In a post liberation war period, an epidemic of severe dysentery emerged in a small island in the northeastern part of the Bay of Bengal named St. Martin's island. It is about 9 km south of the tip of the Cox's Bazar-Teknaf peninsula, and is the only coral island of the country.
Back in 1973, St. Martin's had a population of 1, 318 people, of which 434 people were affected with severe dysentery, caused by a strain of Shigella Dysenterae type 1 bacteria. Within a three-month period, 28 people died – they were mostly young children and elderly. It was amidst the monsoon season when the island was isolated from the mainland. Every year, between May-June to August-September, the island used to be almost cut off from the mainland due to bad weather and high tide. Islanders stockpiled their supplies for the whole season, and contact with mainland was infrequent.
The outbreak started in the middle of April 1973. Rumours of a mysterious killer disease spread. The disease appeared in the form of diarrhoea with blood and mucus, abdominal and cramping rectal pain. National newspaper also reported the news.
On the occasion of Bangabandhu Sheikh Mujibur Rahman's birthday tomorrow, we want to share a lesser known (but nonetheless important) incident of the visionary leader's role to combat this crisis, and how the icddr,b played a part in it.
Formerly known as the Cholera Research Laboratory (CRL), icddr,b's scientists and staff from that period still reminiscence the memory of St. Martin's outbreak, and remember fondly the dynamic leadership of the Father of the Nation.
When he heard the news, he instantly ordered the then Cholera Research Laboratory to investigate the rumour and provide immediate medical assistance. In a war-torn country, reaching out to the most distant part during the monsoon season is a near impossible task. Realising the challenges, Bangabandhu asked then the rehabilitation team of the then Soviet Union (now Russia) to lend a helicopter for the transportation of scientists and supplies to St. Martin'sisland. During that time, the Soviet Union was providing post-war rehabilitation support to the country and had few helicopters with them.
Between July 12 and 25, 1973, a team of CRL scientists made three visits to St. Martin's on helicopter. The first visit was made to investigate the outbreak; they examined and collected samples from 12 patients with a history of 2 to 12 days of diarrhoea and aged between 4 months to 16 years.
The team was comprised of the legendary Dr M Mujibur Rahman, Dr M Moslemuddin Khan, Dr KMS Aziz and AKM Golam Kibriya. The second visit was made by a team of public health scientists to chlorinate drinking water and distribute medications. The third visit was made by a team of scientists and doctors to provide medical assistance and do detailed investigation of the outbreak.
A census was taken, and families were interviewed regarding migration, death and dysentery, as well as their symptoms in the past three months. Information of the deceased was obtained from their mother or the surviving head of the family. Information on sources of drinking water and food and facilities for disposal of excreta were collected. Those who were ill at the time of the interview were examined. Rectal swabs were obtained for bacteriological culture. Fresh stool samples were also examined microscopically. Water samples were collected in sterile containers and cultured within five hours for the detection of Shigella and for presumptive coliform counts. It was a great surprise to learn that the bacteria were resistant to almost all common antibiotics available at that time. For which CRL established a research centre in Teknaf the following year.
There was a dramatic drop in the reporting of new cases from early August and a complete cessation of the epidemic in the following week. This was further confirmed by another visit during September 17 -20. It was found that besides the strain of Shigella dysenteria type 1, no other organism was implicated in the outbreak. And the disease disappeared from the island after the institution of chlorination to the sources of drinking water and effective treatment of patients.
The writers are President, icddr,b Alumni Association, and Principal Communications Lead at icddr,b, respectively.