India - Doctor Homa MANSOOR: “There seems to be no end to this catastrophe”

34-year-old Homa Mansoor is a medical doctor at the HIV/AIDS clinic of Médecins Sans Frontières (MSF) in Mumbai, India. She was called to West Bengal (India) after an MSF assessment found many communities still in dire need of basic assistance a month after cyclone Aila hit. MSF aims to distribute non-food items to 15,000 people in the worst-hit areas of West Bengal.  Homa joined the team to set up a medical surveillance system in Sandeshkhali district in North 24 Parganas.

 “I was born and brought up in West Bengal, but never got the chance to visit North 24 Parganas. The Bengal I knew was concrete buildings and a vibrant middle class society. North 24 Parganas is just the opposite. There people live in mud houses. They represent the lowest economic strata of society. It is a rural area of farming and fishing communities. This was my first emergency response after a natural disaster and an opportunity for me to give something back to the society and my state. Although I have experienced floods before, it was nothing like the devastation I witnessed in North 24 Parganas.

Pitiful situation

This is a delta region. People who lived on islands in the river have been forced to move to embankments or dykes on higher ground, where they’ve built temporary huts. In some of the villages we’ve visited, displaced people are still living with an average of six families under one roof in unhygienic conditions. There seems to be no end to this catastrophe. Initially the water started to recede and things seemed to stabilise, but then high tidal waves came in and flooded the place all over again. It’s a pitiful situation. They’ve lost everything and have been stuck in these harsh living conditions for over a month now, with little hope of bouncing back.

You can really see the desperation of the villagers. When we were in Dhabaparat and Goramari villages, we began distributing non-food items at 9.30 a.m. At 11.30am the tide came and the water began to rise. Within a few minutes it had reached neck-level.  There were not enough boats so people had to leave with their relief items on their heads wading through the flood with water up to their chins.


In Dhabaparat, people had received only a little aid and when we arrived they were so desperate that they began fighting over the non-food-items during distribution.

It’s horrifying and sad to hear people talking about surviving in the muddy, marshy land with recurring tidal waves. They’re worried about the future, the poisonous snakes in the water, and the lack of shelter. Often several families have to share plastic sheeting to protect themselves from the rain. Food rations are insufficient and with seawater flooding their fields, they can’t farm anymore. You can imagine how hard life must be now they have lost their main livelihood.

The drinking water is contaminated, and the latrines are all flooded and people defecate in the river. I had not expected the conditions would be so bad a month after the cyclone.


During the medical surveillance, the health educators and I met up with the local nurses to monitor the situation and gauge the risks of any possible disease outbreak. We checked for cases of diarrhoea, malaria, measles or any other diseases and diagnosed some patients along the way.  So far we’ve found no such outbreaks but we must remain vigilant because with such poor hygiene conditions and with no clean drinking water, people are vulnerable and the risk of outbreaks is high.

In the villages we visited, 70 per cent of the cases reported were diarrhoea-related. In general there is one nurse for 5,000 people and few drugs. Health centres are far away, accessibility is limited and referral of patients difficult. In one of the villages, the nurse told us that two people had died because with the floods and the lack of boats they couldn’t get to the local health centre fast enough. But for the majority the health situation is acceptable for now.

Balancing act

I’ve never seen so much mud. I came with my jogging shoes, thinking they would be good for walking long distances. It turned out to be quite the opposite! We have to wade through deep mud and water. It’s so slippery there is no way you can wear shoes or boots. It’s a real balancing act.  On the first day I fell in the mud, but now I seem to be getting better at walking on bamboo, in the mud or through the floodwaters. You’re covered by mud and muck by the end of the day. I’ve never looked forward so much to having a shower.  It’s been an interesting experience and an adventure for me. Sometimes we have to use local boats to deliver the non-food items. During high tide, the current gets strong and you can see it’s hard to navigate the boat. We all use life jackets as very few of the staff can swim.

The villagers help us through the mud by making a human chain so that all of us walk through carefully. They are used to flooding, but not at this scale. So much water reaching their villages is quite a shock to them.  Sometimes they show us the roofs of their houses, which can just be seen above the floodwater. They have no way to re-establish themselves and resume their lives. The salt water has ruined their paddy fields; the floods have washed away their crops and grain stocks. They’re depending on aid now and they fear it will be years before the land is fertile again, and with the monsoon starting there’ll be more mud and more risks of outbreaks. The coming months will be particularly hard for them.”