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WITH A STING They also say that anti-dengue campaigns and awareness programmes have drawn little response with some state institutions including schools failing to take steps to minimise the menace. The present outbreak of this 'urban disease' is reportedly one of the worst health dilemmas that the country has faced since it first broke-out here in 1989. The worst affected areas are Colombo, reporting 731 cases, Gampaha 725, Kandy 661 and Kurunegala 303. The lack of a permanent body to tackle dengue appears to be one of the main hurdles in combating it. Since it is a seasonal disease – rearing its head during the South-West monsoon (June to July) and the North-East monsoon (October to December) there is no permanent body to fight the menace. Although the Epidemiology Unit of the Health Ministry is vested with the responsibility, the lack of adequate statutory authority and the non-existence of a permanent body, hampers the effective control of the disease, a Health Ministry source told The Sunday Times. While the Entolomological Unit of the Medical Research Institute (MRI) is concentrating on Colombo city and its suburbs, the Anti-Malaria Campaign and the Anti-Filaria Campaign are managing the rest of the island. Commenting on steps that have so far been taken by the ministry to curb the disease, Epidemiology Unit head Nihal Abeysinghe said state institutions had been asked to clean up their premises one hour a week and be vigilant of possible breeding places. Other steps taken by the Health Ministry to combat dengue include the deployment of a flying squad to do spot-checks on state institutions and hold the heads of those institutions responsible and the working out of an action plan with the collaboration of the Ministries of Environment, Local Government, Education and Urban Development. The Sunday Times learns that the Ministry of Environment hopes to present a cabinet paper to formulate a national policy on solid waste management as a permanent solution to the garbage problem. (See related story) The other hurdle in combating dengue is there being no specific cure or medication for the disease. The only treatment as such is that the patient has to be closely monitored and be given supportive treatment. However, Dr. Abeysinghe said the rate of fatalities (0.5% of the total number of cases) in Sri Lanka was low compared to other countries because of the high standard of our health sector. He said the present intermittent showers provided an ideal breeding ground for the dengue carrier- the Aedes aegypti mosquito. He also said since the disease was an urban one and rarely seen in rural areas it was important that the urban population changed their lifestyles. Pointing out the importance of collective action to combat the disease, he said no institution could tackle the growing menace single- handedly. He said a lack of cooperation by the people and some state institutions had worsened the situation. Local government authorities too have to play a major role in disposing of garbage and maintain proper drainage. Under the Quarantine and Prevention of Diseases Ordinance these authorities can pass bylaws to control diseases as well as prosecute those who do not comply. Although the CMC’s Public Health Department (PHD) of the Colombo Municipal Council is carrying on an effective Dengue control programme, other local government authorities appear to be doing very little. Commenting on the situation in Colombo, chief medical officer of health, Dr. Pradeep Kariyawasam, said though the number of cases reported in Colombo was much higher than that of the suburbs, average wise it was lower. He said Colombo with a massive population of 700,000 had reported only 280 cases of Dengue while Sri Jayawardenepura Kotte with one-third of that population, reported almost the same number of cases. However, a Health Ministry source said the available statistics were only limited to dengue cases that were reported from the national hospital and did not reflect the number of cases treated privately. Dr. Kariywasam lamented that the public response was poor and warned that if the rains turned heavy the situation could be worse. He said about 1800 notices had been issued on probable mosquito breeding grounds that included, household premises, schools, universities and properties that belonged to doctors and other well-to-do citizens. He said a CMC dengue-prevention programme that was to be launched in April had to be put off due to general elections and New Year holidays. The Sunday Times learns that the Health Ministry would be presenting in parliament a bill to control mosquito-borne diseases which would enable public health inspectors to levy on-the-spot fines on offenders. Under the existing laws a person can be produced in courts and fined Rs. 50 a day if he/she fails to eliminate any breeding grounds within two weeks of being ordered by a PHI to do so. Kurunegala
fears the worst Dhammika was expecting her first baby when she fell ill and was rushed to hospital. Hosptal sources say she started haemorrhaging and the foetus was removed through a caesarian. Three days later the young mother died. Family members allege that doctors’ negligence had led to her death. There have also been allegations that although the Municipal Council had spent a lot of money on fumigation its effect had been minimal.It has been alleged that money had been misapproriated by people who had come from Colombo to do the fumigation. Commenting on the spread of Dengue in Kurunegala an epidemiologist Dr. Shayama Jayasinghe said, “In the previous outbreaks mosquitos bred in coconut shells, yoghurt cups etc but this time it was breeding mainly in household water tanks especially the plastic types. "Though dengue does not usually spread during dry spells, this time it did. No amount of public awareness programmes will be of use if people do not act in a responsible manner,” she said. Residents complain that the Municipal Council is largely responsible for the spread of dengue.They also say that the facilities at the teaching hospital were inadequate to cope with the increasing number of dengue cases. The two wards meant for dengue patients are spilling over. In some cases there are four patients in one bed.
Health risk amidst growing mounds of dirt Residents who live closeby complain of the unbearable stench and say their children often fall sick. The Sunday Times is thankful to medical officer Sujatha Ekanayake and minor overseer P.A. Serasinghe who allowed us to photograph this stinking site which so far had been off limits to any photographer. The usual practice at any refuse dump is to bulldoze the waste. But the medical officer told us that for the past two months this has not been happening at the site because the bulldozers were out of commission. The water that collects in the coconut shells, plastic ware and polythene bags are ideal breeding grounds for dengue. In addition to the whole of Harispattuwa refuse being dumped at the site, the Kandy Municipal Council also dumps a rubbish load of about 75-100 metric tonnes here. Ms.Ekanayake warned that unless urgent steps were taken to get the bulldozers rolling, there would be a major health hazard. Mr. Serasinghe said that it would cost about 8 lakhs to repair the bulldozers. He said at the moment adhoc measures are being taken with the municipality paying about Rs. 1400 an hour to hire private bulldozers. Spot
the symptoms The female mosquito lays eggs in clean water-even 2 millimetres would be enough. The symptoms of Dengue Fever include sudden high fever, severe headache, pain behind the eyes and muscle and joint aches. Dengue Haemorrhagic Fever is marked by a high fever (103-105 F) which might lead to bleeding and even shock. Treatment is crucial when any of the following manifestations appear- Red spots on the skin, bleeding from the nose, gums or years, frequent vomitting, black stools, abdominal pain and difficulty in breathing. Culprits
get warning Among them are Sri Lanka Telecom Head office, Fort Police Station, Police Welfare Centre, Customs Department, University of Colombo, Fort Railway Station, Maradana Railway Station and Mahanama College. Other detected major mosquito breeding grounds include properties belonging to two medical Specialists in Longdon Place and some construction sites in Bambalapitiya Some ponds, bird-baths and swimming pools in Colombo 7 residences have been found to be infested with mosquito larvae. Health
group urges ban on sili sili bags The National Movement for the Rights of Patients (NMRP) in an appeal to mark World Environment Day said the government should move into promote the wide scale use of biodegradable polythene bags and wrappers. A spokesman for the NMRP said research had shown that Sri Lanka was facing a major environmental and health threat because it was now overloaded with hundreds of millions of polythene or sili sili bags which would not degrade for some thousand years. He said sili sili bags indiscriminately thrown away in gardens, drains and roadsides had become breeding places for dengue mosquitos. Mosquitos are known to breed in even a spoonful of water and the thrown away sili sili bags in gardens and road sides have turned into breeding spots. Research has also shown that if a one foot sili sili bag is thrown in the garden, that one foot of soil becomes less fertile. It means that if thousand bags are thrown in a garden, some thousand feet of soil would become less fertile. It is also known that discarded sili sili bags are the main cause for the clogging of drains, the flooding of roads and all the other drastic consequences. Mounds or mountains of sili sili bags are also seen at popular pilgrim spots bringing not a blessing but a health calamity in those areas. The NMRP spokesman said they hope Minister Fowzie would act fast to ban non biodegradable polythene bags or wrappers and provide incentives for those who produce and market Eco friendly biodegradable bags and wrappers. Meanwhile the NMRP is also urging some health sector trade unions to put off their proposed strike action in view of the crisis over the dengue epidemic. The society of Assistant and Registered Medical Officers is planning a full scale strike this week while the health sector trade unions alliance is planning a two-day token strike over salary disputes. The NMRP spokesman said the movement would organise public protests and would even consider court action if the unions went ahead with the strikes which would cause more suffering to thousands of panic stricken people. |
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