"Look out for landmines," shouted my Indian colleague as we stepped out of the boat at the village of Malitola. I had not heard of landmines being used in this part of India and quickly moved into the middle of the muddy path. As I did I heard laughter from my team members behind me.
"That's a landmine," one of them chortled, pointing to a pile of excrement on the path's edge.
Slightly relieved, I took note of the "landmine" and saw more and more as we entered the village. This was human excrement and it filled the air with a pungent stench.
I have never seen such a concentration of feces so close to village homes before and fear the implications.
I am in the northeastern state of Bihar working on the flood relief effort.
This part of the world is no stranger to flooding but for many in India this year has been the worst in memory.
Eighteen continuous days of monsoon rains drenched the region, the water flowing off the Himalayas through Nepal, into India and draining via Bangladesh.
The floods have claimed hundreds of lives and affected an estimated 50 million people in the three nations combined.
In Bihar, hundreds of thousands of people are still stranded by floodwater, as their villages have become islands. Food is scarce and now the fear of a medical catastrophe is looming over the region.
India now has two distinct faces, one of growth and wealth and one of extreme poverty. Bihar is far removed from the bustling IT economies of India's big cities and is one of the poorest states in the country.
Most people live a life of simple subsistence farming so this disaster will be a major setback and further widen the gap between the Bihar farmer and the Bangalore computer technician.
Operation Blessing is working with the Duncan Hospital in Rexaul, right on the Nepal border. Together we have formed relief teams and have been venturing out to stranded villages by boat to deliver relief kits containing food, essential hygiene items and emergency medical supplies.
Bihar is huge and very remote, as far as I know we are the only organisations serving East Champaran district, where 350,000 people have been affected by the floods.
Over the last few days it has been a rush to reach as many marooned villagers as possible. At first it was a simple task of loading boats with relief kits and sending teams out over a sea of floodwater.
But as each day passes the water level is dropping and navigation is becoming harder.
Yesterday we became grounded several times and we found ourselves having to push our boat through knee-deep, leech-infested, muddy floodwater.
In a few days the water will have receded to where boats are useless. The quagmire left behind will make reaching stranded communities impossible for several days.
We have been able to distribute thousands of relief kits but there are still hundreds of thousands of people trapped throughout the Bihar flood "archipelago" who have received nothing.
Every disaster has a unique set of problems that arise after the main event. Just recently in China we saw how a plague of rats fled rising floodwaters and terrorised villagers in Hunan.
Bihar is also being plagued, but here it is by snakes. The snakes are converging on the same high ground that the villagers inhabit and people are being bitten at an alarming rate.
Duncan hospital is receiving an average of two bite victims per day and those are people that are able to reach Rexaul!
The most common venomous snake is the krait, a member of the viper family. Its deadly bite contains haemotoxic venom that causes its victim to bleed to death.
And then there is the infamous cobra with its neurotoxic venom. The snakebites are claiming lives but not all snakes here are venomous.
I wonder if the psychological effect of the snakebite could become the biggest killer.
I am used to working in the developing world, where we place a great deal of emphasis on hygiene education. One of the most basic principles taught in any hygiene curriculum is to go to the toilet away from your home and water supply.
As I scanned Malitola village and its "landmines" on my first day I was shocked that the villagers seemed to be breaking every rule in the book.
When I enquired as to why the villagers seemed to have such a disregard for sanitation the answer I received put things into perspective.
"We're afraid of the snakes," one villager said in defence.
It seems that the villagers of Bihar fear the very visible threat of a snakebite over the invisible threat of becoming sick through poor hygiene.
Rather than venture out into the bushes they prefer to go to the toilet right outside their home.
Combined with the stagnant floodwater, it is no surprise that the United Nations is warning that Bihar is a ticking time bomb waiting for a huge explosion of disease.
For some places it is already too late.
In Malitola one in five people had acute diarrhoea and were complaining of abdominal pains. The same could be said for all of the villages we have reached, and Duncan hospital has already started treating cholera patients.
Knowing of each village's impending isolation as the waters recede, we have been leaving behind medical supplies such as oral rehydration salts, paracetamol and water purification tablets.
For the villagers in the flood zone the outlook is bleak. If they are not struck by cholera, then typhoid, malaria and a whole host of other diseases are waiting in the wings.
Failed crops and general substandard conditions make life difficult for Bihar's population at the best of times.
One doctor at Duncan hospital told me that even before this disaster they were treating an average of two attempted suicide poisonings per day.
Now many people have lost everything. This disaster has crushed families financially, physically and even spiritually.
For many Hindus the loss of their sacred cows will take the misery of this disaster to a level beyond the norm.
As soon as we have access we will be sending medical teams back into the villages but by then it could be too late for many people.
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