Editorial Daily Times Sept 21, 2011

Dengue epidemic

The latest figures of dengue patients diagnosed with the disease and the number of deaths in Lahore are 6,666 and 44 respectively, and rising. This of course is a fraction of the numbers crowding the hospitals for fear of having contracted the disease, even if on examination, only about 16 percent of those are found to have actually been struck by dengue. Because of a lack of public awareness and accurate information about the disease, a sense of panic has gripped people. Fear of the unknown is the root of this apprehension. In the vast majority of even confirmed dengue fever cases, although modern medicine still has no cure for viruses like dengue, conservative treatment yields positive results and recovery is probable. Only if a person contracts dengue haemorrhagic fever (DHF), a different virus, is the likelihood of fatality greater. Because the epidemic is a new and unknown development, a public awareness campaign with expert input should have been mounted earlier. However, better late than never, as the Punjab and federal governments have benefited from the advice of the Sri Lankan dengue experts team operating in Lahore now and are gearing up for such a campaign through the media.
While the media was being briefed by the Sri Lankan team in Lahore on Monday, Prime Minister Yousaf Raza Gilani also held a national dengue conference in the city to help coordinate the fight against the epidemic. To this end, the federal government has offered all help and assistance to the Punjab government in an all too rare show of solidarity transcending partisan politics. A national coordination mechanism in the shape of a Coordination and Strategy Cell at federal level has been announced. The Cell will coordinate amongst the federal and provincial governments and facilitate coordination and aid from international donors and health organisations for the provinces. Since dengue is no respecter of provincial boundaries or provincial autonomy (Raza Rabbani’s objections to the federal government ‘interfering’ in health matters, devolved to the provinces under the 18th Amendment, notwithstanding), it is rational and positive that the federal and provincial governments, not only Punjab but all the provinces, should be coming together to coordinate their efforts against an epidemic that is showing signs of emerging all over the country.
Meanwhile in Lahore the Punjab government has, in an excess of late zeal, used Section 144 to seal 69 diagnostic laboratories accused of charging more for the dengue blood test than the maximum of Rs 90 fixed by the Punjab government. Their owners and employees have also been taken into custody. Car service stations have been shut. While this end of the Punjab government’s activity smacks of trying to shut the stable door after the horse has bolted, since if the public awareness campaign had been conducted before such draconian actions in the name of public health and safety, any following strict actions would have earned more public support. As it is, that objective may not have been achieved, while the closure of laboratories has exacerbated the overcrowding in the remaining laboratories and hospitals. Closing schools and higher education institutions for 10 days too seems misplaced zeal. The Punjab government needs to reach out to the citizen and institutions in a rational manner to educate everyone on the need for the entire community to pull together if the epidemic is to be combated. For a start, the preventive end of the campaign requires each householder, workplace owner and authority responsible for public spaces to ensure all potential breeding grounds for the dengue mosquito, i.e. stagnant pools of water, both clean and sullied, are either drained or filled up with sand to prevent the female laying its eggs and the larvae hatching to maturity. Spraying to kill the mosquitos and larvae must accompany these measures.
The dengue epidemic has alarmingly exposed the cracks in our public health regime. In today’s interconnected world, countries have to be even more vigilant since mass health hazards have plenty of opportunity to travel. Pakistan must gear up its public health awareness and preventive regimens, while also being prepared to manage the curative side if an epidemic does strike.