No refuge from sanitary woes

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Usha Pandita, 45, feels tired even after finishing the smallest of chores. But that`s not unusual for her. She suffers from Pelvic Inflammatory Disease (PID). For her, it all began with abdominal pain, which she initially disregarded as routine until it steadily increased.

Usha then started to notice a heavy discharge and the feeling of being perpetually run down. That was when she visited the doctor. Tests confirmed she was suffering from PID -- the inflammation of the organs in the pelvic region because of infection. It is during menstruation particularly that the uterus becomes more susceptible to this condition caused by unhygienic conditions. Usha is one of the 10,000 residents of the Purkhoo migrant camp, which is among several camps set up on the outskirts of Jammu for the Kashmiri Pandit community forced to flee the Kashmir Valley when militancy gained ground in the 1990s.

From Kupwara, Usha and her family made their way to Purkhoo, which they have called home since 1990. Years have gone by and even militancy is on the wane, yet time seems to have stood still for the inhabitants of the camps.

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Living in a one-room pigeon hole with a family of four can be trying in itself, but the lack of sanitation has only added to the woes. For women, in particular, it is horrifying. The Purkhoo camp has four phases and each phase has around 300 to 500 rooms. There are 10 toilets each for men and women. So there is one toilet per 150 men/women. The water supply lasts only an hour each day.

Every time Usha, who lives in Phase I, goes to the toilet, she walks about 150 metres. What`s more, she has to carry her wash water along. But there is only that much water she can carry. On numerous occasions the water is found insufficient to keep both herself and her surroundings clean. It is because of these abysmal facilities that she ended up with PID.

Veena Pandita, 40, also lives in the same deplorable environs of Purkhoo. She too has acute PID. Dr Indu Kaul, a well-known Jammu-based gynaecologist treating these women, explains that the symptoms for PID include abdominal pain accompanied by heavy discharge and backache.

She finds that in the case of women like Usha and Veena, PID continues for years. Usha, for instance, has been suffering from it for the last four years. The medicines don`t really help, as the toilet she visits roughly four times a day continues to be poorly equipped. Unfortunately, the medication includes heavy doses of antibiotics, the intake of which has major side effects.

When PID is deep-rooted, surgery is usually the final recourse. Usha has been recommended surgery but her financial condition doesn`t permit the procedure. `We still have four`kanals` (one kanal equals 605 sq. yards) left in Kupwara. We had our own chashm (well) there,` she recalls wistfully, adding, `I did not have to go to a toilet that was used by hundreds of others there.`

Care of Nanny

Purkhoo`s water supply, too, is contaminated. Residents complain that they have to replace their utensils every few months as they get coated with a white sediment. The pipes leak at multiple locations and so germs and dirt merge with the water. Near the toilets at Phase I, there is a water hole from which people draw out water to flush. But not only is the water filthy, it is difficult to draw it out, especially when there is a long line of people waiting for their turn to use the toilet.

Although help has been hired to clean the facilities once every two days, because of insufficient water and the sheer number of users, it is impossible to maintain a basic level of hygiene. Moreover, there is no electricity in the toilets, so going after dark is another hazard, especially for the women. That`s why the maximum number of cases of PID, in the city, come from these camps.

Dr Kaul says that while the national average of PID is six to eight per cent, the cases reported from the camps can be 15 to 20 per cent, which is extremely high. The most affected age groups are the adolescents and those above 35 years. Among adolescents, chronic PID can lead to loss of fertility, so the increasing trend is cause for alarm. Sarla Kaul, 28, who lives in the Mishriwalla camp, a kilometre from Purkhoo, suffers from Urinary Tract Infection (UTI). The sanitation situation here is worse than at Purkhoo as toilets for both men and women are common here and no one comes to clean them. Many toilets are simply holes in the ground.

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Sarla has UTI, caused by poor hygiene and unsanitary conditions that make her vulnerable to other infections too. Lately, she has been suffering from menstrual dysfunction, with heavy blood loss and pain around her abdominal area. Expectant women are particularly vulnerable to UTI, as pregnancy causes hormonal changes that lead to the relaxation of the urethra, which if exposed to poor sanitary conditions is quick to contract infection.

UTI leads to anaemia, itching and swelling, which could eventually endanger the life of the child. It also often retards the growth of the foetus and results in stunted babies or those with low birth weight. That was the case of the baby of Rajni Raina, who is in her mid-20s and lives in Purkhoo Camp`s Phase II. Not surprisingly, Rajni had chronic UTI during her pregnancy. Once again, Dr Kaul points out that while the national average of UTI is about 10 to 15 per cent, it is about 20 to 30 per cent in these camps.

Besides this there are other water-borne diseases prevalent here. Shetu Pandita, 17, of Purkhoo, has been ailing from recurring Hepatitis for the last five years. As also Puneet Bhatt, 16, of Mishriwalla, since he was 10. According to the World Health Organisation, 80 per cent of such cases are caused by lack of safe water and sanitation. Five of the 10 top diseases of children are also related to water and sanitation. Dr K.L. Chowdhury says Hepatitis A and E are common in the camps. Again, among pregnant women, Hepatitis is particularly dangerous as it can put the lives of both the mother and child at risk.

The Third South Asian Conference on Sanitation held in New Delhi recently called for according priority to sanitation and reiterated that sanitation and safe drinking water are basic rights. Such declarations need to be translated into action if life is to improve for women like Usha and Veena, who are rendered without proper homes because of the politics of division and hate. Aditi Bhaduri