Asia-Pacific, Development & Aid, Headlines, Health, Population

HEALTH-SRI LANKA: All-Out War on Dengue Fever Eases Deaths

Amantha Perera

COLOMBO, Sep 20 2010 (IPS) - An aggressive public health and information programme is giving Sri Lanka a key weapon in its battle against the deadly dengue fever, bringing it under control after hitting epidemic proportions in the last two years.

Between 2009 and mid-September 2010, dengue fever infected over 65,000 people in Sri Lanka and caused 563 deaths. The largest caseload was reported in 2009, which had 346 deaths and 35,000 infections. That was the highest number in a decade.

But the second week of September marked the first in four months when no dengue-related deaths were reported, say doctors and health specialists at the Epidemiology Unit of the Ministry of Health. The infection rate also fell to 262 reported cases, the lowest for 2010.

“Definitely, the numbers are falling, the infections have gone down and thankfully so have the deaths,” Dr Sudath Peiris, chief epidemiologist at the unit, told IPS. “Now it is a case of keeping the battle going and not letting up.”

The picture was quite different at the start of the year, when fears about getting dengue – passed on to humans through bites of the Aedes mosquito – reached panic levels among many in this South Asian island nation.

Dengue fever, endemic to many Asian and developing countries, is often mistaken for normal fever and late diagnosis may be too late, leading to deaths. Children are particularly vulnerable. The World Health Organisation (WHO), which classifies dengue as an international public- health concern, has reported significant jumps in dengue in the last few decades.

Prevention – many countries in Asia undertake clean-up campaigns and disinfection efforts especially during the rainy season where stagnant water more often accumulates – is the only way to control dengue fever.

“We knew we had to do something drastic to curb the spread,” Peiris told IPS. “We impressed on every one from the President (Mahinda Rajapaksa) down that this was not a health issue, it was more an issue of how we treated the environment we live in,” he added.

Soon after, “the President gave orders to get the full government machinery involved in the anti-dengue drive, especially the three armed forces and the police,” Peiris said.

The preventive measures, designed to limit the population of the dengue mosquitoes, included clean-ups of streets, telling students about the disease, and publication of information in media.

In Mahabage, a suburb just north of the capital Colombo, policemen waited near a garbage dump frequented by many of the area’s residents as early as 5 a.m. Those caught dumping garbage were arrested, arraigned and courts would issue a fine of 5,000 Sri Lankan rupees (about 45 U.S. dollars).

Security personnel were used to clean up public areas and lend a hand in public campaigns. In northern Jaffna, where a large contingent of soldiers is placed, they were engaged in cleaning the labyrinth of by-lanes in the city in an effort to unclog blocked drains.

Schools became one of the main targets of the mass awareness campaign.

Teachers at the main government school in Ma-eliya, a village in the Kurunegala district about 150 kilometres from Colombo, worked dengue-related extra-curricular activities into the curriculum. These included public awareness campaigns with information about cleaning their school and home environments and avoiding the formation of areas where water could stay stagnant, allowing mosquitoes to breed.

“We made the children aware of how their homes and the school could turn into breeding grounds for the mosquito,” Priyantha Rajapaksa, the principal at the school, said in an interview.

Health experts like Peiris say that practices like keeping flower pots with water without cleaning for weeks can become breeding areas for the dengue mosquitoes.

“We now look at where water can gather and clean them. We know where the mosquito is,” said Thurulu Navodya, a 10 year-old student.

Large companies joined the campaign too. In a busy intersection in Colombo Seven, a large, imposing board warns, ‘If they breed, you will bleed’ with an oversized mosquito next to it, its stomach red and full. The sign was put up by Bartleet Finance, a finance and investment company.

National radio channels and televisions stations have been running regular public awareness slots about the dangers of dengue. Sri Lanka’s largest-circulation Sinhala weekly ran a section reporting possible dengue-mosquito breeding grounds every weekend.

Earlier in September, the government also released bacteria into possible mosquito breeding grounds to kill the larvae of the Aedes mosquito.

Officials now say efforts must continue to keep dengue under control, especially once the rains begin toward the end of September.

“We are also in the inter-monsoonal period, so the rains have also eased,” Peiris explained. He added that authorities would have to monitor infections for a couple of months before they can conclude that preventive measures have indeed worked.

Cautioned Peiris: “There is no cure for dengue, it is (by) prevention. We have to make sure that we don’t allow the mosquito to breed, by omission or commission.”