Two Médecins Sans Frontières (MSF) teams have started providing medical care to the victims of the floods in the northeastern Indian state of Bihar. Staff have also started the first emergency relief distributions in various locations and displaced camps, as well as the necessary assessments, in the districts of Araria (the most affected area), Supaul, Purnia, and Madhepura.

While assessing the needs, and now that the roads are becoming passable again, MSF staff have organised mobile clinics in several locations in order to address the medical needs of the populations, particularly in those western areas of Araria district where relief has not yet reached. Last Tuesday, for example, in the Parwaha area alone, over 100 medical consultations were carried out.

The people displaced by the floods have gathered in makeshift camps, some in the open, others sheltered in structures such as schools, and globally under dire sanitation conditions, in particular access to drinking water limited to some hand-pumps, reduced number of latrines, lack of hygiene facilities and items (showers, soap, etc), and a considerable presence of cattle.

Official estimates speak of about 50 camps in such conditions in the affected areas currently hosting about 30,000 people. Moreover, nearly 400,000 people possibly trapped in areas rendered isolated by the water might arrive in these camps when the water recedes. Some areas are still under water and access is not possible yet.

"So far no epidemic outbreaks have been reported," said Bjorn Nissen, MSF Head of Mission in India. "Yet we need to be on the alert and ready to respond immediately as, when the water level decreases, the situation could worsen. We are also concerned because there are many pockets of people we have not been able to reach."

To date, the organisation has sent five relief trucks loaded with 15,500 plastic sheeting for shelter, 4,200 blankets, 15,000 jerrycans, 15,000 cakes of soap and 3,000 water chlorination tablets, items that are already being distributed, as a first goal, to 7,500 families.

The identified priority areas for the coming days include Bhargama, Narpatganj (both in Araria), Banmakee (in Purnia, where growing needs are being reported), as well as Chhatapur (Supaul), badly affected area where access is not possible yet.

The most pressing needs for the population still include food, plastic sheeting for shelter, water purifying tablets, kitchen utensils, and hygiene kits. In order to prevent and treat diseases, mainly those related to bad water quality, oral rehydration salts and medical care are essential.

MSF has eight workers on the field, most from the current project in Bihar for kala azar patients, among them doctors and other sanitary personnel, logisticians, and experts in water and sanitation. Another exploratory mission is on its way to the affected area and will evaluate the needs and the possible reinforcement of the teams already working.