Dengue needs Citizen action

Do you, dear reader, know someone affected by dengue? How many of you know someone affected by dengue? The incidence of this deadly disease has reached such proportions that many Sri Lankans, though un-affected by dengue themselves, personally know others who have been affected.

In the face of the rapid increase in dengue cases this year, the health authorities are responding on several parallel tracks: expanding treatment capacity, enforcing preventive measures, public awareness campaigning, and strengthening risk monitoring. The degree of initiatives in all these areas, at national and local levels and across sectors, is indicative of the energies deployed in response.

The challenge that faces health workers is of historic proportions. Today, Sri Lanka has been hit by the worst ever dengue epidemic in our island’s long history.

Look at the number of cases reported. In 2016, some 51,000 cases were reported. But, in just the first half of this year, some 61,000 dengue cases have been reported. This means, the country is now treating the greatest number of dengue patients in its history, with the escalation being very sudden, and massive in scale.

One immediate factor above all other causal factors prompted this rapid worsening of the epidemic: the successive years of unusually extreme weather. In the last two years, some regions continuously suffered from drought and its impacts. Other areas suffered from sudden and unusually heavy rains that caused flooding, earth slips, infrastructure damage, human casualties and, epidemics.

Over 200 people have died of dengue so far this year. While, on average, there are now nearly 300 dengue patients per 100,000 of population across the country, 45 percent of the cases have been reported from the Western Province. This is because dengue is very much an urban phenomenon.

The uncontrollable impact of unusually intense rainstorms creates conditions in urban areas that are conducive to the dengue mosquito. Much of the urban sprawl of the Western Province are poorly planned or unplanned urbanization with almost non-existent or overloaded water management systems, unsafe buildings, lack of preventive measures and, un-mobilized public compliance.

Intense storms in some areas this year brought a whole year’s rainfall in a single 24-hour period. Such weather conditions countrywide, and repeated over two years, worsened health risks to unmanageable levels. If the health authorities were overwhelmed, the affected citizenry lacked both, the risk awareness as well as the resources to effectively deal with the health impacts of such freak weather conditions.

Last week, the Health Ministry launched a major dengue eradication campaign. Ministry agencies in coordination with local authorities, the hospital system, and national and local NGOs, are now reaching out islandwide in this effort.

Several aspects of the dengue problem are addressed in this eradication campaign – from practice of response procedures and fumigation to public education and preventive measures by citizens.

So, when our municipal health workers visit our homes in the coming weeks, citizens are called to co-operate, both, to facilitate site inspection and to absorb the advice on prevention and detection.

Just as much as careful garbage management by individual citizens has become crucial for a country’s efficient management of waste, the careful management of home structures and water flows by citizens is crucial to combat dengue (and other diseases and environmental problems).

Urban health inspectors find that up to 12 percent of houses inspected show potential dengue mosquito breeding areas. Minimum preventive standards require such breeding potential to be reduced by half.

The increase in the number of child cases has spurred the campaign to especially, focus on schools and schoolchildren. This year, more than half of the dengue cases were under the age of 18 years. Parents are called on to co-operate in this aspect.

Campaigns are but the cutting edge in the fight against this deadly disease. The scale of the problem requires considerable investment of money and human resources to quickly broaden the response to this health challenge.

This means the rapid expansion of the health infrastructure on the one hand and, on the other, the encouragement of research, innovation and entrepreneurship for new and effective solutions. Government, private sector and the NGO sector will need to strengthen their efforts as well as inter-sectoral co-operation. In addition to immediate action, long term national budget planning may need to add to the health budget of the country if we are to continue to stay healthy.

The need for such co-operation will not provide much room for wildcat strikes. Nor does it allow space for corruption of any kind. 

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