Flood waters challenge logistics of providing care to victims of India's floods

© MSF Relief efforts continue in India, with hundreds of thousands of people living in camps and settlements in the flooded areas in Bihar, India. The displaced, many of whom have lost everything, are likely to live in precarious conditions for months until the water recedes enough for them to go back and resume their normal lives. MSF has been providing medical assistance and non-food items to victims. MSF doctor and field coordinator Siju Seena, who has been dealing with the medical activities of MSF in Araria and Supaul districts, gives an overview of the situation in Chunni camp (Supaul) and looks into the challenges of providing humanitarian aid in the flood-hit areas. Where does your team work? "We are operating in Madhepura, Purnia, Araria and Supaul, which are the most affected districts. But the team I've worked with has been focusing on Bhargama block in Araria and isolated eastern part of Supaul. There are no NGOs there and very little aid from the government because access is very difficult. It can only be reached through the west of Araria district because of the floods. "There are about 15 camps in this area in which one camp at Chunni (part of Supaul) is the most neglected one. Around 4,000 families had gathered on along an embankment and a rescue operation led by the army was still going on when we arrived." What was the situation like in Chunni for the displaced when you arrived?
"People were quite desperate and complained that the government was not doing enough for them. They had received airdropped food but they said the village leaders were keeping it and aid wasn't reaching them properly. Cooking was generally possible in the camps through community kitchens mostly run by govt, but they said it wasn't enough. Although there was a small army health post, they were asking for medicines because they said they didn't have enough." What did MSF teams do there?
"For five consecutive days we distributed non-food items with plastic sheeting, water purification tablets and jerry cans and we ran mobile clinics and we tested the water sources. "Our priority was emergency health care and disease surveillance, with special care to pregnant women, lactating mothers and children under five. We treated a total of about 650 patients with conditions like diarrhoea, upper respiratory tract infections, worm infestation, etc and also 86 cases of malnutrition. "People had sometimes walked long distances in the water. Some of them had to be referred to a clinic. On our second day in Chunni, a girl was being treated by the army doctor for severe vaginal bleeding. The mother said it was because of a leech when they had walked through the floods. The bleeding was really severe and she kept collapsing and with the heat, the army doctor told us she would die and the family was crying and totally desperate. We were the only ones with a means of transport and we took her as an emergency to the local health centre. The leech was removed and she survived." What was the biggest challenge in providing assistance to people affected by the floods?
"Logistics have been a major hurdle, especially in Chunni. The roads were impassable, full of potholes. There were also what we call 'nahar', narrow mud tracks with water on each side; when it rained it turned into a nightmare. We saw many tractors lying on the side of the road. It could take around five to seven hours to reach the camps from our base. On the fourth day at one point on the road, the water was at chest level. We had to leave the car, unload the relief material, cross by boat and then reload on the other side and continue by tractor. But because of the quantity of relief items, we had to do several trips. When the water went down we were able to cross by tractor and finally by car when they fixed the road. But it was very long, tiring and challenging for the whole team. The team had to leave around 6 am and they often came back very late. But the situation was changing fast and we finally finished the distribution. Beyond Chunni, there are still people who are stranded by the floods or who have preferred to stay in their villages despite the floods. How can you help them?
"The leader of the Mushahar Sardas and Althaf, three low cast communities, asked us to help these people. They were stuck on scattered pieces of dry land beyond Chunni. Their villages had been flooded but were not accessible by boat because the water was too shallow. Between 10 to 15 men came to the camp, they had walked through water, sometimes waist-deep, for four to five kilometres to a point where the army boats could give them a lift to the camps. "They brought the relief material for their community, for around 250 families and walked to their villages with the bundles on their heads. The relief went to those who were too weak to walk through the water and come to the camp. We have explored until Chatapur, beyond Chunni, and want to explore further beyond to help people. Access is very difficult, so we are trying to find a way, either by boat or land to reach them." Now that the water is receding will access to victims be easier?
"Yes, hopefully, but we've also had to face other problems. Several times there were roadblocks on the way organised by people and we had to take a longer route. One time on the way to Chunni, people from another camp, less affected by the flood, tried to divert aid. They climbed onto the roof of the vehicle trying to take what we had, thinking it was food. But it was only medicines and after two hours they finally cooperated and let us go. "Another time, while we were in the middle of distribution with the displaced in Chunni, a crowd of people from a village, which had not been affected by the floods, gathered and demanded coupons to receive the aid as well. People in Bihar are very poor. Some were very aggressive and a big fight began between the displaced and the villagers. The distribution team could not control the crowd and had to move to another place of the camp and had to wait for tow to three hours for distribution. "We hope that these incidents will not occur again because of the increasing acceptance and trust in the work of MSF among the local leaders and the public, and we will be able to continue to reach the people who most need the aid."