Guatemalan health minister Francisco Coma on August 31 last declared a national health emergency in the face of a dengue outbreak that has claimed 22 lives and infected over 12,000 persons in his country this year. The emergency will be in place for three months.
In Bangladesh, a total of 671 persons have died and more than 138,000 got infected by the dengue virus until September 06 this year. On September 02, the country recorded the highest 21 deaths, almost equivalent to the total number of deaths in Guatemala.
The health authorities here prefer to remain indifferent and find it proper to shift the responsibilities onto others. This is, in fact, a repeat performance of the health sector honchos. They had behaved almost identically during the COVID-19 pandemic period, remaining nonchalant and unconcerned about what had been happening around them.
At the initial stage of the dengue outbreak, the health minister shrugged aside the suggestion to declare a health emergency. He, possibly, had found the situation quite manageable. The health issues involving dengue have gone deeper thereafter. Nearly 700 people have died and 138,000 infected by the virus. These are official data. Given the overall situation across the country, the numbers are likely to go up three to fourfold. The dengue situation in Dhaka city is far severer with most families having one or more members afflicted with dengue.
The health authorities are happy only if they can ensure accommodation ---hospital ward floors and corridors included --- for patients in case of emergency. Shortage of doctors, nurses and medicines, including IV fluids, is not an issue for them. They know patients would manage on their own as a matter of practice in public health facilities.
The Infectious Disease (Prevention, Control and Eradication) Act adopted in November 2018, however, wants the Directorate General of Health Services (DGHS) some more jobs to do. The directorate, among others, will have to (1) segregate the infected areas from infection-free areas and take steps to keep the latter area protected from infection; (2) ask individuals possessing information about infectious disease to send the same to the DGHS; (3) apply insecticides inside houses, other establishments and on mosquito nets, bed sheets, curtains etc., to control vector-borne diseases; (4) fix the safe limits of insecticides, manage breeding grounds of insects and destroy sources of infection.
The Act in question is a comprehensive one and has made the DG of health services responsible for carrying out all the provisions. Though it was enacted 15 months ahead of COVID-19, the health authorities demonstrated a notable gap in its capabilities during the pandemic time. That they are still in the same state is proven by their reaction to developments involving the dengue outbreak.
Now comes the performance issue of the Dhaka city corporations! It is better to say less about them. The top notches of two major local government entities talk more than what they accomplish. The Dhaka North City Corporation (DNCC) instead of eradicating Aedes mosquito larva has triggered controversy over BTI procurement. The Dhaka South City Corporation (DSCC) made an unconsidered claim about a fall in dengue infection because of its actions on the ground. Undeniably, the residents of two city corporation areas are not happy with the response of two city corporations to dengue outbreak. Such unhappiness is nothing unusual, even though corporations are now doing well in some areas than before.
City corporations and DGHS need to be more proactive in combating dengue which has taken an epidemic form. They should follow in the footsteps of similar entities in neighbouring West Bengal, Singapore, Malaysia and some other countries. The involvement of communities is important in the control of dengue. Yet there are additional measures that are necessary to eliminate the Aedes vector. The agencies concerned should take a well-coordinated move in that direction. But the government needs to declare a national health emergency to deal with dengue and offer all possible help to people afflicted with it.
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