Delhi has witnessed its first outbreak of chikungunya after 2006, is marked by debilitating joint pain. 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 to 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 challenged 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 seem 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 diseases? 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 this years’ experience, the authorities would have mapped all the areas in our cities which they have identified as prone to a 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 the medication needed to handle this.
- 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 - 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.
- 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.
- 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.
- Hospitals, clinics, nursing homes and doctors should be identified and numbers and prices 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 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.