The loss of life to the earthquake stricken areas of Nepal has been catastrophic, but now survivors are facing a new threat that could pose an even greater risk that the quake and its aftershocks - disease.
As the injured and hungry crowd shelters and food and water become increasingly scarce, poor sanitation and life on the streets make the perfect breeding ground for infectious disease.
Dengue fever, malaria and Japanese encephalitis are already present in the country, and the standing pools of water left by the earthquake create the perfect breeding ground for the mosquitoes to transmit these diseases. According to medical expert Dr. Nikhil Joshi, who is returning to Nepal to treat survivors, said that water and other sources are also being used for drinking, and its contaminated.
"There will be water-borne diseases like typhoid fever and things like bacterial diarrhea could be another huge problem," he said.
Of course, this happens when there is water at all. "There's a straight up lack of it ... So, that causes dehydration, and you can die of dehydration," Joshi says.
Tubercolosis is also rampant in Nepal, said Joshi, and can spread quickly through coughing and sputum in these areas. The quake's death toll has already hit over 6,000, but the aftermath could kill more people than the disaster that came before it.
"Put a bunch of people together who are sick, tired and malnourished and you've got a serious problem," Joshi says. "Sadly, this isn't unique. After an epidemic, we often see outbreaks of infectious diseases."
The monsoon season, which begins next month, will make things worse. Rain will fall over those who used to live in the 130,000 homes that were destroyed.
"Getting shelter before then is a huge necessity, and if people don't ... there's the risks of exposure, including hypothermia," Joshi said. "The rain and thunderstorms can cause landslides. The landslides can make it harder for rescue teams to reach people remotely as the roads often get washed out. Villages that barely survived could easily be wiped out."
In Nepal, the quake has put pressure on a health care system that never had a reliable foundation to before the disaster. "Accessibility to health care for the average Nepalese citizen at the best of times was problematic," Joshi says.
While the numbers portray the extent of the tragedy, these figures only paint part of the picture. "We often look at things in terms of death toll from the disaster. But that really only tells a fraction of the story."
