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 seen 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.
The monsoon season is round the corner. Governments are talking about cleaning
the drains, as if this is a one-time annual process. Chief Ministers and Health
Ministers have started calling meetings to “take stock of preparedness”. Closer
to the rains, messages will be published to “educate” the common person on the
problems of breeding mosquitoes in stagnant water.
However, are we really prepared for the onset of such viral infections? Why
do we have a knee jerk reaction every year with same unfortunate consequences?
Why don’t we, the common people, hold the Government accountable and why do we
succumb to their hollow promises that “this will not be repeated next year.”
In
2016, politicians blamed bureaucrats who blamed Municipal Corporations who in
turn, have politicians. Some Health ministers stated that Chikungunya does not
lead to death ignoring the health challenges that the masses face, while
patients grieved about the passing of their loved ones. TV anchors screamed at
the top of their voices about accountability and newspapers gave these stories
headlines, gradually relegating them to inside pages. Have we really learned a
lesson from last year?
The
monsoons will come and then retreat, water logging will reduce and dry up, and
hospitals will make excuses and then will reporting lesser patients. News
channels will gain TRP’s for a few weeks and gradually the news will become old
and disappear only to reappear the following year. Everyone will then heave a
sigh of relief and as always happens in our country after every epidemic or
emergency, the problem of the year would have been “managed” and given the
short public memory, this year’s challenges will soon be forgotten.
Have
we learned from 2016 or will this blame game chorus continue in 2017 as well?
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?
Identify
and map the areas - Hopefully, after
last 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.
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. There should be no surprises.
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.
Laboratories
– Testing of samples 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.
Feedback
– Data from laboratories needs to be collected on an hourly basis and analysed
for course correction. Delays can prove to be fatal for some patients. Teams
set up in advance will help to analyse data and course correct fast.
Funding
– It is hoped that funding for the epidemic has already been set aside for all
the action that need to be taken now. Blaming the centre for not providing
funds at the last minute is not the answer to managing the problem.
Hospitals,
clinics, nursing homes and doctors should be
identified and listed. Contact phone numbers and pre-set prices for tests and
treatment need to be widely advertised well before the outbreak.
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
1. What
to watch out for and where to report the disease.
2. Making homes mosquito free
3. Spraying all rooms with safe aerosols
4. Using mosquito nets
5. Covering water containers
6. Drying water tanks, pets’ bowls and potted plant plates
7. Not letting water stagnate and other such preventive steps.
Once
a clearly documented plan is agreed and in place, getting it activated should
be relatively easy and 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 while the hapless common man waits for
treatment.
The
blame game needs to stop immediately. To say that there will not be an outbreak
in future is wishful thinking and a pipe dream. To plan for the outbreak and
contain its spread is more realistic.
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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