DEWAN RAI LISTEN CAREFULLY: In Doti, Asha Shahi explains how to use WFP's vitamin powder sachets

DOTI – A lorry full of rice sacks screeches to halt where the dirt road ends in Kalikasthan, 27 km from Dipayal. Women and children, dogged by swarms of flies, surround the vehicle. They clap and scream in joy and soon volunteer to offload the sacks as a two-man band beats drums.

The World Food Programme (WFP) is distributing food. Under its Food for Assets intervention, the immediate food needs of the population are met while mobilising them to build assets that will contribute to local enterprises, income generation and improved agricultural production.

As the clamour dies down Asha Shahi, a social facilitator from local partner Maxpro, orients the women by instructing them how to use micronutrient powders for children under the age of five. "Do not mix it with liquid food," she cautions.

In the light of the terrible diarrhoea-cholera epidemic that swept over parts of mid and far western Nepal last year, killing 282 (WHO, August 2009), it's a warning they'd do well to heed. WFP is especially keen to get the message across.

This is understandable. Last summer WFP, which provides food to 3.5 million Nepalis in 40 districts, was accused by several rights organisations, most notably INSEC, of providing sub-standard food that contributed to the epidemic. The government initially seemed to go along with the story rather than concede that it was its slow response and totally inadequate preparation that prolonged the public health disaster. Though it later issued statements denying the link between WFP and the epidemic, the damage was done. An uncritical media fraternity, too, appeared willing to cast unsubstantiated aspersions upon a donor.

This is as attributable to the tenor of journalism in Nepal as the plain ignorance of many reporters. At a March press conference held by Sameer Dixit's Centre for Molecular Dynamics to announce the results of tests on last year's stool samples from Doti, many mediapersons seemed palpably confused. Faced with evidence that cleared WFP, some protested, "But government told us WFP food was responsible!"

A much larger investigation was commissioned from the Natural Resources Institute in London by WFP last year. This was also categorical that WFP food could not have been responsible for the epidemic.

In Doti's Kalikasthan, meanwhile, Basanti Kumari Bhatta cuts her rice sack open and examines the contents. "Look, this is so fine," she mutters. She is well aware that this year, too, there have been rumours that WFP food is causing diarrhoea. But DR Bhatta, who coordinates food distribution in his ward, says there haven't even been any cases of diarrhoea in his VDC. "We've already talked with members of the Federation of Nepalese Journalists in the district about this. It's just a rumour."

Diarrhoea was also falsely reported in Tikhattar VDC. "We have already digested WFP rice without getting diarrhoea. People here want more rice," says resident Saru BK.  Padma Devi Shahi, a health volunteer in the VDC, says she has not found a single case of diarrhoea caused by consuming vitamins or rice. She says volunteers have visited every village of the VDC twice since the rumours began.

The situation in Basudebi VDC is similar, and in Barbata, locals are angry about the false reports of an outbreak in their VDC. Ramesh Rokaya wants to know who spread the rumours in the first place. "The offender should be booked," he says, "We know what to do with the fraud reporter." Tula Ram Bhatta of Kalikasthan believes such rumours will ultimately put poor people at risk, and should not hamper WFP projects. The dirt road from Dipayal to Kalikasthan was constructed under the Food for Assets program, after all. Further, many Dalit communities in the region can only produce enough food for two to three months a year, so one can understand Bhatta's anxiety.

While some newspaper reports claimed that locals were wary of WFP food because of last year's controversy, the ground realities do not appear to bear this out. Ultimately, they divert attention from the real triggers of diarrhoea outbreaks – the lack of potable water, sanitation facilities, and proper hygiene in affected areas.

Ram Ikbal Shah of Kalikasthan's health post says villagers, especially in the Dalit communities, lack hygienic practices. When the water sources dry up and the number of flies increases, risk is heightened. "Food is not the cause of diarrhoea, unhygienic practices are," Shah says. "They excrete in the open space around their houses because they don't know any better."

Bishwa Raj Khanal, senior public health administrator at the Department of Health Services, acknowledges that diarrhoea is a common seasonal phenomenon. His recent visits to Jajarkot and Rukum didn't indicate a full-scale outbreak was imminent. "The government has been doing everything it can," he says, "by filling in health worker vacancies and providing medicine stocks. But we need support."

The near-daily reports of diarrhoea cases, with fatalities on the rise, can't be dismissed wholesale. But if an epidemic does gather momentum, coordinated support rather than the all-too-easy blame game might be better appreciated at the end of the dirt road to Kalikasthan.

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Learning from Jajarkot - From issue #498 (16 April 2010- 22 April 2010)