Urgent medical attention is needed for the people displaced by the floods on 18 August taking refuge in temporary shelters, including school buildings and tented camps, in Sunsari and Saptari districts, according to the Nepal Red Cross Society (NRCS).

Government health officials said more than 11,000 displaced families in Saptari camps needed medical attention.

Most suffer from diarrhoea, gastroenteritis, fever, respiratory disorders and skin infections that have worsened because of inadequate medical care, according to the UN Children's Fund (UNICEF).

Oxfam has built more than 2,000 temporary shelters in Saptari District alone, which has seen a large influx of displaced families over the past two weeks, and is constructing more camps to house up to 23,000, according to NRCS.

Health concerns are mounting with the growing numbers living in the tiny camps in very hot weather.

Lack of awareness

'I'm worried about my son. He's been sick for days,' said 50-year-old Abhina Khatun in Bhardaha VDC of Saptari District, where nearly 15 people have died this month.

Khatun's 12-year-old son Mohammad Hafij was suffering from dehydration and diarrhoea after drinking polluted water from the river where he had been swimming.

Many children and adults have come down with diarrhoea after swallowing river water, despite warnings by village facilitators who educate the displaced families on hygiene and sanitation. The heat and humidity are so intense that residents cool off in the river.

'There is a challenge to ensure that the communities follow hygiene practices. The children often do not pay attention until they get very sick,' said Shila Karn, working with Sabal, a local NGO supported by UNICEF to promote hygiene and sanitation in the camps.

Emergency response

Following increasing health problems among displaced families, the government is boosting health services with the help of international agencies and NGOs, including the UN Population Fund (UNFPA), UNICEF and World Health Organization (WHO).

'We have stepped up our services and this has helped to reduce the number of patients,' said Garib Das Thakur, chief of the Epidemiology and Disease Control Division of the Department of Health.

Hand-pumped tube wells, bathing spaces and toilets have been installed, helping to reduce the incidence of diarrhoea.

But some NGOs remain concerned over the lack of doctors at the camps, which are run by health workers, including community medicine assistants or health assistants.

Medical staff also complain they are overburdened by the sheer numbers of people.

'There is a need to expand the team and also involve more workers to disseminate health education as that could save a lot of lives,' said health worker Bhupendra Chaudhary.

He was particularly concerned over the plight of children, with nearly 6,000 in the camps of Saptari District alone.

However, the District Public Health Office said it had already expanded its team and services.

It now maintains a 24-hour emergency healthcare service close to the camps. Moreover, 18 doctors from Kathmandu have arrived to provide additional support.

At the same time, Rotary International is building a special health camp to help provide better medical aid.