The early arrival of the monsoon and its late departure, coupled with civic indifference and lack of specific medication, has contributed to the enormous number of dengue cases in Delhi this year
In Delhi, Rajokri village’s Harijan Basti residents are tired of having their repeated pleas to political representatives and civic authorities to fumigate their area and clean open drains ignored. The escalating dengue menace has convinced them of the urgent need to keep environs clean so as to pre-empt breeding of mosquitoes. About 150 families are at risk.
The municipal sweepers do a shoddy job. Karamdhari Yadav, who runs a welding shop, expends half his daylight hours on either trying to arrange clean drinking water for inhabitants so that they are not stricken by water-borne diseases, or tracking down the councillor, who can push the cleaning drive through. The councillor remains elusive, as do the sweepers. Stinking, rancid water in the drains and garbage heaps bear testimony to their absence. The only option is to mobilise residents to clean their surroundings themselves if they are not to fall prey to swarms of mosquitoes.
Dengue plagued Delhi and the National Capital Region this year as the region notched up three records: longest monsoon since 1956, hitting in mid-June and extending up to mid-October; highest rainfall, over 875.8 mm, as against the annual average of 780 mm; and unusually high number of dengue cases — 4,402 by October end. There were over 6,000 dengue cases in 2010, with public works and heavy rains engendering breeding grounds for mosquitoes. In 2008, 2009, 2011 and 2012, registered dengue cases numbered over 1,300, 1,153, 1,100 and 2,093 respectively.
This year, too, abundant rains and water accumulation, along with construction sites and public works, were conducive to mosquitoes breeding. Inadequate municipal services are largely blamed for creating the unhygienic environs that facilitate spread of mosquitoes. The Delhi Municipal Corporation (North) recorded 1,876 cases, followed by the South with 1,298 cases and the East body with 1,061 cases.
Prof. Y.K. Gupta, head of Department of Pharmacology at All India Institute of Medical Sciences, avers that high humidity and high temperature during the monsoons favour breeding of mosquitoes. Additionally, Aedes aegypti mosquitoes live in urban habitats and breeds mostly in man-made water habitats, further favouring their breeding during the monsoons. He pinpoints flower pots, rubber tyres, air coolers, open drains, open overhead tanks and the like where water accumulates and provides breeding grounds for mosquitoes.
Unlike malaria, triggered by the bite of the female Anopheles mosquito and which is endemic and present throughout the year, says Dr. Navin Dang, whose South Delhi laboratory regularly conducts dengue tests, dengue is seasonal, “assuming epidemic proportions” during the monsoons. The fact that the monsoons hit the city and NCR early and ended late aided the spread of the disease, given the deficient responses of municipal agencies. For, as New Delhi Municipal Council Chairman Jalaj Shrivastava, who assumed office in early August, concedes, “Systemic response such as sprays and fogging is municipal function. So is hospitalisation, tests, platelet management… larvae-breeding identification, introducing larvicidal fishes, etc.”
However, observing that the government cannot do everything and be everywhere, he stresses that people should not be “casual or passive about their own health”. Households, offices and villages need to do some things to prevent creating conditions for larvae to breed. These, put simply, are preventing water collection in planters, tanks, coolers and the like, and covering water pitchers with cloth.
The medicos point out that a grave challenge is the lack of specific medication whereas malaria has proper medication, such as chloroquine, quinine, primaquine, and newer ones like artesunate. Dengue infection necessitates repeated blood tests to monitor blood counts and platelets, a costly exercise. Treatment needs to be supportive, and maintenance of the patient’s body fluid volume is critical in serious cases. The doctors are sceptical about the efficacy oftraditional remedies such as avoiding solid food, plentiful intake of water, consuming tulsi and coriander leaves, papaya juice, application of neem leaves and oil and so on.
Dr Dang highlights the media’s role: educating people before the onset of the monsoons on the importance of preventing water accumulation, when to visit a doctor, correct diagnostic tests and measures to arrest platelets fall. Dr Gupta recommends keeping surroundings and building interiors clean, and use of window screens, mosquito repellants and clothes that cover the body.
Clearly, prevention is better than cure.