Tamil Nadu has managed to prevent any outbreak of epidemics after the once-in-a-century kind of floods in Chennai and neighbouring parts. Dr J Radhakrishnan, a 1992 batch IAS officer who is the state health secretary, was well prepared for the task, with his much-praised work as collector of Thanjavur and Nagapattinam in the aftermath of the 2004 tsunami. Former US president Bill Clinton was among those who lauded his skills, and he went on to head the disaster management team of the UNDP in India during 2009-12. The 49-year-old officer, a trained veterinary doctor, spoke to Shivani Chaturvedi on how the health department dealt with the situation after disaster.

How did you prevent the epidemic outbreak?

We focused on handling the situation  comprehensively instead of taking immediate reactive measures. Our focus was on the immediate disposal of the remains of dead animals like rats, stray dogs and removal of the garbage. Simultaneously, to prevent outbreak of water-borne diseases, we doubled up the chlorination at source and supply level and also at the retail point. In inundated areas, we gave minimum half-a-kg of bleaching powder to each house to clean water sumps (in Chennai and neighbouring areas people have water storage sump in homes). Our teams would visit the spots from where cases of  diarrhoea or fever would come up and besides providing medical aid to the patients, they would parallely look at the sources of the diseases. Identification of causes that may lead to diseases, and eliminating and treating them, was the approach. Initially, there were only static health camps but we started mobile camps too and later hired smaller vehicles to reach out to narrow lanes and by-lanes and hence more flood victims. Even now we have deployed teams to check chlorination and breeding of mosquitoes and flies.
 

Has the health situation stabilised?

We have sailed through the initial risks of water-borne and vector-borne diseases. But we have to be extremely cautious and prepared dealing with public health. In a dynamic situation like this, we have to constantly keep our focus on cause management.

What challenges did you face in dealing with the situation?

The challenge was finding new sources of contamination. For example, on either side of rivers we had a lot of ground-level wells that were contaminated, so we had to go for a second round of information and education campaign and are still continuing.

Are there healthcare camps for the displaced people?

Yes.

What steps are being taken in inundated  villages?

Places that remain inundated are the ones which would have been water bodies. There, besides sprinkling bleaching powder, we are also pumping out water. Technically, this water does not harm as long as it is not consumed but its smell can cause irritation. So, we are trying to provide some treatment on a regular basis.

What measures were taken for the safety of health workers?

They were all vaccinated. There were a few instances of skin infection but those were immediately attended to. We offered continued treatment to those working on ground.

Is there still a long way to go or things are under control now?

Everything is a learning experience but considering the suddenness and the intensity of the floods, the response has been really remarkable. We have been able to prevent an outbreak so far.

Do you feel crisis management in health sector is in place in the state?

We conduct an inter-department meeting before every monsoon. Subsequently, there is health-related preparedness and people are made aware about steps during disaster. For a situation like this, we will strengthen these measures.

What action has been taken against the management of the MIOT hospital where 18 people died?

There is a case on it (following a PIL). Meanwhile, the agencies will also probe the matter of not just the MIOT hospital but also of similar incidents in other hospitals.

What are the lessons learnt?

There were many. For example, it was learnt that in the government hospital in Tambaram, the ground floor is far lower than the main road, leading to water-logging. We are looking at the possibilities of converting the ground floor of the hospital into parking. The other lesson is, place the generator  above the highest flood-mark and not in the basement of a hospital. Inventory was one area where especially private hospitals faced problems. We have also learnt to reassess the reserves each hospital needs to maintain.

Hospitals have to envisage hazards, look at the vulnerability of the place and come up with plans. We have alerted all hospitals about the areas that need to be taken care of.

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(The interview appeared in the February 1-15, 2016 issue)