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HindustanTimes Thu,18 Dec 2014
A PPP model that makes Delhi the dengue capital
Shivani Singh, Hindustan Times
New Delhi, September 23, 2013
First Published: 22:21 IST(23/9/2013)
Last Updated: 22:25 IST(23/9/2013)

For a virus that infects thousands and kills many every year, the annual dengue outbreak triggers a routine cycle of procrastination, denial, panic, and procrastination in Delhi. In a dubious public-private partnership of sorts, both authorities and residents play their part in this farce.

While Dengue cases crossed the 1,000-mark this season, we did precious little to fight the outbreak. As a result, five deaths have already been reported although the government has confirmed only two. Hospitals, both government and private, are crammed with patients and many are being turned away.

Blood banks are churning out 20 times more platelets in a day than they usually do.

Official records, however, downplay the numbers, nitpicking over tests, case histories and the domicile status of the patients. But, in the absence of standard operating procedures, dengue is already a big business in the unregulated healthcare market. Hole-in-the-wall nursing homes are admitting anyone running a high temperature and anxious patients, just too relieved to get a bed, are asking no questions.

 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.

Last year, it was a less virulent strain. But this year’s is a more menacing one. But whatever be the strain, 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. There is no vaccine or treatment for dengue but early detection and good medical care can lower damage and fatalities. We need more government hospitals to take the increasing patient load. But medical infrastructure alone cannot fight the disease. We lose half the battle once the mosquito breeds and flies out to get us.

It is simpler and most economical to kill them at the larva stage. Surveillance is the weakest in Delhi. Our budgets are low and just about cover the wages of the disease control teams and limited operations. Fumigation, not good for asthma patients and pregnant women, is still the standard practice. Even this is sporadic and limited to main roads. But authorities are not the only ones to blame for keeping the dengue menace alive.

Aedes mosquitoes, that carry the dengue virus, don’t breed in dirty drains but need clear water. Due to stagnant water in desert coolers, overhead tanks, Feng Shui plants and water collecting from condensers of ACs and refrigerators, half of those infected are bitten in their own homes. But most residents resist inspection and complain of harassment when they are fined.

In Singapore, dengue prevention patrols have not hesitated in taking extreme steps, even breaking into homes suspected of mosquito breeding, Bloomberg reported this August. Homeowners in the citystate are fined Sg$200 (` 9,942) if mosquito breeding spots are found in their homes.

Repeat offenders can be fined up to Sg$5,000 (`2.48 lakh) or jailed for up to three months, or both. In Delhi, more than 1,11,000 homes have been fined by the civic agencies for mosquito breeding since April this year.

The health department now wants to increase the penalty from `500 to `1,000 and enact laws to punish reckless builders who leave water standing at construction sites.

It is funny how we blame the authorities for the outbreak and fight steeper penalties for breeding mosquitoes in the same breath. But the government will not feel apologetic in cracking down on errant households that endanger the health of the entire city if it can also take care of the fertile Aedes breeding pools outdoors.


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