In India's Sundarbans region, natural disasters will continue to complicate vision, health care

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A medical staff member at work in the screening camp on Sagar Island in the Sundarbans region. Photo by: Sightsavers

NEW YORK — Life in the Indian subcontinent’s Sundarbans has long been “very difficult” for the people that inhabit 54 of the region’s 102 low-lying, flood-prone islands, according to Sampa Paul, Sundarbans program manager for vision health nonprofit Sightsavers.

But then Cyclone Amphan hit India and Bangladesh in May, damaging 2.9 million homes and more than 563 primary health centers in West Bengal. Routine health and vision care access dropped immediately. And the significant storm surge and salinization of land gave way to a rise in eye infections in children, Paul said.

“The houses were torn down within seconds. Electric poles and transformers were ripped beyond recognition,” Paul told Devex. “Domestic animals, like chickens, goats, cows, were washed away, and people were just devastated.”

Sightsavers is rolling out new public health strategies intended to help close health care access gaps for people during the COVID-19 pandemic but also amid recurrent threats of future, equally devastating cyclones.

While patients quickly returned for eye health care when Sightsavers’ clinics reopened after the cyclone, patient numbers have not yet reached pre-cyclone levels. From January through August, the organization dispensed eye glasses to more than 2,000 people and performed about 2,500 cataract surgeries in the Sundarbans, according to Paul.

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“Whatever damage was caused in the primary centers, the renovation work was done quite fast. And within 15 days, they started functioning again. But the secondary hospitals took about 1 1/2 months to restore their services because there was no electricity,” Paul said.

While the prevalence of blindness in India has nearly halved since 2007, blindness still affected 4.8 million people in 2019, according to the National Blindness and Visually Impaired Survey. Cataract disease is the most common cause of blindness in the country.

As part of the new strategies, Sightsavers is now providing more preventive eye health care and guidance, “even if there is not a surgery or there isn’t a clear problem with the eyes,” Paul said. This includes explaining how to take care of the eyes so that even people accompanying patients for surgery have that knowledge and can talk to others about it.

“We are also disseminating messages of general health. ... Our health workers go door to door, giving the message that our vision centers have opened after a long closure of COVID and the cyclone,” Paul said.

The idea is to avoid spikes in eye infections and other problems during natural disasters in the future, according to Paul. Following the cyclone, Sightsavers vision clinics observed “a very high rise” in eye infections among children because of waterborne diseases that the storm surge helped fuel. They also saw cataract cases worsen among patients.

More health care and other services are likely to face prolonged interruptions in the Sundarbans and the surrounding regions in Bangladesh and India.

“The experience of Bangladesh and India reveals an uncomfortable truth: complex and multifaceted disasters are the way of the future and, therefore, require a multifaceted set of responses,” wrote Kayly Ober, senior advocate and program manager of Refugees International’s climate displacement program, in a new report on COVID-19 and Cyclone Amphan. Released Wednesday, the findings show how the simultaneous health pandemic and natural disaster have created a complex crisis.

A vision technician at work in a health center on Sagar Island in the Sundarbans region. Photo by: Sightsavers

Humanitarian responses to natural disasters have slowed during the pandemic because of funding reallocations for COVID-19 and limitations on travel and supply chains, Ober said in a recent interview.

“There is a huge underfunding underway when it comes to natural disasters. For comparative storms in the past, you can see funding was higher. And requests from [United Nations] agencies like UNICEF, FAO [the Food and Agriculture Organization], and OCHA are hugely underfunded in these instances,” Ober said.

“Disasters are getting the short shrift. And in the short term, they are not able to get on the footing to build up their capacity or rebound from disaster,” she continued.

The cyclone’s impact in the Sundarbans could be experienced for more than five years, according to Ober, given the intense salinization of the land. Up to 50% of the total croplands were inundated by the storm surge, rendering them “unusable.”

“The experience of Bangladesh and India reveals an uncomfortable truth: complex and multifaceted disasters are the way of the future and ... require a multifaceted set of responses.”

— Kayly Ober, senior advocate and program manager, Refugees International’s climate displacement program

“You cannot plant anything, and nothing you planted before can grow. Imagine if another cyclone occurs — Sundarbans is one of the regions with the fastest sea level rise in the world. This is a long setback for the region,” Ober said.

The combination of the cyclone and COVID-19 has had an additional impact on people’s livelihoods. For migrant workers who returned to the Sundarbans during India’s lockdown in March and April, their chances of finding new work at home are more remote because of the cyclone’s destruction of the land, eliminating agricultural opportunities. West Bengal alone saw the return of more than 1 million migrant workers, many of them “jobless and penniless,” a local NGO worker told Refugees International.

“One issue is to understand that the need is greater than it would be in the past, and the second is to be able to be nimble and ensure migrant workers can access social protection schemes so they can ‘weather the storm,’ so to speak,” Ober said. “If you are forced home, it is almost impossible to do.”

Devex, with financial support from our partner Essilor, is exploring challenges, solutions, and innovations in eye care and vision. Visit the Focus on: Vision page for more.

About the author

  • Amy Lieberman

    Amy Lieberman is the U.N. Correspondent for Devex. She covers the United Nations and reports on global development and politics. Amy previously worked as a freelance reporter, covering the environment, human rights, immigration, and health across the U.S. and in more than 10 countries, including Colombia, Mexico, Nepal, and Cambodia. Her coverage has appeared in the Guardian, the Atlantic, Slate, and the Los Angeles Times. A native New Yorker, Amy received her master’s degree in politics and government from Columbia’s School of Journalism.