Geo-Analyst , ISSN 2249-2909 July, 2016
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Geo-Analyst , ISSN 2249-2909 July, 2016 DIARRHOEA, ENVIRONMENT AND HUMAN HEALTH: EXAMINING THE INTERFACE IN BURDWAN DISTRICT, WEST BENGAL Dr.Srabani Bose* Abstract Diarrhoea, a water borne disease has been a public health problem in the West Bengal.Diarrhoea is endemic in the district of Burdwan. It creates a heavy disease burden in the district of Burdwan.The environmental conditions of the studied district provide opportunities for occurrence and spread of diarrhoea. Occurrence of Diarrhoea is closely associated with the given environment, whether it is physical or social .In this paper an attempt has been made to assess the connection between diarrhoea andenvironmentin the district of Burdwan. Key words: Disease, Endemic, Epidemic, Morbidity, Mortality Introduction Diarrhoea is a major public health problem in the district of Burdwan. Numbers of patients suffering from diarrhoea are found in maximum number in the hospitals. Still now it is regarded as a great killer. It causes so many deaths especially among children. Most of the blocks of the district are identified as diarrhoea prone. Sometimes the disease becomes epidemic. Causes of the disease are so many that makes the disease a complex one. Literally, Dysentery means dysfunction or impairment of the functioning of intestines. Technically it means passing of blood and mucus in the motion. It can occur as a result of one of several factors. When it results from dysentery organisms like Genus Shigella , Shiga , S.Flexner , etc. it is called bacillary dysentery. Endamoeba Histolytica can also cause dysentery (Misra, 1970). Study Area The district lies between 22°56 / to 23°53 / N latitude and between 86°48 / E to 88°25 / E longitude while western part of the district represents the transitional zone between the plateau and plain, the eastern part is dominated by flat monotonous plain. It has an area of 7024 sq. km.The diarrhoea is endemic in some blocks of the Burdwan district and sometimes the diseases take the form of epidemic which is alarming. *Assistant Professor, Department of Geography, Dr Bhupendra Nath Dutta Smriti Mahavidyalaya, Hatgobindapur, Burdwan East, West Bengal -713407 126 Geo-Analyst , ISSN 2249-2909 July, 201 6 The diarrhoea is endemic in the blocks of of Katwa I, Katwa II, Purbasthali I, Purbasthali II, Kalna I, Kalna II, Memari I, Memari II, M anteswar, Burdwan I and Burdwan II. Villages like Bhatigacha, Mukundapur, Selenda, Bamunara, Jajigram, Kashipur,Srikhanda and Khandra are worst affected. Fig. 1 : Endemic Blocks of Diarrhoea Objectives The work has been done with the aim of following o bjectives: To delineate endemic zones of diarrhoea in the district of Burdwan To identify favourable factors for the occurrence of diarrhoea To find out relationship between environment and diarrhoea in the district of Burdwan To study the trend of partic ular disease in respect of morbidity and mortality Materials and Methods Relevant data have been collected from different volumes of Health on March, published by State Bureau of Health Intelligence, Directorate of Health Services, Government of West Be ngal and from Chief Medical Officer of Health II, Burdwan, West Bengal . The study has used descriptive research methods. 127 Geo-Analyst , ISSN 2249-2909 July, 2016 Environmental Factors for the Occurrences of Diarrhoea As diarrhoea is water borne disease, therefore the role of socio-cultural environment is important in causing and spreading of disease. Although physical environment also plays an important role because the existence of several diarrhoea causing bacteria depends on specific temperature and moisture conditions. Physical Factors In a majority of cases, dysentery results from bacterial infection. Genus Shigella is a type of the several bacteria which can cause dysentery. They prefer to live in human intestines and the existence of Shigella depends on the condition of environment either physical i.e. temperature, moisture or social, conditions of living etc. The optimum temperature in which the Shigella thrive is 37°C. They die at a temperature of 55°C within an hour (Misra, 1970). Diarrhoea is more frequent in tropical lands. Its frequency increases during the hot season, the condition is deteriorated if the environmental sanitation is poor. The agent Shigella are transported to man by flies. Thus the conditions which favour the growth of flies also favour the occurrence of bacillary dysentery. The breeding of the fly is closely related to the temperature. At 16°C, the average time required for the house fly to develop from the egg to the adult stage is 44 days. The hatching time drops to 16 days at 25°C and to 10 days at 30°C. Socio-cultural Factors Dirty living conditions and poor sanitation, poor personal hygiene are perceived to be causes of loose motions. Contaminated dirty impure water used for drinking and domestic purposes is regarded as a major cause. Drinking water fetched from worm infested wells or community ponds contaminated by bacteria are felt to be very important cause of loose motions. Food and food habits are considered to be responsible for diarrhoea. Eating dirty, unwashed food may be regarded as the main cause. Overeating and poor quality of food cooked in dirty utensils are also responsible for causing in digestion or stomach disorders (Diarrhoea in Rural India, 1990). Malnutrition is also regarded as a major cause of diarrhoea. Among children loose motions occurred as a result of malnutrition because the underfed child could not digest food as easily as a normal well fed children. The growing use of fertilizers in agriculture is believed to be a cause of loose motions among children. Crops grown with the help of these fertilizers are felt to be somewhat poisonous because of the chemical used. Frequency of diarrhoea increases during summer and monsoon seasons, particularly if the environmental sanitation is poor. In the summer season loose motions are caused by summer heat, owing to the fact that the body heats up. (Diarrhoea in Rural India, 1990). During monsoon, 128 Geo-Analyst , ISSN 2249-2909 July, 2016 excessive rainfall leads to run off water, causing flood, responsible for stagnation of water in both villages and towns. Standing water, which villagers consume is highly contaminated. Diarrhoea, Environment and Human Health Diarrhoeal diseases remain major killer in the district of Burdwan. Most of the sub-divisions are diarrhoea prone. Polluted water and inadequate sanitation are the leading factors of human illness. Diseases and deaths are directly attributable to the lack of these essentials. Safe drinking water is vital for human needs of health. Quality of public health depends to a great extent on the quality of drinking water. But most of the villages of the understudied district are affected by diarrhoea because of unavailability of quality drinking water. Same source has been used for bathing, cooking and washing. So insufficient supply and increasing contamination lead to the occurrence of diarrhoea. Most of the blocks of Kalna and Katwa sub-divisions are frequently affected by diarrhoea (Fig.1). Katwa I, Katwa II, Ketugram I, Ketugram II, Purbasthali I and II, Kalna I and Kalna II are river dependent. Frequency of disease increases in the monsoon months. Because most of the aforementioned blocks are inundated, resulting in chronic flooding for three to four days in each of the villages. The use of standing water after monsoon is the only cause of diarrhoea in the understudied blocks. The problem is more complicated particularly in those blocks where environmental sanitation is poor. Burdwan I, Burdwan II, Memari I and Memari II blocks are rich in agriculture. Increasing use of pesticides has been aggravating the problem in those blocks. Coal belt and the industrial belt of the district are not least affected. Blocks like Jamuria, Barabani and Raniganj associated with collieries and industries are more prone to diarrhoea. Poor drainage condition of the factories, lack of proper sanitation facilities, along with impure drinking water contaminated with industrial wastes have accentuated the problem of diarrhoea in Asansol and Durgapur sub-divisions. Diarrhoea can also be caused by dirty food and food habits. People of the Kanksa block, a tribal dominated area, are habituated with fungus as a regular food item and as a result they frequently get affected by diarrhoea. Morbidity out of Diarrhoea Diarrhoea is considered as one of the major disease among the prevalent diseases of Burdwan district and the disease becomes a major public health problem in the district of Burdwan. Recorded data were available from the year of 1997. Morbidity due to diarrhoea increased rapidly up to 1999. It registered minimum number of patients in 2000 but after that it again showed a rising trend of growth. Fig. 2 represents the year of 1997, 1998 and 1999 when number of reported cases were more or less similar. The numbers of reported cases in those three consecutive years were 18,875, 19,274 and 20,176 respectively, after which the number has reduced dramatically in the year of 2000 due to effective control measures adopted by the government. Villagers were given Norflox tablet, Metrogyl tablet, Halogen tablet and Oral Rehydrated Solution (ORS) by the 129 Geo-Analyst , ISSN 2249-2909 July, 2016 Department of Health, Government of West Bengal. Houses and tubewells were disinfected by the health workers. Many meetings were organized with villagers to teach them about the nature of disease. But in the years of 2001, 2002, 2003, 2004 and 2009 again increasing trend in reported cases were noticed. This is due to lack of campaigning by the health workers, poorly managed health systems and overall the repetitive occurrence of natural hazards like flood. In 2000, a devastating flood occurred which increased the propensity of this disease. Due to unplanned urbanization and lack of consciousness among the villagers, diarrhoea has become a regular feature in the rainy season.