Killing the buzz

A recent three-day dengue eradication program in the Western Province fined over 3,000 people for failing to clear breeding grounds for mosquitoes opening up fresh concerns regarding consistent implementation of prevention methods. 

So far this year 27,696 suspected dengue cases and 54 dengue deaths have been reported to the Epidemiology Unit from all over the island. Approximately 52.1 per cent of dengue cases were reported from the Western province and from this, a total of 9,215 cases had been reported from the Colombo District.

The numbers raise the question whether the Government’s dengue policies are effective and whether they are sufficiently far-reaching. The numbers say ‘no’. Sri Lanka appointed the Presidential Task Force on Dengue Prevention in 2010, following much public criticism as patient numbers soared. The outbreak hit hardest in the Western Province where rampant urbanisation has created the perfect breeding ground for dengue mosquitoes. Schools were closed and parents lived in daily fear of their children coming down with fever. Yet, the panic did not result in regulations that had long-term impacts. Just two years later, the number of dengue cases hit 44,456 – the highest tally since 2010. 

Again, the Government responded to public pressure by introducing the National Dengue Prevention Act, which makes unwittingly creating dengue breeding grounds a punishable offense. Sri Lanka is not alone in taking this road. 

In the Pakistani province of Sindh, the regional government has taken a hard line against dengue. Last year, it introduced the Sindh Prevention and Control of Dengue Regulation 2013, which obliges everyone – from public officials to ordinary members of the public – to take responsibility for dengue. Failure to comply with the legislation can result in severe penalties. It’s a radical approach, driven by concern over nearly 5,000 cases of dengue reported in the province during 2013. 

But is the threat of legal action enough to make people use insecticide or empty pots that could turn into mosquito breeding grounds? Will fear of a fine make doctors report suspected dengue cases within an hour? Sindh is not the only province to use legislation to fight dengue; Punjab Province takes its anti-dengue regulation so seriously that failure to comply with it is a non-bailable offence. 

It’s a trend that can be seen all over the world: in Venezuela, there are calls to fine hospitals that fail to report cases of dengue and Brazil has bred genetically modified mosquitoes to wipe out dengue. But the disease continues to thrive. In Sri Lanka, despite increased public awareness, dengue remains a serious and sometimes fatal urban health problem. With 32,063 dengue cases in 2013, it is clear that efforts made thus far remain largely ineffectual. 

A frustrated Government has thrown many initiatives at the disease, including the Army, deploying patrols to frighten people into compliance, but these have all been stopgap measures. People remain under the heel of the epidemic’s natural cycle with one year ending only to find fresh patients a few months later. 

Regardless of intense media coverage, there also seems to be little citizen interest in stemming the disease. There are no calls from the public at large for a sustained policy measure that reaches deep into all parts of the country, well-funded and long-term. In the absence of such sustained public pressure, it is unlikely the Government will change its current knee-jerk reactions.