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day, another death A killer is on the loose. It is in our streets, offices, schools, playgrounds and also in our homes. It does not come with a bomb, gun or sword but creeps insidiously into cool, dark corners, awaiting a chance to bite here or there. It multiplies in the most common of places - a yoghurt cup discarded in the garden, the vase in the corner of the hall, the flower pot tray, the water-collecting tray of the fridge, the polythene bag or plastic bottle dumped in the kitchen yard or by the wayside, the common tyre thrown on rooftops to hold down the tin or takaran sheets or the tiny droplet of water on the leaves of the bromelia plant. As these tiny stalkers, the deadly dengue mosquitoes, roam far and wide, felling a little child, a youth or an old woman in the most ruthless manner, we, numb-brained Sri Lankans continue our journey towards disease and death. All Sri Lankans, starting from national level, and going down to provincial, local government and community level talk shop, draw up plans and sit around for another day and another death. The deaths say it all, the strongest indictment on our lethargy and inaction, sometimes wanton neglect. Sixty-three people have died of dengue up to end July, this year and 10,886 have been ill. Is dengue new to Sri Lanka? The resounding 'No' should reveal the absolute lack of coordination and planning against dengue, a disease that has emerged as the country's plague in recent years. We have had dengue since 1989 in endemic proportions, with several outbreaks being reported in some years, with seven months of 2004 beating all others to head the list as the worst year. "We predicted an impending epidemic of dengue by April because there was a 40% increase in the figures when compared to 2003. We warned all relevant authorities," Epidemiologist Dr. Nihal Abeysinghe said. This is August, three months after and what has this country done to curb this disease that is not treatable because there is no drug for a cure or vaccine. While looking after those who have already been stricken by dengue, isn't it imperative that a strong prevention campaign is launched forthwith? The systems, The Sunday Times learns, are all in place to curb dengue. The moment a dengue victim is diagnosed by a hospital, it is the duty of the hospital authorities to inform the Medical Officer of Health (MOH) under whose purview the area falls. Thereafter, the wheels should turn quickly and the MOH is supposed to "visit, investigate and control" the disease immediately by going to the home and environs of the victim checking out the source of disease and advising people to clean up the area. In the event of the family not heeding the advice, the local government body (municipal council, urban council or pradeshiya sabha) has the power to charge them in court under the Local Government Act. But does this happen? For most local bodies health is a secondary matter. At the same time, health experts warn that this is not just a health issue but also an environmental and social issue. What of prevention and how can it be done? There is supposed to be a National Task Force on Dengue chaired by the Health Ministry Secretary with all crucial authorities connected to environment, education and transport, to name a few, having representation. However, where are the results? The only visible result is a rising number of deaths, a poor record for such a highly represented body. Sitting in air-conditioned conference halls deciding on paper how the country should tackle the dengue epidemic or going around the city of Colombo with TV cameras, cleaning up breeding places once in a blue moon on the whim of a politician have not worked. Concrete action is the need of the hour. "Dengue has to be dealt with on a priority basis. While dealing with the present crisis, the long-term issues such as the environment, awareness programmes and a change in the lifestyle of the people have to be addressed," a leading doctor who declined to be named told The Sunday Times. Without wasting precious time talking about the Cuban model, we should get on with it. The Cuban model indicates that everyone does his/her share of the work - the government, the local bodies and the people, another official said. The danger signals are loud and clear. If we as a nation do not take action now, by October-November when the next peak season comes round, most of us may not be around. Dengue would have got us. How
they tackle the dengue crisis Galle
MC: Fifteen municipal wards were cleaned, Mayor Mohamed Arif said.
No routine fumigation has taken place in recent times. Kesbewa
PS: Instructions have been issued by the authorities to use fumigation
only as a secondary method, an official said. Sri Jayawardenepura-Kotte MC: The entire focus has been on the anti-dengue campaign, stressed Mayor J.M. Somadasa, adding that other activities such as road maintenance have been put on the backburner. “The fumigation is most effective in the evenings, and my staff carries out the spraying of chemicals after six p.m. on all weekdays.” All public places including unused land are being sprayed with chemicals. Jaffna MC: Commissioner Dr. Kandiah Kunaresa said various anti-dengue schemes including cleaning of public places and the distribution of pamphlets were taking place. “Labourers are cleaning the roads and drains.” Ampara UC: Regular clean-up programmes were being carried out in public places, while an area covering 100m around a dengue victim’s house was being fumigated, said Chairman Amarasena Illangamage. However, no routine fumigation is done. - Mahangu Weerasinghe
Three-pronged battle
Then, of course, comes the sore issue of garbage collection and disposal which has become a joke among many people. "The bottom line is that non-biodegradable products such as polythene and plastic should be banned. Until such time as these are eased out of the system, solid waste management is essential, starting from home-level right through to local government level and national level," another expert said, citing the example of local bodies not collecting garbage being an encouragement for the public to throw rubbish on the roads. Take the example of Dhaka in Bangladesh, a not-so-developed country in comparison to Sri Lanka, which has banned polythene and uses jute instead. Schools, daham pasalas, NGOs, voluntary bodies and the people should see it as their duty to keep their premises or a small area clean, sans mosquito breeding grounds. This would be a good way of mobilising the people themselves in the battle against dengue. "Schools should have their own garbage disposal system with a compost plant on the premises. Students should be banned from bringing sili-sili bags and other polythene stuff to school. This is already being done in a few schools. There are also a few local bodies such as the Negombo Municipality, the Katana and Horana Pradeshiya Sabhas and the Vavuniya Urban Council which have good solid waste management systems," another doctor said. These could be models for others to follow.
Profile of a killer The number of mosquitoes or their density increases seasonally (June-July with the southwestern monsoon and October-November with the northeastern monsoon), especially when there are intermittent rains as of now. Though the main vector is Aedes aegypti, another milder mosquito, Aedes albopictus seen in suburban and rural areas also spreads the disease. They are dubbed "day-biters" because the attack times are from 7-10 in the morning and 3-6 in the evening. The egg-larvae-pupa-adult mosquito cycle takes only 7 to 10 days and half an eggshell or a spoonful of water is adequate for them to breed. The most fearful aspect is that after the eggs are deposited even if the water dries up, the eggs do not die. As soon as there is a small shower, maybe in a few days, a week or even a year, the eggs get reactivated and produce adult mosquitoes. The adult mosquitoes love cool, dark places such as almirahs, shadowy toilets and kitchens. |
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