Published Date: 2008-08-19 01:02:30
Subject: PRO/MBDS> Flooding, Mekong River - MBDS countries: alert
Archive Number: 20080819.2578
FLOODING, MEKONG RIVER - MBDS COUNTRIES: ALERT
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: 18 Aug 2008
Source: The Age [edited]
Torrential rain and overflowing rivers have brought some of the worst
flooding in decades to Viet Nam and its neighbours in the past week,
affecting cities and farmlands in 5 nations.
In northern Viet Nam, at least 130 people have been killed, dozens
are missing and thousands have been driven from their homes. Hundreds
of tourists were evacuated near the hill tribe resort area of Sa Pa.
Flooding has also hit parts of Thailand, Cambodia and Laos as well as
Burma [Myanmar], where waters rose in the Irrawaddy Delta, still
recovering from a cyclone that left 138 000 people dead or missing in
May [2008; see prior PRO/MBDS postings listed below].
The floods have hit much of Burma [Myanmar], including the main city,
Rangoon [Yangon], as well as Mandalay in the centre and the Karen and
Mon states in the south-east.
In Vientiane, the capital of Laos, officials said the Mekong River
had brought the worst flooding in memory, rising to nearly 15 metres
above its lowest level in the dry season.
The high water in Vientiane broke a record set in 1966 and overflowed
a levee that was built after that flood.
Mud slides also cut the main road from Vientiane to the ancient
capital of Luang Prabang, a city of temples and monasteries where the
Mekong also rose.
Laotian Foreign Ministry spokesman Yong Chanthalansy said 4 people,
including a child, had died in Vientiane after being injured in
landslides triggered by the flooding.
Speaking by phone from Vientiane, Mr Yong said there were reports
that the flooding was receding.
The flooding also cut electricity in Luang Prabang, a popular tourist
In parts of north-eastern Thailand, officials said the Mekong had
reached its highest level in 30 years, inundating farmlands and
forcing the evacuation of thousands of people in 3 provinces along
the river, which divides Thailand from Laos. Officials said the high
water had been caused by downpours in southern China, Laos and Thailand.
As the high waters of the Mekong moved downstream, Cambodia and
eastern Thailand prepared for major floods, and officials were
telling residents in some areas to move to higher ground with their livestock.
In the southern Mekong Delta of Viet Nam, where the 4800-km river
flows into the sea, forecasters said rising waters had reached a
critical level 2 weeks earlier than last year  and that worse
flooding lay ahead.
The most destructive flooding in recent years came in late 1999 in
Viet Nam's central provinces, leaving 750 people dead or missing.
[Byline: Seth Mydans]
Dr. Moe Ko Oo
[PRO/MBDS would like to thank Dr. Moe Ko Oo for bringing this alert
to our attention. We are concerned about these reports of flooding
of the Mekong River and the impact on the health of the population
(human, animal and plant) in the Mekong Basin countries affected by
this flooding. This will also be a significant setback for the
progress achieved in the post recovery period in Myanmar following
Cyclone Nargis (see prior PRO/MBDS postings below).
In the face of natural disasters, the public health community has
challenges both in the direct relief response (addressing the actual
problems confronted as a result of the natural disaster) as well as
in the indirect relief response (addressing the actions of many
organizations and voluntary groups that mean well but sometimes
become more of a problem for the responders due to inundation of the
area with non-essential personnel, equipment and other supplies.
Parts of the moderator comments this moderator (Mod.MPP) wrote
accompanying some of the earlier post cyclone postings (see Post
cyclone situation - Myanmar: RFI 20080510.1601 and Post cyclone
situation - Myanmar (02): cholera 20080517.1648) are worthwhile repeating here:
"Frequently, in the immediate days following natural disasters
associated with flooding, vector borne diseases such as malaria are
reduced, as the mosquito breeding sites have been affected by the
disaster as well, but after a period of time, the standing water does
serve to help repopulate the area with the mosquito vectors.
"To address many of the concerns in the immediate and medium term
following natural disasters, this moderator recommends an excellent
review article in Lancet, by Dr. Claude de Ville de Goyet, the former
director of the Pan American Health Organization's Disaster
Preparedness and Mitigation Program, where he addresses many of the
myths surrounding post disaster response actions (see ref. 1). Myths
mentioned and discussed include the fears that dead bodies contribute
to the spread of disease in the immediate post disaster period. An
important point mentioned in this article is that: "There is no need
for fancy aerial insecticide spraying or improvised mass
immunizations, which are so often recommended. The real needs are for
access to essential drugs, water, and sanitary facilities, and for
improved waste disposal." He also points out that in areas with
existing medical infrastructure, very few survivors owe their lives
to foreign teams, with most rescue and relief conducted by neighbors
or local authorities.
"Another good reference review of health impact post flooding is
Ahern et al's article in ref. 2 below. In this article, there is
mention that while outbreaks of cholera and other diarrheal diseases
have been reported following flooding, in many cases, the numbers of
cases of cholera and diarrhea are not above those seen in prior years
when there weren't floods. There is a discussion on rodent-borne
diseases, mentioning numerous outbreaks of leptospirosis in Latin
America post flooding. There is mention of the significant mental
health effects post flooding with a high incidence of post traumatic
stress disorder, something that was noted and reported on in the
literature following the tsunami a few years ago as well. In the
author's discussion, they begin with: "There is a surprisingly
limited evidence base about the health effects of floods,
particularly in relation to morbidity. This may in part be due to the
difficulty of carrying out rigorous controlled epidemiologic studies
of floods, especially in low-income countries. Evidence on public
health interventions (e.g., the need for measures to reduce the
spread of infectious disease, dealing with mental health impacts,
targeting of vulnerable groups) appears particularly limited. We
found no studies on the effectiveness of public health measures,
including early warning systems." They also conclude that: "Floods
with the largest mortality impacts have occurred where infrastructure
is poor, and the population at risk has limited economic resources."
A similar conclusion/observation made by Dr. de Ville in his
discussions on disasters can be found in ref. 1 below.
1. CV de Goyet. Stop propagating disaster myths. Lancet. 26 Aug 2000.
356 (9231); 762 - 764 (available at
free registration required).
2. Ahern M, Kovats RS, Wilkinson P, Few R, Matthies F. Global health
impacts of floods: epidemiologic evidence. Epidemiol Rev.
2005;27:36-46 (available at
For a map of Southeast Asia with the countries of the Mekong Basin Region, see
As a reminder, the member countries of the Mekong Basin Disease
Surveillance Initiative include: The Kingdom of Cambodia, Yunnan
province and the Guangxi Autonomous Republic of People's Republic of
China, Lao PDR, The Union of Myanmar, The Socialist Republic of Viet
Nam, and the Kingdom of Thailand.
PRO/MBDS would appreciate receiving more information on the current
health situations related to the flooding of the Mekong River from
knowledgeable sources in the region. - Mod.MPP]