Recent floods in South Asia have devastated parts of northern India, Nepal and Bangladesh. Millions of people have been affected and hundreds of thousands displaced. In a number of areas, the monsoon rains are said to be the worst in years.

Authorities and local aid organisations have been working hard to cover most of the current needs in the affected areas by running clinics, distributing basic relief items and getting ready for potential outbreaks.

Considering this strong local response, the MSF teams in Bangladesh, India and Nepal are now in an assessment stage. In India and Bangladesh, there is no need for MSF to assist with the medical response for now. In Nepal, a team is now assessing the situation.

Reaching the affected communities is a logistical challenge. Many roads have been cut off by the floods and it is very difficult to reach these areas. Therefore, MSF has decided to focus on the most remote areas that are not yet covered by other relief organisations.

MSF will continue to monitor the situation and may decide to intervene on a larger scale after the waters have receded. When people return to their homes, hygiene may be very poor, increasing the risk of disease outbreaks.

INDIA

MSF teams are monitoring the situation and assessing the needs in the northern States of Assam, Uttar Pradesh, and Bihar.

In Assam, where MSF was already running a malaria project, 26 districts are affected with some seven million people affected.

In Uttar Pradesh 20 districts are flooded. Two million people are affected, with 65 deaths.

So far, rescue and assistance operations have been carried out by the authorities and local organisations, who have distributed shelter, water and food parcels. The government has started to distribute chlorine tablets and bleach, to decrease the danger of contamination via polluted drinking water. So far no outbreaks have been reported.

People have sought refuge with their families, in government camps or in improvised tents in the higher regions. The water has started to recede, which enables people to return to their homes. However, this increases the risk of disease outbreaks.

MSF assessed some health centres which had been flooded, but the health staff had moved to buildings higher up to continue the work and they were coping with the situation. So the MSF team decided to focus on more remote areas in the coming weeks.

In the northern State of Bihar, it has been very difficult to get accurate information on the situation in the different areas affected by the floods. In order to get a clearer picture of the needs, the MSF team went to the different flooded areas to assess the situation. A number of local organisations are currently working in these areas.

Darbanga district seems to be the most affected district. Despite security problems in recent days, the MSF team managed to reach Darbanga on Thursday. Over the 40 kilometres to Darbanga, there is stagnant water on both sides of the road. After the flooding, between 1,000 and 1,500 people gathered in a makeshift camp in the city. But there has been no rain over the last week and these people are now starting to return to their villages. After the assessment in Darbanga, the MSF team will leave for East Champaran district, where there seem to be no other aid organisations.

Another MSF team has been assessing Saharsa district. The government and other organisations are working there and there is no need for MSF’s assistance for now. However, we remain vigilant as there is a risk of outbreaks of waterborne diseases in the next few weeks.

In Supaul district, which is on the border with Nepal, it took the team 7 hours to reach the most remote locations by boat and we are now waiting to hear what they found yesterday.

In Bihar, it is estimated that the water levels in some places will take 2 to 3 months to go down. Therefore the risk of outbreaks of waterborne diseases such as diarrhoea will be high in the coming weeks. Since there is no epidemiological research centre in Bihar, the situation needs to be kept under control.

BANGLADESH

Two teams are assessing the situation in the capital Dhaka and the north of the country. The diarrhoea hospital in Dhaka has admitted five times the normal number of patients. MSF is following the developments in the facility. The teams are preparing for developments after the waters recede. The water and sanitation situation is expected to deteriorate, which will enhance the chance of disease.

NEPAL

In the coming ten days teams will assess three districts in the southern state of Terai.