By Saddia Mazhar
Islamabad, January 11 (newsin.asia): Standing in a long queue of almost a hundred people for hours to see a doctor in the Out Patient Department (OPD) of the Benazir Bhutto Hospital in Rawalpindi, Shahnaz Begum was on the verge of a breakdown.
Sick with high fever, headache, a bleeding nose and unsteady feet adding to the misery, the 59 year old Shahnaz had been brought to the hospital by her daughter for a dengue test.
Shehnaz was a nervous wreck as she had heard that 26 year old Amara had died in the ICU of the very same hospital a few days earlier. As a widow with two daughters and as the sole breadwinner in the family, Shahnaz was weighed down by the fear of dying leaving her daughters to the mercies of the big bad world.
In the wake of the recent outbreak of dengue in Punjab, an increasing number of patients had headed to the three government hospitals in Rawalpindi – Holy Family Hospital (HFH), Benazir Bhutto Hospital (BBH) and District Headquarters (DHQ) Hospital. The hospitals had been struggling to accommodate the sudden influx of patients.
A record 44,000 people had suffered from dengue in Pakistan in 2019, a senior health official said. The outbreak was linked to rising temperatures and erratic rainfall.
Transmitted by the Aedes Aegyptus mosquito. This thrives in densely populated tropical climates and breeds in stagnant and clean water. Dengue could be a killer if not treated in time. Mosquitoes pick up the virus from infected humans – even asymptomatic ones – and transmit it to others through bites.
Rana Safdar, a senior official at the National Institute of Health (NIH), said that the figure is a huge leap from the previous record of 27,000 infections in the year 2011. However, while 370 died of dengue in 2011, in 2019, deaths numbered 66. The southern province of Sindh reported 10,142 cases and 26 deaths, while Punjab reported 9,260 cases.
2011 was the year when the country, especially Punjab, witnessed the ravages of the dengue virus for the first time on a such a large scale. Lahore was the worst effected city. It was a major test for the then provincial government led by Chief Minister Shahbaz Sharif.
Dr .Zafar Mirza, the Prime minister‘s Special Assistant for Health said that the number of teams fighting dengue had gone up from six to 96 since he took charge. He totally rejected the claim that government hospitals had a shortage of medicines, dengue vaccines and trained paramedical staff.
Ex- Chief Minister Shahbaz Sharif had a “war room” at his secretariat to monitor the work of professionals engaged in dengue control who were expected to ensure real time implementation of his directives. Sharif held many early morning meetings in Lahore, where all administrative heads and public representatives were present. Assessment of the field work done across the province was carried out in these meetings.
A set of detailed Standard Operating Procedures (SOP) were published in the form of a book. But the SOP and the accompanying awareness campaigns were not done in a timely manner from the national to the grassroots level. This was the reason for the record number of cases in the Punjab.
The present Chief Minister of Punjab Usman Buzdar visited Rawalpindi hospitals after the outbreak of dengue in 2019. Dr. Yasmin Rashid, Health Minister of Punjab, was satisfied with the efforts made by the government and rejected claims that the number of patients was going up.
“If a hundred patients came for dengue treatment, only one would be in a bad condition. The other 99 would recover early. So numbers are not a worrying,” she said in an interview.
Rashid further said that the dengue mosquito spray had some side effects. So the government could not spray it in every place but only in places where dengue larvae were found by visiting health teams.
However, the official claim proved to be baseless as the number of dengue cases increased rapidly in Punjab, forcing Chief Minister Sardar Usman Buzdar to order an inquiry. He deputed his Chief Secretary to supervise a fresh anti-dengue drive.
Conditions in the government hospitals are terrible. At the Benazir Bhutto Hospital a special ward for dengue patients has been established, but this is facing a shortage of medicines and trained staff, an inside source said.
The Prime Minister‘s Special Assistant on Health revealed in an interview that dengue control teams got activated only after dengue broke out this year. They had not done any preventive work to mitigate the epidemic.
In the National Assembly proceedings dated 05 October 2019, the Parliamentary Secretary for the National Health Services (NHS) Dr. Nusheen Hamid admitted that the government did not take timely precautionary measures to prevent dengue in the capital, Islamabad.
“Unfortunately, spraying was not done in April this year. However, it is being ensured that timely spraying will be done from next year onwards. Fumigation should have begun in April, the season of larva development,’ Nushen Hamid said.
When the Shabaz Sharif government was there, the Agriculture Department field staff and entomologists were asked to do preventive spraying all over Punjab. The Cooperatives Department was given the responsibility for taking preventive measures in all housing colonies in big cities.
Since the dengue virus was spreading through water accumulating in old truck and car tires, the Environment Department was tasked to scan and clear each and every tire shop and godown in the Punjab.
Special anti-dengue campaigns were conducted in schools with the participation of students and youth. They were asked not to let dengue larvae grow in their surroundings. The Fisheries Department introduced a special variety of fish in water bodies which eliminated dengue mosquito larvae. A mobile app was designed to monitor the work of sanitary inspectors and public health workers. These field workers would take photographs of dengue larvae where ever spotted, and would upload them on the computer for their superiors to see and act.
At the same time the government worked on capacity building in private clinics to enable them to treat dengue patients. Incentives for learning were given in the remote areas.
Government, by law, fixed the price of a dengue diagnostic test at Rs. 90 for private clinics/hospitals. Private laboratories were charging Rs. 900 for the test.
This multi-agency effort, it is said, contained the deadly disease. Sri Lankan experts commented that the Punjab provincial government’s efforts “saved more than 20,000 citizens”.
However a blame game is on. Pakistan Muslim League –Nawaz leader Uzma Bukhari believes that the present Buzdar government has totally failed to control dengue. The SOPs which were put in action every year from 2011 till 2017 are still in the files of the government and therefore accessible.
“The PTI government can just pick the threads from where Shahbaz Sharif left,” she said.
After Potohar Town in Rawalpindi division reported the death of dengue patients, people panicked and the provincial and district administrations banned hospitals from providing to the media, the number dengue patients being treated .
Dengue is cyclic virus that revisits a region after a specific interval. It is a seasonal disease, a health official said. He observed that the current functionaries of the government are working hard on eradication of dengue. There are a number of people affected by dengue but, due to government’s efforts, this number is far less than it was between 2011 and 2017.
Modern technology can help fight the menace. Dr. Saif, who helped in designing and introducing the Smartphone-based early epidemic warning system in 2012 said: “ Our technology enabled the government to pinpoint and predict hotspots of dengue. This early warning system can save many lives.”