By Peter Apps
LONDON, August 9 (Reuters) - After earthquakes, tsunamis and floods such as those ravaging south Asia, aid agencies invariably warn of serious disease outbreaks -- but in reality better prevention and education mean they rarely happen.
Historically, related outbreaks of disease such as cholera often killed more people than the disasters themselves -- for example, in the floods that have repeatedly hit Bangladesh.
But these days better disaster management mean that those who escape the initial disaster will usually survive.
"Outbreaks of disease can easily follow disasters," said Matthew Cochrane, a spokesman for the International Federation of Red Cross and Red Crescent Societies in Geneva. "But there has been a long experience in learning how to stop them."
The risks are still there and are obvious.
Visitors to a disaster zone -- or the sidelines of a conflict -- may be struck by the stench of untreated sewage, the lack of clean drinking water, the crowds living cheek by jowl in basic camps, the flies and lack of resources.
Hungry and often unwashed, children are usually the first to clog makeshift health centres.
Respiratory, skin and eye infections dominate, but both children and adults are often also exposed to insect-borne diseases such as malaria and snake and scorpion bites.
But -- thanks to concerted public-health efforts -- that is usually as bad as it gets.
Aid workers say there was a small outbreak of acute watery diarrhoea after flash floods last month in Pakistan.
STAGNANT WATER, SOARING TEMPERATURES
Health teams were already aware of the risk and the outbreak was brought under control with only three deaths.
Experts say they probably had cholera, endemic in Pakistan, but governments are extremely reluctant to admit to cholera as it is associated with poor health care and infrastructure. Aid workers also steer clear of naming outbreaks publicly as such.
Experts say as well as providing rapid health surveillance and assistance, ensuring clean water supply and separate toilets and washing facilities are crucially important. It is no coincidence that many agencies make it their prime concern.
While attention has been focused on widespread flooding in Asia, Sudan has also seen some of the worst floods in living memory. As elsewhere, disease is a real threat.
"You have got stagnant water all over the place and soaring temperatures," said the Red Cross's Cochrane. "In one area, the water people were drinking had the colour and consistency of milky coffee. We have just airlifted in a water treatment plant."
Aid workers say they need to raise the spectre of mass disease outbreaks even if they rarely actually occur.
If people become complacent, they may simply drink dirty water and thereby spark an epidemic. Put simply, fear spreads responsible behaviour and makes sure people boil water.
They also say that proper funding is necessary if they are to manage to provide drinkable water. Perhaps overshadowed by Indian and Bangladeshi floods, the $38 million U.N. appeal for Pakistan is only a third funded.
"Without the extra funding, we will not be able to make sure everyone has access to clean water," said UNICEF spokeswoman Sandra Bisin. "That will make it more difficult to stop disease."
