Clad in a white sari and apron, 30-year-old staff nurse Arskmani Hembram moves tirelessly from one patient to another in the Kashipur government hospital in Orissa asking if they need any help.
She has been taking care of the huge influx of patients for more than a month and a half after a serious epidemic of cholera and diarrhoea broke out in the area, claiming at least 150 lives in the three tribal districts of Rayagada, Koraput and Kalahandi.
The Kashipur block in Rayagada district has been hit particularly hard. Thousands are battling for their lives in hospitals and health centres.
Health officials have detected the incidence of cholera only in villages of the Kashipur block, situated about 500 km from state capital Bhubaneswar, in this eastern Indian coastal state.
"I have never seen such an outbreak in my life," said Hembram, who has been working in the hospital for the past 11 years.
Initially, diarrhoea patients in the hospital numbered only one or two every day in July. Recounted Hembram: "In August first week the numbers went up. I remember that on Aug 7, all the 16 beds of the hospital were full and the rush was in the hundreds.
"We had to accommodate some patients on the floor because their condition was serious and required immediate attention. The hospital at that time had only one doctor and a few other staff including me. Our first priority was to save lives."
"We managed the pestilence for over a week, after which the government sent a team of doctors to the affected areas," she said.
Hembram lives near the hospital. "I was just going home to change and eat. The rest of the time I was taking care of the patients," she said.
"The death toll could have been much more. There were many who helped check the spread of the disease," said Rayagada district collector Bhaskar Jyoti Sharma, who spent about 15 days at Kashipur during the outbreak.
The incidence of cholera was not immediately reported. It was on Aug 22 that doctors told Sharma unofficially that the symptoms were of cholera - a deadly disease that could kill a patient within two-three hours if left untreated.
"It was time to act," he said. "I rushed to Kashipur and brought doctors from other places in the district, used Red Cross funds and sought the help of local corporates, particularly the J.K. Paper Mill and Indian Metals and Ferro Alloys," he recalled.
"We deployed doctors in each village and asked them to treat villagers in the village schools and whatever shelter that were available. All these happened days before the test report confirmed a cholera outbreak in the area," Said Sharma.
He deployed government officials to bring patients from inaccessible areas to the nearest government hospitals.
"Dilip Patra, a 57-year-old government official, was swept away in a river on Aug 28, when he was trying to bring three serious patients to the nearest government hospital. The patients however survived," said Sharma.
"We treated at least 23,000 people in 15 days. Of them more than 7,000 were afflicted with cholera," he said.
Rayadaga district has a population of about 850,000. It has about 45 government treatment centres and 17 mobile health units. However, about half the posts of doctors in the districts are vacant at present, according to district medical officer P. Sitaram.
"People worked without permanent infrastructure, insufficient medicines and bad road conditions. Since there are not enough doctors, many government and non-government officials worked day and night to save people from death," said Sitaram.