MANILA, Philippines — Nearly a month since a tropical storm dumped unprecedented amounts of rain that flooded much of Metro Manila and its nearby provinces, hundreds of thousands of Filipinos are still suffering from its aftermath, particularly from an outbreak of a water-borne disease called leptospirosis that has killed so far 167 people and infected thousands.

Apart from leptospirosis and other diseases, tens of thousands of residents in the capital and elsewhere in Luzon, the main island north of the country, remain homeless after two storms in short succession, Ketsana then Parma, destroyed houses, properties and crops.

The Philippines isn't new to devastation wrought by storms and typhoons, but these recent ones have been particularly crippling, especially in poorer areas. Several districts of Metro Manila remain flooded in waist-deep water, raising concerns that the leptospirosis outbreak could worsen.

Health officials have said that the outbreak of the disease is one of the largest in the world. Leptospirosis is a constant threat in flooded areas and has been made significantly worse by continual floods in the wake of Ketsana and Parma.

“This is unprecedented,” health secretary Francisco Duque III said last week. “There’s been no situation like what we have in the Philippines where within less than a month’s time we have doubled or tripled the average number of cases in a year’s time,” Duque said.

“We have also already sent an SOS to the international community because this is one of the biggest outbreaks, not just in the Philippines but in the world,” he said.

The World Health Organization estimates that as many 4,000 could be infected by leptospirosis, which is a bacterial infection caused by the urine of rats and vermins, among other mammals, in flooded areas. The disease, if untreated, can damage the kidney, among other effects. Symptoms include high fever, severe headache, muscle pain, chills, redness in the eyes, abdominal pain, jaundice, hemorrhages in skin and mucous membranes, vomiting, diarrhea and rashes.

The government estimates that as many as 1.7 million people are at “high risk” of exposure to the disease and that more than 1.2 million residents still live in inundated villages, most of them in the capital. In Pasig City, whole communities remain flooded and residents have turned their neighborhoods into canals, with gondola-like contraptions now serving as a means of transportation for many of them.

The additional problem created by the outbreak has put further strain on the already dwindling resources of the government, which has appealed to the international community for help after the typhoons destroyed millions of dollars in crops and property.

Government hospitals have not been able to cope with the rise in leptospirosis cases and, this week, the government convinced private hospitals to take in patients. The health department said it would subsidize the cost of the treatments, which can range from $100 to as much as $400, depending on the complication. For poor families who are invariably the ones most affected by the outbreak, this expense — $400 is equivalent to two months salary of a minimum wage earner — can be forbidding.

Alarmed, the World Health Organization announced last Thursday that it was sending in a team to help the Philippine government cope with the outbreak.

In many ways, the outbreak of leptospirosis and the rising incidents of illnesses — such as diarrhea, E. coli infections and skin rashes — underscore the sheer inability of the affected communities to cope with the destruction brought by the storms. For example, the continued presence of floodwater has been blamed on the clogged drainage and sewage systems of cities and towns comprising Metro Manila, many of which have slum areas where houses block waterways.

As if this were not enough, tens of thousands of residents who live in at least 500 evacuation centers may not be able to find new homes as the government, under pressure now to do something about the slum communities that are choking Metro Manila, attempts to relocate them to other areas. Kadamay, an urban-poor group, has criticized the government for forcing these residents to live in relocation sites with no viable means of livelihood.

The immediate and lingering impact of the typhoons has put further pressure on the government to find more money to finance its rehabilitation efforts. It announced last week that it would float $1.1 billion worth of bonds precisely for this purpose. But critics now say that that would only add to the country’s ballooning debts, which now stand at $51.8 billion. Interest payments alone for that debt would eat up a fourth of the country’s whole budget for 2010.

Some Filipino officials find it unconscionable that the government still insists on paying these debts — and even adding to it by borrowing more — at a time when the country needs all the resources it could gather to rehabilitate itself. They are demanding a moratorium on debt payments.

“We should request foreign lending institutions for a debt moratorium so that we can realign and use a sizeable portion of the hefty debt service fund to the projects aimed at alleviating the plight of disaster victims,” said Aquilino Pimentel Jr., a senator.

“It would be the height of insensitivity and callousness if the government continues to allocate billions toward debt servicing when the Filipino people are in desperate need for relief,” said Satur Ocampo, a congressman. “It will take years to rehabilitate the damaged areas, and it is certain that it will take much longer for the Filipinos severely affected by the calamities to get back on their feet and recover physically, emotionally and psychologically,” he said.

The administration of President Gloria Macapagal-Arroyo has ignored such appeals and instead tried to reassure Filipinos that the government is doing its best to mitigate the impact of climate change, which has been blamed for the unusual amount of rainfall, and environmental degradation. On Friday, Arroyo signed a law, the Philippine Climate Change Act of 2009, that would put in motion programs to deal with climate change. After the signing, the President called on Filipinos to get serious about climate change.

“We will be seeing more and worse Ondoys and Pepengs in the future, if we do not start greening our ways and our environment now,” Arroyo said, referring to the local names of Ketsana and Parma.

http://www.globalpost.com/dispatch/philippines/091027/tropical-storm-aftermath-disease-outbreak