The cholera outbreak that has struck Birgunj and its surrounding areas has begun threatening neighbouring districts, particularly Chitwan, where health officials have warned of growing risks as people continue to move between Parsa and Chitwan. The rising number of infected people in Birgunj has created the danger that the infection could spread to new districts. More than 90 confirmed cases, 300 suspected patients, and three fatalities have been reported in Birgunj, with many patients requiring critical hospital care. Narayani and Terai hospitals, along with several private hospitals, are working at full capacity as Birgunj Metropolitan City has announced a two-day school closure. Experts believe this is the largest outbreak since the Jajarkot epidemic of 2009. Cholera flourishes where water is contaminated and sanitation is poor. Once it enters a community, it spreads rapidly, leaving little time to respond. Symptoms such as sudden watery diarrhoea, vomiting, weakness, and muscle cramps can become fatal within hours if left untreated. This reflects both a lack of awareness and weaknesses in the response system.
Take measures to contain the spread of cholera
Six years ago, the government declared Nepal open-defecation-free, but outbreaks like this expose the fragility behind such announcements. Health experts rightly warn that neglect and complacency in water and sanitation infrastructure have left Nepal vulnerable to deadly epidemics. For Chitwan, the danger is immediate: the district shares constant movement with Parsa and its towns connect to the highway leading directly to Kathmandu. A slow or weak response risks the outbreak spreading into the capital and beyond. The government and the health ministry must act swiftly in Chitwan by setting up emergency monitoring, water testing, and rapid-response medical teams. Local governments should enforce simple but effective measures: ensure people drink boiled or filtered water, eat freshly prepared food, keep food covered, and wash hands with soap before meals. For now, roadside food stalls must be strictly monitored, as contaminated food is a direct carrier of the bacteria.
Public awareness campaigns through radio, television, and social media should guide people on what to do at the first signs of symptoms. Early medical care saves lives, while delays can be fatal. The Ministry of Health must also coordinate with local hospitals to maintain adequate stocks of oral rehydration solutions, intravenous fluids, and antibiotics. It is heartening that Health Minister Pradeep Paudel visited Birgunj hospitals and instructed them to provide fast and effective care to patients free of cost. Chitwan and nearby districts should prepare as though cholera has already arrived, rather than waiting for cases to rise. Nepal cannot afford another public health crisis after the ordeal of COVID-19. If uncontrolled, cholera could spread into an epidemic that overwhelms hospitals and worsens the lives of already vulnerable communities. The larger lesson is clear: water, sanitation, and hygiene must become long-term national priorities, not temporary goals. Every few years, outbreaks of diseases like dengue, typhoid, and cholera remind us of the same systemic gaps. To save lives, the government must treat this outbreak as a wake-up call to build resilient public health systems.
