According to the Birgunj Metropolitan City’s Health Division, at least 71 cases of cholera have been confirmed since Friday, with over 200 patients currently receiving treatment for diarrhea and suspected cholera in various hospitals across the city. Two deaths have been reported among patients suffering from severe diarrhea, though cholera infection has not been confirmed in those cases.
Medical experts suspect the outbreak is linked to contamination of drinking water pipelines with sewage. Samples from 11 affected locations have been collected and sent to the National Public Health Laboratory in Teku, Kathmandu, with test results expected soon.
Hospitals in Birgunj, particularly Narayani Hospital, are struggling to cope with the rising patient load. “Due to a shortage of hospital beds, we have been forced to treat patients on the floors and verandas,” said Dr Uday Narayan Singh, spokesperson for Narayani Hospital.
The outbreak has particularly affected Birgunj Metropolitan City-11, 12, 13, and 16. With community-level spread confirmed, the municipality has ordered all schools in the city to remain closed for two days (Sunday and Monday) as a precautionary measure.
Minister for Water Supply Pradeep Yadav, who visited Narayani Hospital and other affected areas, acknowledged that sewage contamination in water pipelines may have triggered the outbreak. “Water samples from affected areas have been sent to Kathmandu for testing. Only after the results arrive can we confirm the exact cause,” Yadav said. He assured that the government is fully sensitive to the crisis and that teams with water purification materials, including chlorine solutions such as Piyush, have already been dispatched to Birgunj.
Mayor of Birgunj metropolitan city, Rajesh Man Singh, said the city office has also mobilized local health teams for door-to-door awareness campaigns, water sampling, and immediate intervention since Friday night when the first cluster of cases emerged in Murlitol of ward 12. “Strict monitoring is underway at marketplaces to ensure hygiene in the transport and sale of fish, meat, sekuwa and other animal products.” As part of the campaign, authorities have begun inspecting vendors, who display food items openly, sell products in unhygienic conditions or neglect sanitation standards, with actions being taken against violators.
Officials confirmed that this is the first major cholera outbreak in Parsa district in the past decade. Cholera, caused by the bacterium Vibrio cholerae, spreads through contaminated food and water. Symptoms include acute diarrhea, vomiting, abdominal pain, sunken eyes, dehydration, muscle cramps, and in severe cases, fever.
With patient numbers still rising, health authorities warn that the situation could worsen unless water sources are secured and mass preventive measures are enforced immediately.
The Madhes Provincial Government has supplied medicines and health materials to Narayani Hospital in Birgunj for the treatment of cholera patients. On Sunday, Dr Bipan Kumar Jha, Chief of the Health Division at the Ministry of Health and Population, Madhes Province, and Public Health Officer Santosh Thakur handed over the medicines and supplies to Dr Chumanlal Das, Medical Superintendent of Narayani Hospital. The provincial government has provided 17 types of medicines and materials needed for the treatment of diarrhea and cholera patients through the Parsa District Health Office, Thakur said. He added that the provincial government is committed to controlling the cholera outbreak in Birgunj and is prepared to provide additional medicines and supplies if required.
Meanwhile, Home Minister Ramesh Lekhak has directed security agencies to remain on high alert to support efforts in containing a cholera outbreak that has spread across Birgunj. During a meeting of the Central Security Committee on Sunday, Minister Lekhak instructed the Nepali Army, Nepal Police and the Armed Police Force to remain ready for mobilization if required. “The minister has also instructed preparations to deploy medical teams, including doctors, should the situation worsen,” said Ministry spokesperson and Joint-secretary Anand Kafle after the meeting.
Environmentalist Ujjwal Upadhyay says the cholera outbreak in Birgunj is a direct impact of climate change. Taking to Facebook, he explained that reduced monsoon rainfall and recurring droughts have dried up water sources, creating an acute shortage of drinking water. As a result, local residents have become dependent on unsafe alternatives, such as jar water that is often not quality-tested. When water quantity declines at the source, the concentration of pathogens increases, making the water more contaminated and heightening the risk of infectious diseases.
According to the World Health Organization (WHO), every individual requires at least 100 liters of safe water per day. When supply falls below this level, the likelihood of waterborne diseases rises sharply.
As tube wells began to dry up one after another, the municipality started supplying water through new PVC pipelines, many of which run alongside sewerage canals. During times of acute shortage, people broke open these pipelines to access water but never repaired them afterward, leaving the system highly vulnerable to contamination.
While open defecation has nearly ended in the city, the lack of safe water has compounded the problem. “The bigger question,” Upadhyay stresses, “is who should bear responsibility and provide compensation for such climate-induced losses and damages caused by the excessive carbon emissions of major powers?”
