Rising Waters, Rising Challenges-WHO's Response to Severe Flooding in Bangladesh

In the third week of August 2024, heavy rainfall and upstream water releases caused significant flooding across multiple districts in Bangladesh, particularly affecting 11 districts in the eastern regions. The districts of Feni, Noakhali, Lakshmipur, and Cumilla experienced the most severe impacts. According to the National Disaster Response Coordination Center (NDRCC), approximately 5.8 million individuals were affected, with 502,501 people displaced into 3,403 evacuation shelters.

The flooding submerged rural roads, agricultural fields, and fishponds, creating substantial access challenges that were worsened by power outages. The resulting displacement and overcrowding in temporary shelters raised serious protection concerns, particularly for vulnerable populations, including women and girls.

To address the emerging health issues following the flooding, an emergency health cluster meeting was convened on August 23, 2024. This meeting included Civil Surgeons from the affected districts as well as representatives from various partner agencies, including UN organizations and international and local NGOs. Participants shared their experiences and coordinated efforts to respond to the crisis. A dedicated Core Group was established, led by the Director of Disease Control (DC) and the Line Director of Communicable Disease Control (CDC). This group actively monitored the stockpiling of medicines and medical supplies to minimize gaps in healthcare facilities in the severely affected districts.

WHO field staff coordinated closely with district civil surgeons to provide critical support during the initial days of the flooding, including continuous power backup to maintain the viability of vaccines in refrigerators, given the widespread electricity outages. Additionally, WHO facilitated the printing of IEC materials to raise community awareness about preventing waterborne diseases.

In response to the urgent health needs, WHO supplied essential emergency life-saving medicines and medical supplies, including antibiotics, Inter-Agency Emergency Health Kits, and Cholera Rapid Diagnostic Test (RDT) Kits, which were instrumental in providing much-needed health services.

From September 1 to September 3, 2024, the WHO Health Emergency team, Divisional Coordinator (DC), and Surveillance and Immunization Medical Officers (SIMO) of IVD unit conducted site visits to the most severely affected districts—Feni, Noakhali, Lakshmipur, and Cumilla. They assessed conditions and readiness at key facilities, including the 250-bed District Sadar Hospitals in Feni and Noakhali, as well as flood shelters and affected communities in Begumganj Upazila. These districts experienced significant impacts, marked by a high incidence of illness, fatalities, and damage to health facilities.

As floodwaters receded, there was a notable increase in outbreaks of waterborne diseases, particularly diarrheal illnesses and skin infections. As of September 30, 2024, the National Health Emergency Operations Centre and Control Room of the Directorate General of Health Services (DGHS) reported over 160,000 cases of diseases and injuries. Among these, approximately 14% (23,015 cases) were attributed to diarrheal diseases, while 27% (43,137 cases) were skin-related conditions.

Tragically, 75 flood-related deaths were reported, with 43 of these (57%) resulting from drowning. Additionally, of the 1,262 health facilities across the affected districts, 391 were impacted by the flooding. Those that remained operational faced challenges in providing emergency care to the influx of patients seeking treatment.

The Civil Surgeon Office, in collaboration with WHO, conducted health cluster meetings in Feni, Noakhali, Lakshmipur, and Cumilla districts. The primary objective of these meetings was to enhance collaboration among partners, identify gaps in the response efforts, and prevent duplication of activities. These health cluster meetings were set to continue regularly to ensure ongoing coordination and effectiveness in addressing the health challenges arising from the flooding.

Health cluster partners collaborated with the government to enhance the coordinated response to the flooding. More than 460 Government Mobile Medical Teams were deployed to address health issues in the affected areas. Various organizations, including the Armed Forces Division, BRAC, Sajida Foundation, BDRCS/IFRC, and several philanthropic entities, provided essential services such as medical teams, ambulances, and health camps across different locations. To facilitate communication, all Civil Surgeon Offices established WhatsApp groups for organizations interested in offering support. Additionally, UN agencies, including WHO, UNFPA, and UNICEF, provided emergency health support that encompassed sexual and reproductive health, maternal and child health, as well as mental health and psychosocial first aid. This collaborative effort aimed to ensure that the health needs of the affected population were effectively met.