There has been a graphic rise in the number of patients arriving at the ICDDR,B and eight other cholera treatment centres. The usual annual figure of one lac ten thousand patients is likely to be surpassed by thirty thousand this season. The nine cholera treatment centres have their IV fluid supplies from donors, but as far as the rest of the hospitals are concerned they have to depend on local sources. The health directorate claims that the stock position of IV saline is sufficient, but the ground situation speaks of scarcity of ORS and its high market price.

Our suggestion would be to approach multinational companies for supply of saline at low cost to us and have them distributed in parts of the country where there have been shortages of IV saline.

It is important to remember, however that IV saline is not enough to cope a diarrhoeal situation with, what we also need is sufficient antibiotic cover to treat cholera. So the focus should be on getting both IV fluid and antibiotic tablets and vials.

The most fundamental area where we need to pay attention to is providing a reasonable guarantee for supply of pure drinking water. A highly placed Wasa spokesman says that they have launched repair work on tubewells in stagnating or receding waters in and around Dhaka. They are trying to distribute water via country boats as well. The authorities should concentrate on supplying water purification tablets and bottled water extensively in the affected areas, which should be easily done. We should bear in mind the fact that in 2004 a huge quantity of water purification tablets was wasted through lack of preservation.

Not all the people who are afflicted by diarrhoea make it to hospitals. Thus the emergency medical service should not remain confined to hospitals and clinics, rather it must reach out to the interior. The medical teams of the health directorate and the army must be complemented by those from the private sector to fend off and treat water borne diseases on the required scale.