The outbreak of chikungunya and dengue, both vector-borne diseases, in Delhi has become a major cause of concern. So far the outbreak has claimed over 20 lives, underpinning the urgent need for revamping civic bodies in the national capital and all the states of India.
Both diseases are caused by viruses carried by the Aedes aegypti mosquito, and both present with similar symptoms: high fever, muscle and joint pains, and a rash. According to the World Health Organization, “these diseases are commonly found in tropical and sub-tropical regions and places where access to safe drinking water and sanitation systems is problematic.”
It is estimated that in Delhi alone, there are over 3,000 cases of people infected with dengue and chikunguniya. There is no specific antiviral drug treatment or vaccine for chikungunya. The treatment is directed primarily at relieving the symptoms, including the joint pain.
In Delhi, the fledgling Aam Aadmi Party (Common Man’s Party) was swept into power in 2014, defeating India’s two major parties. Public expectations were high that AAP would make a huge difference in the governance, as it was led by an honest chief minister. A series of scandals has belied those hopes, as the performance of this party is no different from others. The party, when confronted with the growing incidents of the deaths, has deflected responsibility to the local civic bodies. In fact, it is a complete failure of both the state government and the civic bodies, who were busy blaming each other rather than coordinating with one another in dealing with the crisis.
The spread of mosquito-related viruses is nothing new to India. In 2015, over 10,000 cases were reported in Delhi, of which around 40 patients lost their lives. However, many deaths stemmed from the inability of government hospitals to take in patients, due to the lack of beds and testing facilities. This led to a national debate, where the government was hauled up for not building enough hospitals and also for its failure to provide additional beds to meet the contingencies. Both the central and state governments assured the people that they would build more hospitals and also arrange more beds in government hospitals to avoid such a crisis. The government also promised to educate the local civic bodies about taking effective measures in garbage and waste disposal and also spreading pesticides in areas prone to water logging. Unfortunately, no worthwhile steps were taken by either the state government or the civic bodies, and now history is repeating itself.
An analysis of data prepared under the aegis of the Ministry of Health and Family Welfare for the period covering from 2010 to 2015, shows that there has been an over 1,000 percent increase in vector-borne diseases in Haryana and Madhya Pradesh, a 957 percent increase in West Bengal, over 300 percent increase in Andhra Pradesh, and a 154 percent increase in Delhi. The statistics show that both the central and state governments have not learnt lessons from their past failures.
Most of India’s civic bodies are corrupt, and are led by people belonging to various political parties. Unless they are made accountable to the people, one can’t expect any improvement in basic civic services. Poor waste disposal systems, poor sanitation, rapid urbanization, and lack of awareness among the public are some of the major causes for the spread of such illnesses. Effective steps should be taken to evaluate the performance of the heads of the civic bodies and inefficient people should be removed from their positions. The government should include prominent citizens in their panels to bring pressure.
Public Awareness Programs
As a first step, the government should launch a public awareness program, where people can be sensitized on the importance of keeping the environment clean. The proximity of mosquito breeding sites to human habitation is a significant risk factor for both chikungunya and dengue, as well as for other mosquito-borne diseases like malaria.
In India, there are a number of natural and artificial water container habitats that support the breeding of mosquitoes. Solving this problem requires the mobilization of affected communities. During outbreaks, insecticides should be sprayed to kill flying mosquitoes, applied to surfaces in and around containers where the mosquitoes land, and used to treat water in containers to kill the immature larvae.
For protection during outbreaks of chikungunya, clothing which minimizes skin exposure to mosquitoes is advised. Repellents can be applied to exposed skin or to clothing in strict accordance with product label instructions.
In the rural areas, as many people sleep outdoors, they should be encouraged to use mosquito nets. Basic precautions should be taken by people traveling to risk areas; these include the use of repellents, wearing long sleeves and pants, and ensuring rooms are fitted with screens to prevent mosquitoes from entering.
Learning From Other Countries
India can also learn from the steps taken by Vietnam and Cambodia. In the case of Vietnam, scientists, in collaboration with health workers, introduced Mesocyclops (a type of crustacean) into household water tanks and water jars in rural provinces of northern and central Vietnam. Because the various species of Mesocyclops are known to prey on mosquito larvae, they can be used as a nontoxic and inexpensive form of biological mosquito control. The local leaders, together with schoolchildren, conducted cleanup campaigns and awareness events. The strategy, which was gradually expanded by health authorities, eliminated the dengue fever vector in most of the communities. No cases have been reported since 2002 in these areas.
In Cambodia, tests are being conducted with the support of the national and local leaders on a new long-lasting insecticide-treated netting cover for household water storage containers – using an insecticide treatment technology that has been developed for bed nets in malaria prevention and control. The cover, fitted over concrete rainwater storage tanks, is designed both to prevent mosquito breeding in these key containers and to reduce adult vector densities and longevity.
The government of India, along with all the stakeholders, should learn from the measures taken by Vietnam and Cambodia in containing the disease. A three-pronged approach, with the harnessing of scientific knowledge on vector ecology and disease epidemiology and with effective environmental management and community participation can go a long way in effectively combating vector borne diseases.
K.S. Venkatachalam is an independent columnist and political commentator and writes a regular column for many newspapers.