Experts call for immediate steps to stop cholera from turning into an epidemic in Nepal

 The emergency ward of Narayani Hospital is overflowing with patients. Some are in severe pain, while others are unconscious.

The ward only has 26 beds, but over 50 people suffering from cholera and diarrhea arrive every day. On top of that, many patients with other illnesses are also coming in. Since there aren’t enough beds, mattresses have been placed on the floor. Doctors and nurses are working non-stop.

“We’ve had to keep patients on the floor. A separate ward has been set up for treatment,” said Dr. Chumanlal Das, the hospital chief.

Since the cholera outbreak began in Birgunj Metropolitan City, more than 612 patients have been admitted, including 84 in just the last 24 hours. Currently, 31 patients are in the ICU, 6 in HDU, and 141 in general wards. Cases are also being reported in Parsa and Bara. “The numbers are still rising,” Dr. Das said.

Calls for health emergency

Public health expert Dr. Baburam Marasini has warned that the outbreak could soon get out of control. He has urged the government to declare a health emergency, impose curfews, and close border points.

“Hospitals are full, and deaths are increasing. If not controlled, cholera will turn into an epidemic,” he said, adding that contaminated drinking water is the main source of infection. Once declared a health emergency, both public and private hospitals must treat patients for free.

Experts believe sewage water might have leaked into drinking pipelines, but even after a week, the source of infection hasn’t been confirmed.

Dr. Marasini recalled the 2009 Jajarkot cholera outbreak that killed 350 people and infected over 60,000 across several districts. He warned that Birgunj could face a similar disaster if urgent action is not taken.

Senior infectious disease expert Dr. Sher Bahadur Pun also stressed the urgency. He said the actual number of infections may be ten times higher than reported because many carriers show no symptoms but can still spread the disease.

“Cholera spreads quickly through contaminated water, food, or public toilets. If ignored, Birgunj’s outbreak will spread to other districts,” he warned.

So far, three deaths have been confirmed in Birgunj. Lab tests show cholera bacteria in most patient samples, proving it is spreading at the community level.

Struggling to find the source

Health Minister Pradeep Paudel admitted that identifying the exact source of infection has been difficult. He said more doctors and health workers have been mobilized, and treatment is being provided free of cost at Narayani Hospital.

Although chlorine cleaning campaigns are underway, it’s still unclear whether sewage contamination or other factors are behind the outbreak. Teams from the Epidemiology and Disease Control Division and Nepal Health Research Council are investigating.

When asked about declaring a health emergency or closing borders, Minister Paudel said no such decision has been made yet. However, the issue will be discussed in the cabinet meeting tomorrow as cases continue to rise.