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Why the Capital loses its fight against dengue

columns Updated: Nov 05, 2012 00:05 IST

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Dengue knows no class barriers. On September 29, it killed nine-year-old Tabassum in an unauthorised colony of south Delhi. In less than a month, veteran filmmaker Yash Chopra died at Mumbai’s Lilavati hospital of multiple organ failure triggered by dengue.

Since Tabassum’s death, more than 1,000 cases and another fatality have been recorded by the municipal agencies in Delhi. But each private hospital reports at least 10 cases a day and there are over 40 private hospitals in Delhi. Clearly, official records downplay the numbers, nit-picking over tests, case histories and the domicile status of the deceased. A 38-year-old man who died at Lok Nayak hospital of low platelet count was not counted among the Delhi’s dead because he was a resident of Ghaziabad.

Delhi has had outbreaks of dengue caused by various virus types in 1967, 1970, 1982, 1988 and 1996. In 2006, it assumed epidemic proportions when 56 deaths were reported. In 2010, the spate coincided with the Commonwealth Games. It is back again though doctors assure that this year’s strain is a less virulent one. But whatever be the type of the virus, the first official response has always been of denial. Once cases pour in, authorities take perfunctory measures, which are always too little and too late.

So it didn’t surprise many when the state government that partially funds the civic agencies’ vector disease control programme admitted that the city was facing an "unmanageable challenge" in dengue. The Delhi high court has asked civic agencies to submit its action plan to control the disease. The National Human Rights Commission has also issued a notice.

There is no specific vaccine or treatment for dengue but early detection and good medical care can lower damage and fatalities. So it is necessary to invest in a good public healthcare system where even peripheral government hospitals are able to handle cases and ease the burden on the bigger ones. But medical infrastructure alone cannot fight dengue.

We lose half the battle once the mosquitoes breed and fly out to get us. Irrespective of all the fumigation, repellents and nets, some always bite and some of the bitten invariably fall sick. Yet, we let the mosquitoes emerge from water when it is simpler and most economical to kill them at the larva stage.

Surveillance, the most crucial part, is the weakest in Delhi. Our budget is low — Rs. 70-80 crore per annum — and just about covers the wages of permanent employees and limited operations. Even this fund does not reach the municipal bodies on time. The 3,200 domestic breeding checkers, hired on a temporary basis, do not receive wages for months and there is always the danger of them going on strike when they are needed the most.

Fumigation, not good asthma patients and pregnant women, is still the standard practice. But even this is not regular and limited to the main roads. The prime breeding grounds of the Aedes mosquito are not in the open. Surprisingly callous in their attitude, most residents do not allow inspection of their desert coolers, flower pots or overhead tanks.

The 2010 outbreak was primarily due to mosquito breeding in stagnant water collected in numerous construction sites. But few builders or house owners are ever booked or penalised. In any case, the fine for violating civic norms is R 500 — the sum has not changed since 1975. The health department now wants to increase the penalty to Rs. 1,000 and enact laws to punish reckless builders. Delhi can’t wait till the next dengue season.