diagram 5 unfortunately has limited housing, and many of the people end up in the slums (Hayhurst, Cholera, 200, p.31). Therefore, the poor remain poor, and -overcrowding continues to contribute towards sub standard sanitation. Peter T. White, writing about Kolkata in National Geographic magazine 1973 wrote: “Dreadful, gruesome, frightening. The world’s largest slum. A disastrously overcrowded place where tens of thousands sleep in the streets… A dying city. A vision of the end of man…” (The Ganges p22). When people contract Cholera, they need to be treated very quickly because the disease moves incredibly fast. The infected who are farmers or business owners, especially need immediate treatment because of the economics of their situation. Farmers need to be well to tend to their crops of cotton, jute, cereals, pulses, rice and sugar cane because when the monsoon strikes, heavy rain storms cause flooding. New reports are suggesting that global warming will increase the amount of disease, especially occurring during the warmest months of the year. The Increases in daily and seasonal temperatures together with an expected increase in severe weather e.g natural disasters will make pathogens multiply and spread more readily. Thus, making a living for the farmer is extremely difficult The Disease has a devastating path of destruction- a path which continues even today. The skin becomes cold and droops, the circulatory system which keeps blood flowing to all parts of the body, may collapse. Blood pressure drops. The victim may go into shock, a condition that is life threatening when there is a lack of blood to the head. Other major organs, for example, kidneys may stop working. If nothing is done in just a few hours death is possible. Two alternative proposals will be evaluated for treating this disease against three criteria: affordability; long term effective proposal and a solution fair and equitable, practical and easily used. Two alternative proposals Scale: -10 to 10 I chose this scale to compare the negative and positive results of each proposal. Criteria | Proposal 1: Oral rehydration | Proposal 2: Cholera Vaccine | Affordability: | * Drinking 5/10 * Drip 10/10 | * Wealthy people 3/10 * Poor people -10/10 | Long term effectability: | * Drinking 6/10 * Drip 8/10 | * 2 months -3/10 * 6 months -7/10 | Socially acceptable: | * Drinking 8/10 * Drip 10/10 | * Religion -4/10 * Atheist 0/10 | Guidance for deriving the above figures was obtained through various tables and statistics. One proposition for the prevention of Cholera is for Oral Rehydration to be implemented, and this is achieved by using a mixture of water, salt & sugar to restore the fluid levels and electrolyte & carbohydrate levels. This process combats the diarrhea and stabilizes the patient toward a more speedy recovery. One essential ingredient here, is access to clean water, or the boiling of water before it is used. An alternate approach which has previously been tried, is the use of a specific Cholera Vaccine. Field studies have shown however, that this approach is not effective, because unless the source of the infection ( a clean drinking water supply ), the use of a massive scale of vaccines does not prevent the spread of the infection in the longer term. To evaluate the two alternate proposals, you have to consider that the recommended proposal is: 1. Affordable to the usually poverty stricken patients, 2. Effective over the long term, and 3. Socially acceptable in each particular location. Rattings of criteria for proposals Negative The most effective Proposal KEY (http://www.google.com.au/imgres'imgurl=http://www.reuters.com/resources/) This graph was obtained by comparing the data that was collected in the table above. By adding all of the ratings for the criteria it was possible to show which proposal is definitely the preferential one. The Oral Rehydration process appears to be affordable, as no expensive vaccine is required, and to date, it has proven to be most effective in the long term. This proposal is preferred because of its practicality in that a formulated oral rehydration solution, which is pre packaged. Finally, this solution is socially acceptable in all situations e.g. religion, because it does not require the use of injections or the introduction of foreign matter. The alternate proposal of using a vaccine, does have a number of negative impacts, being: * Vaccines are not as economical as common household ingredients of water, salt & sugar; * Mass vaccination programs have not proven effective over the long term, and * In some countries and specific religions, the taking of a vaccine is not socially acceptable. In conclusion, I recommend that the Oral Rehydration proposal be implemented, because it satisfies, the assessment criteria more completely. Thank you for listening BIBLIOGRAPHY: * http://www.google.com.au/imgres'imgurl=http://www.reuters.com/resources/ * http://www.google.com.au/imgres'imgurl=http://www.planetinsane.com/wp-content/uploads/2010/11/cholera-bacteria-300x229.jpg&imgrefurl=http://www.planetinsane.com/un-alerts-as-haiti-cholera-death-rate-rise/ * http://www.google.com.au/imgres'imgurl=http://volunteer-nepal.abroaderview.org/images/cholera_map_asia.gif&imgrefurl=http://www.mountainvolunteer.org/ * http://www.google.com.au/imgres'imgurl=http://thecatatthecatsdiarydotcom.files.wordpress.com/2010/03/ganges- * http://www.google.com.au/imgres'imgurl=http://www.flutrackers.com/forum/ * http://www.google.com.au/imgres'imgurl=http://www.siyanda.org/docs_gem/images/d_core1.gif&imgrefurl=http:// (Hayhurst, Cholera, 2001) (Dodd Law Meyer O’Brien, Senior Geography for Queensland 2, 2009)