Caught in the net: The dengue scare

The Government of Pakistan, already under immense pressure to aid hundreds of thousands of people affected by massive floods in the south of the country, is now also struggling to contain the dengue epidemic, which has so far claimed the lives of at least 17 people across the country.
The mood in the country has taken a dark turn in the last week as the disease took on epidemic proportions, forcing the provincial government on Tuesday to close down schools and universities for 10 days. Another seven people have died of the disease in Lahore in the last 24 hours, including a child, and one each in Nowshera, Karachi and Rawalpindi, signaling that the epidemic has now reached countrywide proportions.
People are largely frightened and a sense of helplessness prevails because of lack of awareness about the disease and its treatment, if possible. “Eight of my family members are down with fever and we suspect it is dengue. The problem is that we don’t know where to take them or how to get them tested or treated for it. Even if we do figure out what to do, there is no room in the hospitals and labs that were previously giving test results in a day are now taking up to five days,” said Fatima, a resident of Model Town. Even though dengue has a very low mortality rate and most patients survive after bearing fever and rashes, it remains an incurable disease without a vaccine, a fact that has triggered much panic among the general public despite assurances from the government that dengue is curable. That the disease most commonly ails those who spend most of their time outside in the open – such as traffic wardens and policemen on duty – has also scared people off leaving the house unnecessarily.
To wit, a private TV channel reported on Wednesday that players at a football camp were wary of catching the disease, which is spread through the bite of a particular kind of mosquito, and are taking protective measures such as mosquito repellents and extra clothing to cover the normally exposed parts of the body during practice sessions.
Health experts say the illness is spreading across the Punjab because of poor hygiene conditions, and heavy monsoon rain provides ideal conditions for dengue-carrying mosquitoes to thrive in stagnant waters. The recent outbreak of dengue has confirmed the presence of all four types of the virus in Pakistan, they say.
PUNJAB GOVT MAKING EFFORTS:
Punjab Chief Minister Shahbaz Sharif, whose province is the worst-hit in the country with some 4,989 reported cases of the disease – 4,118 of which were reported in Lahore alone – has told private hospitals to provide free treatment to dengue patients or face stern action. The Punjab government has also announced a state of emergency in hospitals, and the army has also set up separate medical camps to help civilian hospitals deal with the crisis.
The chief minister has also announced that the Social Security Hospital Manga Mandi has been reserved for dengue patients only, and appealed to citizens to take their patients to the well-equipped hospital on Raiwind Road. He said his government had ordered the urgent import of 150 fumigation machines from Germany, the latest technology from Britain and medicine from India to deal with the swiftly increasing number of patients.

The Punjab government has also asked the federal government to waive the import duty on the medicines brought in from India to eradicate the dengue virus. The government, however, has been criticised heavily for its handling of the epidemic, which many complain was inept, inadequate and primarily reactionary. Its preventive measures, such as awareness drives, mandatory fumigation and efforts to eradicate the dengue mosquito’s breeding places, have largely been rubbished as too little, too late.
The Punjab government took major flak in the provincial assembly as well. Shoukat Basra, the deputy parliamentary leader in the Punjab Assembly for the ruling Pakistan People’s Party, which is in the opposition in the province, said the government was using ineffective and adulterated insecticide to kill dengue mosquitoes. Treasury member Saeed Akbar Nawani said he supported the opposition in its protest and that enough was not being done to control the spread of dengue.
The treasury’s Zaeem Qadri, however, defended the government, saying the deaths were due to some other fatal diseases and not dengue, a statement that was ridiculed by most members in the House. He admitted, though, that some medicines and sprays were ineffective as they were not mixed properly. Indeed, the death a couple of days ago of Punjab Mines and Minerals Secretary Ataullah Siddiqui at the hands of dengue and the accompanying reports of many senior government officials also coming down with the disease does beg the question whether the government is in fact able to deal with the crisis at all.
PEOPLE SCARED: “My mother has been admitted to the National Hospital with a high fever, and since she has tested negative for malaria and typhoid, doctors suspect it is dengue. Her platelet count is steadily dropping and I am desperately trying to figure out where and how I can acquire a platelet transfusion kit, should she need it,” said Malik Zohaib, a resident of Defence.
The government seems to be clueless and apologetic as well. “We are trying our best to control this epidemic,” Punjab Health Secretary Jehanzeb Khan said on Wednesday, even as a 12-member Sri Lankan team of experts arrived in Lahore with medicines and equipment to help fight the disease, which has all but completely stymied local authorities.
Hospitals, too, are at a loss as to how they should best deal with the disease.
“The doctors are misdiagnosing the disease, which is leading to its spread. There is a lack of donors as hundreds of people wait in lines at donating points. Many donors are shying away, fearing that since the government is unable to control dengue, they too will get infected sooner or later and would need their own blood to survive,” says Ahad Awan, a volunteer at the Punjab University’s Institute of Administrative Sciences blood society.
The disease is a threat to nearly half of the world’s population. Of the estimated 220 million people infected each year, two million – mostly children in Latin America and Asia – develop a severe form called dengue hemorrhagic fever, for which there is currently no cure or vaccine.
The National Institute of Health (NIH) said so far 5,200 people had been brought to hospitals with suspected dengue fever across Pakistan. The disease is rapidly taking hold in Islamabad and Rawalpindi as well, with seven new cases reported in the twin cities on Wednesday.
A dengue patient being treated at Pakistan Institute of Medical Sciences (PIMS) told Pakistan Today that there was no special treatment for dengue patients. “The doctors are treating us as they are treating normal patients,” he said. With the outlook decidedly bleak, the fate of those infected with dengue remains uncertain, at least for now.
Additional reporting by Pakistan Today bureau in Islamabad.