Dengue is raising its head again and this country’s health care system as well as public sanitary infrastructure and urban sanitation need revitalizing and purposeful action if things are not to go out of control.
When a foreign government advises its citizens to be cautious about the dengue illness in Sri Lanka, it takes the impact of this disease beyond its direct human toll.
The warning was by the United Kingdom’s government to all British citizens intending to visit this country. The ‘travel advisory’ as these warnings are termed, warned visitors to Sri Lanka from the UK that since there is an increase in the outbreak of the disease, they face a greater risk of being affected.
Dengue is transmitted by a certain type of mosquito and, if improperly treated, could be fatal to those affected by it. At present, there are close to 20,000 cases of the illness although fatalities are not high – yet.
The Ministry of Health currently undertakes a continuous island wide campaign to combat the disease-bearing mosquito. While the campaign may have prevented the impact of the disease from becoming a serious health disaster, the fact that there is an increase in the number of cases indicates that current levels of action are inadequate.
Generally, thanks to past generous State investment in the national health system, the country’s medical care has substantially coped with the disease. The public health system has been competent in detecting cases and ensuring rapid medical treatment so that the fatalities from dengue have been restricted.
What seems to be lacking is the ability to control the spread of the disease via the mosquito. This is not so much about medical action as about urban sanitation conditions and mosquito prevention.
Prevention of the disease can be by means of an effective vaccine on the one hand and, on the other, by the combating of the spread of the dengue mosquito. An anti-dengue vaccine yet awaits its inventor. That is something sought the world over in both, rich and poor countries.
Fighting the spread of dengue mosquitoes is the crucial preventive dimension which is a major challenge due to the sheer scale of the required action. Since the dengue mosquito is nurtured by the smallest sheltered moisture deposit –even damp sand – it is an enormous challenge to detect and fix every single such nook and cranny in every building, house compound, storm drain, roadside, and urban and rural water bodies. It involves the tightest possible management of water disposal. It must aim at controlling or stopping the reproduction of the dengue mosquito.
It is not enough to have occasional public campaigns and infrequent building and property inspections. Every local government body and local health unit must be adequately equipped for such sustained surveillance as well as guidance of the public. Every local authority must be equipped with staff and legal resources to enforce the anti-dengue regulations.
Despite the successive epidemics of dengue over the last few decades, despite the fatalities, the dengue prevention measures remain sporadic while the preventive systems remain weak in terms of staffing and other resources.
If the issue is one of budget, then the math is simple, especially, after the UK government health advisory issued to visitors from the UK. If originally the direct impact of dengue endangered the lives of just us, poor Sri Lankans, now it is a matter of an impact on the tourism industry, a most important pillar of the national economy.
Thus, any ‘savings’ by reduced investments in public health systems and urban infrastructure are likely to be off-set by the potentially even bigger losses to the tourism industry and the economy caused by the dengue deterrent. Perhaps the tourism industry might be a more effective advocate than our medical community in calling for serious public investment in preventive action against dengue.
What is needed is for governmental initiative in comprehensive preventive measures.
Political culture?
Two of the country’s most prominent politicians were in the dock, as it were, last week for their public behaviour as politicians.
Dinesh Gunawardena, the more senior and with the more distinguished pedigree, found himself in trouble in Parliament after his behaviour in the House obstructed proceedings to the extent that he had to be thrown out.
When the Speaker ruled against the recognition of the National Freedom Front as a separate political party in the legislature, Mr. Gunawardena joined fellow MPs of the UPFA dissident faction in causing an uproar. Sadly, this veteran politician, himself, the son of an early great national leader, failed to heed the Speaker’s request for calm and found himself temporarily banned from the House for a week.
If this incident may be seen as misplaced chivalry, MP Bandula Gunawardena, while not of the same august pedigree as the MEP leader, found himself in much hotter water.
He was hauled up before the Presidential Commission examining the Central Bank bonds issue for apparently making a false statement regarding the Commission proceedings. The Honourable Member did not hesitate to admit to the Commission that his statement to the media was untrue.
What both these senior politicians must keep in mind is that such violation of institutional norms have become so ‘normal’ in society. Indeed there is the danger that many citizens may even see such behaviour as acceptable.
If such senior leaders are not to set an example by their own personal behaviour, who should?