Health officials struggled Tuesday to cope with outbreaks of mosquito-borne diseases in northern and southern India that have killed at least 87 people and overwhelmed hospitals and clinics.
At New Delhi's All India Institute of Medical Sciences, India's premier state-run hospital, a makeshift ward was set up in a hallway to deal with hundreds of dengue fever patients, some of whom were forced to hold intravenous drip bags above their heads because of a lack of equipment.
The dengue outbreak began in late August, and the death toll in New Delhi and surrounding areas of northern India rose to 16 on Wednesday when a patient at the institute died.
The situation was even worse in the southern state of Kerala, where 71 people have died in the past month from another mosquito-borne disease, a rare viral fever known as chikungunya, said the state's health minister P. K. Sreemathi.
In the hardest-hit district of the state, Alappuzha, some 40,000 people were showing symptoms of the disease _ such as high fevers and severe joint pain _ and thousands had been hospitalized, said the area's chief medical officer, K. Velayudhan.
Across the state, local authorities were overwhelmed by the outbreak, and Sreemathi said a World Health Organization team made up of experts from India's National Institutes of Communicable Diseases was to arrive Thursday.
"The expert heath team from WHO needs to make an on-the-spot assessment to tackle the situation," she told The Associated Press from Alappuzha.
The outbreaks of dengue in the north and chikungunya in the south come as the annual monsoon tapers off across much of the subcontinent, leaving behind countless small pools and puddles of dirty, stagnant water where infectious mosquitoes breed. Open sewers that are features of many Indian towns and cities provide even more breeding grounds.
While a dengue outbreak is an annual post-monsoon occurrence in parts of northern India, this year's has been particularly widespread, with more than 400 cases compared to last year's 217 infections.
India's health minister, Anbumani Ramadoss, blamed the spike in cases this year on a construction boom in New Delhi, where scores of new malls, high-rise apartment towers and office blocks are going up and a new subway system is being built.
The result of the largely unregulated building boom is a city filled with poorly maintained construction sites where water collects in pits, adding to the already ample mosquito breeding grounds, Ramadoss told reporters.
"There is a lot of stagnant water collecting in places due to construction activity. We are aware of the health risks posed by this and have begun a concerted campaign to make people aware of the need for sanitation," Ramadoss said.
Female Aedes mosquitoes transmit the disease, and symptoms include high fever, joint pain, headache and vomiting. It is fatal in rare cases. India's annual outbreak normally dies off with the end of the mosquito breeding period in November.
Authorities in New Delhi were pressing home and business owners to spray their properties with insecticides, and teams of municipal workers sprayed some construction sites, office buildings and residential neighborhoods. Fogging machines were also used to spread clouds of insecticides in densely populated areas of the city.
But such efforts have only begun in recent days and it remained unclear what, if any, impact was being made.
Further complicating matters was a shortage of staff at the All India Institute of Medical Sciences, where one doctor has died from dengue and 19 other physicians and medical students had fallen ill with the disease.
Authorities in the capital were, however, urging residents to remain clam.
"We don't want to create any panic. The efforts of the past few days should kick in and the number of dengue cases should taper off shortly," Ramadoss said.