Presidential Task Force:

Joint effort to battle dengue - Addl. Secy, Ministry of Health

By Jaliya Wijeyekdom

The Dengue epidemic could be considered as the most dangerous health hazards experienced by the people during the recent past in our country and the government has initiated a number of programs to combat the epidemic and save the nation.

The Sunday Observer had an exclusive interview with the Additional Secretary of the Ministry of Health Sarath Chandra Vithana to ascertain the present position of the problem and the measures taken to curb the spread of the disease.

Q: Can you briefly explain the epidemic and how it is transmitted from place to place?

A: Dengue is a common mosquito-borne infection that is found in tropical or sub tropical regions of the world and in the recent decades has emerged as a major public health concern especially in South and South East Asia including Sri Lanka. We have experienced an epidemic of dengue fever in the country during the year 2009, with 34,896 suspected cases and 345 reported deaths.

The epidemic was at its peak during the monsoon months with Colombo, Gampaha, Kandy, Kegalle and Kurunegala identified as the worst affected areas with the south western monsoon followed by Trincomalee, Batticaloa, Vavuniya and Jaffna being affected during North Eastern monsoon rains.

Dengue fever has a wide spectrum of diseases outcome with the majority consisting of either asymptomatic or having an undifferentiated fever only. About 25% of the infected persons develop classical dengue fever and around 4% of the patients with classical dengue fever progress into dengue haemorrhagic fever/ dengue shock syndrome which can lead to complications and death particularly among children.

Dengue is caused by an Arbo virus with four closely related sero types, transmitted by day biting “Aedes aegypti” and “Aedes albopictus” mosquitoes. Dengue virus is transmitted throughout the year in most parts of the island with greater intensity in more urban, densely populated areas.

Wet climatic condition in the island with heavy rainfall during the Southwest (May-July) and North-East monsoons (October-January) and the high humidity and the rapid urbanization, over-crowding of cities and careless human behaviour all provide a conducive environment for the rapid breeding of the dengue mosquito vector and the spread of dengue infection.

Q: Dengue is found in some other countries in our region and do you think that the same reasons have caused the problem in their countries too?

A: The burden of Dengue fever is evolving rapidly, with increased frequency of outbreaks and expansion to new geographical areas that were previously unaffected. The progressive worsening of dengue in many countries is attributed to population migration, proliferating trade and travel, developmental activities and expansion of agriculture, unplanned urban development, poor water storage and unsatisfactory sanitary conditions creating breeding places.

In many countries dengue epidemics are an indication of the failure of the public service system to respond rapidly.

Q: What action have you taken to avoid the spread of dengue when it was first detected as a deadly disease in the country?

A: Well the Ministry had taken precautionary measures from the beginning to curb dengue from the first reported death of confirmed dengue. We provided necessary medical facilities, including treatments and equipment to all hospitals, launched awareness programs among the stakeholders, educated the public about the danger of the disease, propaganda campaigns were conducted in schools and in social organisations in the country.

Q: With all those propaganda campaigns against this epidemic, there seems to be a steady growth in the epidemic during the last year and the public outcry is that the government has failed to combat this deadly disease which has taken over 300 lives.

A: It has been observed in the past, that however much the Ministry tried to control the epidemic through its numerous programs and propaganda campaigns, the public support for same was not adequately extended and when few deaths are reported with short intervals, naturally the public outcry is more. At the same time the Opposition points the finger at the government to gain some political milage from this unfortunate situation.

Q: What action has the government taken to obtain public support to eradicate the menace recently?

A: Well, a large number of steps were taken during the last few months by the government to obtain the public support for this program.

The appointing of a Dengue Eradication Presidential Task Force by President Mahinda Rajapaksa could be considered as the most effective action taken recently in combatting the epidemic.This task force consist of seven ministries working tirelessly round the clock for the last few months and we have been able to achieve positive results already. The Health Ministry, Defence Ministry, Local Government and Provincial Council Ministry, Environment Ministry, Housing and Construction Ministry and Finance Ministry working as one unit and different areas of work in respect of the eradication process is delegated to the officials of all these seven ministries.

Therefore the government had successfully overcome the delays and structural procedure in coordinating the program. And also it had been easy for the government to muster the support of the public too resulting in the controlling of the spread of the epidemic.

Timely control of epidemics requires sustained high level government commitment, strengthening of the public health infrastructure, intersectoral collaboration and community participation to maximize the provision of integrated services. It is recognized that for optimum control of vector, operational capacities and resources at central and local levels be improved.

Non health sectors are usually not aware of the technical, managerial skills on the vector management, and synergistic actions are thus fragile.Collaboration among national health agencies and major stakeholders to implement dengue program is therefore urgently required for an integrated program.Dengue Eradication Presidential Task Force is of immense benefit to the ministry and to the entire country at large through which we have already managed to combat the problem to a great extent. It had been proved by the monthly statistics of the corresponding months of the previous year.