The primary school headmaster in Nuapada district realised diarrhoea had hit the village when just 45 out of his 160 students marked attendance two months ago in his institution in Dudkamunda.
By the time the medical team found time to arrive at the place, about 80 km from district headquarters of Nuapada, two persons had died and more than 100 infected.
Since then, the official death toll has shot up to 64 only in two districts of Orissa — 37 in Rayagada and 27 in Nuapada — both about 500 km southwest of Bhubaneswar.
"After the outbreak of diarrhoea the Nuapada collector visited the village and ordered supplying drinking water by tankers till alternative arrangements were made. The tanker stopped coming after four days and we again had to drink pond water," said Khirabati Majhi (33), who lost her seven-year-old daughter, Pramila, to diarrhoea. Majhi too suffered from the disease when she was expecting and her baby died in her womb.
The government has not confirmed the reported deaths in other neighbouring districts such as Kalahandi, Koraput and Nabarangpur. "More deaths have taken place in Rayagada than what the official figures state," said local journalist Ranjit Padhi.
Of the 17 swab samples sent on Thursday to the Regional Medical Research Centre here, six, all from Rayagada, have tested positive for cholera.
Orissa Health Minister Prasanna Acharya said the situation was grim. "I have asked the district collectors to engage staff from other departments in the case of emergency," he said.
Since 2007, diarrhoea and cholera have claimed more than 200 lives in Rayagada, Koraput and Kalahandi. And they have hit the poorest of the poor.
An acute lack of health services infrastructure is a major factor contributing to the epidemic. In Nuapada, of the sanctioned 65 doctors for the district, 28 posts are lying vacant.
"Recently the state government recruited 408 doctors in the KBK (Koraput, Bolangir, and Kalahandi) districts. Many of them preferred to stay away..." a senior doctor said.