Dengue

What the community should know and could do

Dr. K. D. P. Jayatilaka

Continued from Oct. 27)

It is very encouraging to note, that so many organizations, non government, government, security forces, media, business etc. have come forward with different activities to help to fight the current dengue epidemic and all these are very useful. The important thing is to continue them in the same way and make it a part of the people's daily life. We hear many community education and community mobilization talks on the TV/radio, see many interesting articles in the newspapers and leaflets distributed by some organizations on dengue control and that too is very encouraging.

Community education

A common theme every one talks is of 'destroy' and 'eliminate' Aedes mosquito breeding places and this is what should be done to reduce the vector densities.

This is easily said than done. Community education is very essential in the dengue control programme but the correct facts in a way acceptable to the community should be given. Also when problems are discussed the solutions should be practical.

There are many types of breeding places. Majority of them are known and few are still elusive to the public eye. Some go to the extent of showing how to reduce the breeding of mosquitoes by puncturing discarded tyres or filling them with sand or bailing out water from concrete water tanks which the people have built for a purpose. I wonder whether these demonstrations are practical.

No doubt, these are very important Aedes breeding sites. As mentioned in my earlier article last month only a person who tries to cut or puncture a discarded tyre will know the difficulty. The problem is not with toy car tyres, but with those of buses, trucks, lorries and even cars tyres which need 2-3 people to lift. To fill such a tyre with sand will need 1-3 wheel-borrows of sand which costs about Rs. 500-600 these days. After filling the tyre with sand what are we going to do with it? It is not possible to keep it as an ornament.

Also, we are not speaking of one or two tyres, but some times of tens, hundreds or even thousands of tyres as in various depots/workshops and business places. Small plastic cups and coconut shells could be collected and buried in pits and this is possible in places where people have large gardens. But, nowadays many people built houses on small plots of 4-6 perches and there is hardly any space to dig a pit for this purpose and even if it is done and when the pit is full and covered with sand it becomes the end of their dengue control.

There should be practical and acceptable solutions. To assist the community in their effort and participation in the dengue control program, there should be an efficient collection and a disposal mechanism for the collected garbage.

WHO advises to avoid burning PVC. material and not all plastic. Actually what happens at the collected garbage mountains is that they catch fire instantaneously and burn for days, weeks or even months. The other problem most people face is collection of rain water in pits either man-made or natural. Most people (community) are helpless in such a situation. They cannot drain it, fill it or dry it.

However, temporarily they can pour some oil either kerosene or diesel to the water, but most people in the community has no idea about it.

Garbage

For situations like this, the important thing is to get the information and corporation from the public and provide assistance, advice and help. Having a special telephone number (like 118, 119 or emergency) even temporarily and friendly staff to advise and assist the people who noticed a problem and were responsible enough to notify the Aedes breeding place. Instead of displaying large expensive posters of mosquitoes at bus stands and walls it is more useful, meaningful and cost effective to have this telephone number displayed to notify, in case the community notices mosquito breeding places which they cannot handle by themselves.

If there are discarded tyres, they could be collected to a central dumping place for regular larviciding (once in 2 weeks) collection of ground waters could be subjected to either larviciding (Temephos, B. t.i.) etc., or use biological control methods (introduce some larvivorous fish like guppies) depending on the duration it is going to last. On a long term basis, to handle the discarded tyres, which is an escalating problem either the Government or a private entrepreneur could start a recycling plant to produce material for ground filling and road building. (Nat, Geographic, June 2008. page 78 'Oil boom in Siberia).

Dengue control or for that matter control any communicable disease or a social condition should be a combined effort involving many Government Ministries, Departments, Voluntary, Religious Organizations and the Community where all possible control strategies are applied.

To be continued