Friday, December 1, 2023

No more ad hoc measures

At the end of an emergency meeting among doctors, Dimapur district administration officials and the Health Minister Paiwang Konyak on September 20, the DIPR reported, the authorities came up with certain standard operating procedures (SOP) to address the rapid rise in Dengue cases in the district. Other than forming a Dengue Response Team headed by the Minister, they also devised a contingency plan for Dengue patients requiring hospital admission and treatment. Towards this, the Christian Institute of Health Sciences and Research (CIHSR) and District Hospital Dimapur (DHD) agreed to keep aside 140 beds and 40 beds respectively. This is in the midst of reports that hospitals in Dimapur are running out of empty beds. It was also decided that the Chümoukedima Police Hospital would be activated by Thursday. As regards manpower requirement, the Health Minister resorted to type: an assurance to “look into it” immediately. Already, the Medical Superintendent of DHD, Dr. Kavito has admitted that the status of Dengue in the district has become an epidemic. Our Health Department is all too aware of the annual occurrences of Dengue cases in Dimapur. And in the current epidemic, people are fighting for their lives in hospitals and our health infrastructure is groaning near-capacity. The very fact that the Government has failed to control the disease’s spread only demonstrates their apathy. Given this, it wouldn’t be an exaggeration to say that the negligence on the part of our authorities over the years is to blame for our current dengue outbreak. As responsible are the citizens, who are complacent despite knowing the dangers of the vector-borne disease. At the previously described meeting, several doctors were said to have stressed on the need for source reduction/preventive measures as the best weapon for mitigating Dengue cases. In this regard, it was decided that massive awareness campaigns and cleanliness drives with active participation of the community would be carried out with the initiative of the DCs and Health officials. As welcomed as those measures are, certain concerns still persist. Various studies, especially the one conducted in 2018 by the International Centre for Diarrhoeal Disease Research in Bangladesh, show that regular insecticides are no more effective against these mosquitoes, which in turn calls for assessing the effectiveness of mosquito-killing methods we are employing. We should also look at other States and countries to understand how they deal with Dengue. Kolkata City Corporation is said to be controlling the dengue-carrying agepti mosquito year-round. Singapore has also been successful in closely inspecting female aedes mosquitoes and destroying their breeding grounds in public spaces, construction sites and housing estates. If Dengue cases are found in specific places, they are declared Dengue cluster areas and people are alerted. The authorities are correct in calling for community participation to ensure effective implementation. But the mechanism/tool being implemented should also be effective. To contain the spread of a vector-borne disease like Dengue, it is important to implement standard approaches, at the very least. The basic but crucial search-and-destroy and public awareness programmes should run simultaneously but we appear to be struggling even at that. Individuals should keep their surroundings clean and cover any stagnant water inside as well as outside their homes, such as in drums, buckets, flower pots, bottles, etc. With so many social events and festivities approaching, there is an increased risk of spreading Dengue to the rural areas with limited infrastructure and health personnel. Putting a lid on Dengue needs concerted effort of the Government and individuals. Civil society organisations in Dimapur and Mon districts have already sounded multiple alarms to the Government. As it is, Nagaland Government itself is plagued by a perennial tendency to delay action. It’s high time the authorities took this vector-borne disease seriously and realised that their old-school, ad hoc control measures no longer work. If only they could prioritise the fight against vector-borne diseases like Dengue, which claim many lives, we could contain them.