Dengue’s vice-like grip over the country due to provincial negligence

Another year of failing to control the dengue outbreak raises serious questions about the country’s lack of preparedness, disease related awareness campaigns, and health infrastructure.

In Lahore, which is one of the country’s most populous cities and a dengue hotbed, there has been a shortage of beds for patients in hospitals and the painkiller medicine panadol, used for treating the mosquito bite induced fever, is not easily available at pharmacies due to which patients and their families are facing severe difficulties.

Punjab’s provincial government’s claims of spraying the city were shunned by numerous residents of Lahore stating that no spray operations were being conducted in densely populated areas.

Elsewhere to the northwest of Punjab’s capital, some 500 kilometers away, Khyber Pakhtunkhwa’s (K-P) capital, Peshawar is another hotbed for the mosquito-borne viral disease. Just like Lahore, residents of the city are frustrated with the government’s efforts to control the virus.

Ajab Gul, a resident of the Tehkal area in Peshawar, while talking to The Express Tribune said, “when the situation deteriorates only then our health department and local administration wakeup before that no concrete steps are taken to eliminate the dengue larwa in the area.”

Towards the southwest of Peshawar, colloquially known as the city of lights and the country’s most populous city, the situation has been equally grim. Professor Dr Saeed Khan of Dow University of Health Sciences, stated that dengue has mutated and the new strain was worrisome.

An ongoing study at Dow has found that more than 80% of patients infected with the dengue virus in Karachi have been reported to have serotype two which is causing severe complications in patients. The professor blamed the Sindh government, saying that a lack of disinfectant spray in Karachi had turned it into a breeding ground for mosquitoes.

“Spraying campaigns have been missing for the last several years,” an irate Khan informed The Express Tribune. Gul, who works as mechanic in Peshawar, had a similar bone to pick with the provincial government.

“In several areas no disinfectant spray was sprayed nor were any other steps taken to control the dengue disease, that is why the situation is out of the government’s control now,” he said.

Insufficient facilities Several of Gul’s family members were recently infected with the illness and finding suitable treatment was hard.

“The local ‘doctors’ who have no formal degree have set up shop under the nose of the health department and are playing with people’s lives by claiming they can treat dengue,” he lamented. Gul’s woes of not finding adequate treatment were echoed by residents of Lahore as well.

According to sources, contrary to the Punjab government’s claims of having the virus under control, there is an immense pressure of patients in government hospitals and finding a bed in any intensive care unit (ICU) is proving to be a tough task.

The strain is such that hospitals have adopted a policy of admitting only critically ill patients and the others are resigned to treating the dengue fever at home, as per Dr Salman Kazmi, the General Secretary of the Young Doctors Association (YDA).

“No precautionary measures have been taken to curb the spread of dengue and the people have not been made aware of the steps to be taken to stay safe from the disease that is why the hospitals are suffering,” Kazmi told The Express Tribune.

Tall claims

However, according to Imran Sikandar Baloch, who is the Secretary for the Department of Primary and Secondary Health Care Punjab, steps have been taken to eradicate dengue larvae and stop its spread across the province.

Read More: Health dept fails to visit 4,567 dengue hotspots

“The number of beds for patients of the virus is constantly increasing and the disease is under control. So far, the government has checked 371,767 indoor places across Punjab for eradication of dengue larvae,” Baloch said, lauding his government’s efforts.

Similarly, K-P’s Information Minister, Kamran Bagash, also gave a pat on the back to the provincial government’s efforts, stating that the K-P government had planned a successful strategy for dengue as so far only nine deaths have been reported in the province.

“Special teams, composed of entomologists and health experts, are performing their duties in hotspots by conducting awareness campaigns. Teams are also in place to eliminate the deadly mosquito larvae from the worst infected areas,” Bangash informed.

Missing statistics Despite both provincial governments claiming wins, K-P has reported more than 10,000 cases whereas Punjab has reported more than 25,000 cases out of which nearly 18,000 are from Lahore.

However, various health experts and sources from private hospitals told The Express Tribune that the numbers coming out from every province were underreported and the ground reality was much different.

What all provinces have in common is a missing official virus related statistics or infected and recovered persons counter similar to the one National Command and Operation Centre (NCOC) has dedicated for the COVID-19 superspreader, leading to a lack of transparency regarding dengue.

For instance, in Sindh, a correspondent for The Express Tribune contacted the Directorate General Health Services to obtain figures on total dengue infections but was told that the department did not have authority to release the figures.

The department informed that a spokesman for Vector-Borne Disease was appointed but this representative did not attend calls or respond to requests for comments.

Precautionary measures

The provincial governments’ claims of having dengue under control were further derided by Dr Izhar Ahmad, former President of the Pakistan Medical Association, who stated that at present there were no spray operations being carried out in proportion with the population to control the mosquito-borne viral fever.

“Since there is no infrastructure to control the disease the onus is on the people to take precautions such as mosquito nets and avoiding stagnation of water bodies. At present, a mosquito's cycle lasts for ten to twelve days and if a patient is attacked by a mosquito, he becomes a carrier,” Ahmad informed, also suggesting that the population should wear winter appropriate clothing to avoid being bitten by dengue-carrying mosquitoes.

While Ahmad cautioned people to be more wary, Kazmi the YDA’s representative sounded the alarm-bells for another dengue onslaught. “If the government still does not conduct spray operations the mosquito-borne disease will become an immense problem again come spring season,” he told The Express Tribune.