Shared responsibility - key to prevent dengue

By Dhameshi YATAWARA

‘Aedes aegypti’ has brought a dilemma to the society along with a febrile disease. It may be difficult to identify this character, yet all of us know much about this. It’s the mosquito that flies specifically during the day in search of food. And our blood becomes its meal. The speciality is not the mosquito but the diseases it spreads which cause the Dengue fever and Dengue haemorrhagic fever.

The female Aedes mosquito spreads the disease infecting the human with anyone of the four dengue viruses it carry. Dengue has become the most common mosquito borne viral diseases that has caused major international public health concern.

According to the World Health Organisation statistics, globally 2.5 million people live in areas where dengue virus can be transmitted.

There is no specific treatment for dengue but appropriate medical care can save the lives of patients with serious dengue haemorrhagic fever.

According to the epidemiology Unit of the Ministry of Health 23,145 cases of Dengue Fever and Dengue haemorrhagic fever were reported islandwide within this year. Out of the total number of deaths within these seven months, 47 cases were reported from Colombo district, 23 from Gampaha district, 16 from Matara and 12 from Batticaloa.

Understanding the gravity of the condition the Sri Lankan Government, under the directive of President Mahinda Rajapaksa, launched a collective effort merging every ministry that bears a responsibility towards ending this menace.

Established on May 25, for the first time in Sri Lankan medical history, the Presidential Task Force on Dengue headed by President Rajapaksa today functions under the close supervision of Health Minister Maithripala Sirisena, restructuring and coordinating the existing administrative structure, to make it more effective at the grass roots level.

Shared responsibility is the key to eradicate dengue. As Dengue is a vector borne disease upgrading the treatment facilities alone would not be enough. The mosquito, ‘Aedes aegypti’ travels an area of 500 metres radius and the people should be responsible to keep their gardens clean and also the environment.

“Controlling the vector means controlling the epidemic,” said Dr. Palitha Mahipala, Director General of Health Services (Public Health) of the Ministry of Health said.

Through the Task Force the aim is to make an effective participation at the grass root level,” Dr. Mahipala said. Accordingly the Task Force, Committees at the Provincial and District level, would coordinate and lay out plans to implement it islandwide. The actual implementation would take place at the Divisional Secretariat level and Pradeshiya Sabha level. “These officials can take legal action against the citizens who pollute the environment creating dengue mosquito breeding grounds,” he said.

Even the WHO highlights that a rapid rise in urban mosquitos bring a great number of people into contact with this vector, specially in areas favourable for mosquito breeding. Hot spots would be where the solid waste are disposed.

It is said to realise that in Asia and America, the mosquito ‘Aedes aegypti’ breeds primarily in man-made containers - we dig our own graves! Containers used to store water for domestic usage, discarded plastic containers, used automobile tyres and many other items that collect water, provide optimum conditions for the mosquitos to breed.

The application of appropriate insecticides to larval habitats is, a common practice of the medical authorities today, which should be repeated after a period of time. Thus, the most effective way to prevent the disease is to destroy the breeding grounds and as the golden rule says ‘Prevention is better than cure’.

If people at the grass roots level are aware of such places it would help the local committees the Task Force to be more effective in achieving the target.

“In the modern world the health sector always centres around lifestyle changes and environmental modifications in disease preventative methods,” Dr. Mahipala said explaining the importance of individual responsibility in achieving the target.

According to Dr. Mahipala the Ministry of Health has taken all measures to equip the hospitals with necessary medicine and other facilities to treat dengue patients.

According to the very recent news records quoting the Ministry of Health, the Dextra plasma expander - the intravenous injection that expands plasma in dengue patients will be provided immediately to all tertiary care hospitals in Sri Lanka.

The injection will be obtained from Thailand and on a special request made by Minister Sirisena the WHO will provide them free. The intravenous injection will be used on patients in the risk category with the possibility of developing Dengue Shock Syndrome and Dengue Haemorrhage fever.

The Central Environment Authority also will shoulder a huge responsibility in the Dengue eradication program working along with the Presidential Task Force and the Ministry of Health, Chairman Charitha Herath said speaking to the Sunday Observer . “We have sent directives to the Municipal Councils, Pradeshiya Sabhas and local authorities to strongly control the solid waste management,” Herath said.

“We have organised public awareness programs to make the people understand that the responsibility start at home with each citizen. We may try our best to control solid waste management but it is these people who have to use the facilities provided to them to dispose solid waste,” he said.

The Civil Defence Forces and the Sri Lanka Police have taken the responsibility in controlling the dengue epidemic as a part of their routinal work.

“There is a good response from the public and people are ready to take more responsibility in these efforts,” Herath said adding that efforts of the Government are showing signs of success. Rather than restricting to a specific time period the Sri Lanka Dengue Control Program will be carried out islandwide throughout the year with the coordination of the Health, Defence, Environment, Education, Provincial Councils and Local Government ministries.

The Task Force focus on the worst affected 65 DS divisions spread across 15 districts. According to the Epidemiology Unit of the Ministry of Health highest number of dengue cases are reported in Colombo, Gampaha, Kandy, Kurunegala, Kalutara, Jaffna and Matara.

Across the globe Governments, medical professionals and people at all levels are fighting hard to stop dengue spreading. According to the WHO not only the number of cases are increasing. Outbreaks are occurring in new areas of world as well. As the WHO states before 1970 only nine countries had experienced Dengue Haemorrhagic fever epidemics and in 1995 the number increased by four folds. Today Dengue is endemic in more than 100 countries.

The countries are mainly in Americas, the Eastern Mediterranean, South-east Asia and the Western Pacifics. According to the WHO reports South-east Asia and the Western Pacifics are the worst affected.