Cholera has once again shaken Nepal, this time in Birgunj. What should have been controlled early has now turned into a serious outbreak. Since the beginning of August, more than 500 people have been hospitalized, and three lives have already been lost. Most of those who went to hospitals tested positive for cholera. This shows how quickly the disease spread while health authorities delayed proper testing and response.
The first mistake was the slow action from health institutions. In the rainy season, when diarrhea cases rise suddenly, hospitals are supposed to test for cholera right away. This did not happen in Birgunj. By the time the seriousness was realized, the infection had already gone beyond the city and reached nearby municipalities.
Health Minister Pradeep Paudel visited Birgunj on August 25 and asked officials to find the source of the outbreak. But even days later, no source had been confirmed. This delay has left people in fear. Some residents are even leaving the city to protect themselves, which only increases the chance of cholera spreading to other areas.
To his credit, the minister announced free treatment for all patients, and hospitals are still handling the cases. But this alone is not enough. Without finding where the infection started, the outbreak cannot be controlled. If cholera continues to spread at the current pace, hospitals could run out of capacity. This makes it urgent for all three levels of government -- federal, provincial, and local -- to act together.
Nepal has faced such crises before. Fifteen years ago, Jajarkot suffered a cholera epidemic that killed more than 100 people because the government reacted too late. Just five years ago, Kapilvastu had another major outbreak, forcing the state to vaccinate around 200,000 people to bring the situation under control. These examples show what happens when prevention and early action are ignored.
Birgunj is especially vulnerable. It is a crowded city, and during monsoon, floodwater from fields, drains, and canals can easily mix with drinking water sources like wells and tube wells. On top of that, open defecation is still common in many parts of the Terai, which makes the spread of cholera even faster. Local governments should have treated this as a top priority long ago.
Doctors have also pointed to another possible cause. According to Narayani Hospital's information officer, Dr. Uday Narayan Singh, the outbreak may be linked to poor handling of water systems during last month's drought, when deep boring and water pipelines were expanded without enough care. If this is true, then the outbreak is not just a natural disaster but a man-made failure, even a crime against public health. This calls for a serious investigation by an independent committee.
Declaring municipalities open-defecation free was a good step, but it means little if people still choose fields instead of toilets. The government must enforce rules with fines and penalties where needed. At the same time, people need more awareness about hygiene, clean water, and the dangers of open defecation.
The outbreak in Birgunj is a reminder that cholera is preventable, but only if governments act early and citizens take responsibility. Without this, the same tragedy will repeat year after year.