Delhi has witnessed its
first outbreak of chikungunya after 2006. Malaria, which was supposed to have almost disappeared from Delhi is back with
a vengeance. Chikungunya is
an emerging, mosquito-borne disease caused by an alphavirus, Chikungunya
virus. The disease is transmitted predominantly by Aedes aegypti and Ae.
Albopictus mosquitoes, the same species involved in the transmission of
dengue.
We have learned that
Chikungunya results in high fever accompanied with severe debilitating pain,
especially in joints. Rashes can also be
seen in severe cases. Weakness, dizziness, continuous vomiting leading to dehydration,
very poor oral intake and bleeding are dangerous signs. We have been told that
we must not let water collect anywhere and many people have been challaned
because of their errant ways in managing water!
Politicians have
blamed bureaucrats who have blamed MCD who has blamed politicians. Ministers
have stated that Chikungunya does not lead to death while patients have cried
about the passing of their loved ones. TV anchors have screamed at the top of
their voices about accountability and newspapers have given these stories
headlines, gradually relegating them to inside pages.
The monsoons have
retreated, water logging has reduced and dried up, hospitals are now reporting
lesser patients, the subject of ill patients has disappeared from the news
channels and hopefully, mosquito borne diseases will disappear for this year. Everyone
seems to have heaved a sigh of relief and as always happens in our country
after every epidemic or emergency, the problem of this year has been “managed”
and given the short public memory, this year’s challenges will soon be
forgotten.
Knee jerk reactions
to a health scare seems to be the norm rather than the exception with us. We
know that this problem recurs every year and will continue to recur in the
years ahead till we are able to eradicate the disease. So why is it that we are
not able to plan earlier and reduce the severity of the impact of these
mosquito borne disease? Why don’t our Governments have a task force that will
focus on planning for the coming year?
1.
Identify and map the areas
- Hopefully, after this years’ experience, the authorities would have mapped
all the areas in our cities which they have identified as prone to collection
of water. With proper planning, we can ensure that steps are taken to rectify
all such areas well before the onset of the monsoons.
2.
Epidemiological evidence
– Based on the records for the current year our health researchers would be
aware of the strain of the virus and medication needed to handle this.
3.
Quick reporting
of the outbreak is essential – this would mean setting up situation rooms /
monitoring and evaluation centres in areas where we have seen the problem.
These need to be manned and monitored with clear accountability and
responsibility documents and communicated.
4.
Laboratories
- These became a huge bottleneck in 2016. We should ensure that laboratories
are identified and communication sent to the citizens. And of course, we need
the tariffs for tests agreed and announced in advance.
5.
Feedback
from laboratories needs to be collected on an hourly basis and analysed for
course correction. Delays can prove to be fatal for some patients.
6.
Funding
for the epidemic needs to set aside for all the actions that need to be taken
now as planning commences for the next year.
7.
Hospitals, clinics, nursing homes and
doctors should be identified and numbers and prices
need to be widely advertised well before the outbreak.
8.
Education
of the citizens is an ongoing matter and should become a part of the curriculum
of schools rather than delay action till the problem strikes. Education should
be in the areas of what to watch out for and where to report the disease. In
addition, people need to be educated on making homes mosquito
free; spraying all rooms with safe aerosols; using mosquito nets; covering
water containers; drying water tanks, pets’ bowls and potted plant plates; not
letting water stagnate and other such preventive steps.
Once a clearly
documented plan is agreed and in place, getting it activated will be quick.
Finally, no mass
health programme can work unless there is clear accountability established. No
politician, bureaucrat or health worker can be permitted throw up their hands
and shrug their shoulders. The blame game needs to stop immediately.
If Sri Lanka, one of
the worst victims of malaria, can become malaria free, as certified by the
World Health Organisation in September 2016, is it too difficult to hope that
India too can reach levels of cleanliness where malaria and other mosquito
borne diseases will no longer plague our citizens?
*******************
The author is the founder Chairman of Guardian Pharmacies
and the author of the best-selling books, Reboot. Reinvent. Rewire: Managing
Retirement in the 21st Century; The Corner Office; An Eye for an Eye and The
Buck Stops Here - Learnings of a #Startup Entrepreneur.
Twitter: @gargashutosh
Instagram: ashutoshgarg56
Blog: ashutoshgargin.wordpress.com
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