Beware of dengue fever

Beware of dengue fever

As many as 32 of 5,800 people suffering from dengue fever in
Jakarta have died since January, while last year 5,750 cases of
the same scourge occurred in Jakarta, but the number of
fatalities was not made available.

This is a shocking reality that deserves the serious attention
of the public, the government and the city administration.
Surprisingly, however, head of the City Health Agency Choliq
Masulili described this year's situation as "normal", merely
because the fatalities amounted to "only" 0.05 percent of the
total dengue fever cases that occurred in the capital city during
the last four-and-a-half months.

Early in March this year, a health official warned of the
possibility that the capital could experience the peak of the
lethal disease's five-year cycle during this year. In May,
another official from the same office announced that 32 people
were killed by the disease.

What does all this mean?

Data recorded by the City Health Agency shows that cases of
dengue fever in the Greater Jakarta area hit a high of 15,360 in
1998, 3,998 in 1999, 8,729 in 2,000, 8,820 in 2001 and 5,750 in
2002. Either the population has failed to respond to City Health
Agency warnings, or the agency has done nothing significant to
encourage the public to deal with the Aedes aegypti mosquitoes
that carry the dengue fever virus.

The large number of victims could also indicate poor public
awareness of the importance of healthy living in a healthy
environment. Most residents, however, have been duly informed of
the vital importance of keeping their neighborhoods clean in
order to prevent the disease from spreading. They surely also
know that the disease is transmitted by the Aedes aegypti
mosquito, which lays its eggs on the surface of pools of water.

Nevertheless, any visitor to most of Jakarta's kampong
neighborhoods is most likely to be presented with the sickening
sight of clogged, open sewers and residential complexes that are
far from clean and tidy. It appears that many of Jakarta's
residents are still ignorant of the importance of environmental
health, which they seem to consider second in importance to
earning their day-to-day income.

There are those who speculate that the public's ignorance
could be seen as an apathetic response to the constant exposure
to anti-dengue fever campaigns on televisions, which have been
aired for years. New diseases, such as Severe Acute Respiratory
Syndrome (SARS) may have diverted public attention away from the
dengue scare.

Unfortunately, concrete data to substantiate such conclusions
does not exist. Therefore, a study by local health offices in
cooperation with local administrations is needed, in order to
find out why people have failed to protect themselves against
dengue fever attacks, despite repeated warnings.

People are usually jolted and become aware of the hazard of
dengue fever only after members of their family or neighbors are
stricken by the disease. Another factor could be that the
authorities' efforts to help the public curb the spread of the
disease have been inconsistent. We have heard complaints from
residents about the difficulty of getting help from either their
district or subdistrict offices, whenever cases of dengue are
reported by the public. What residents usually do in such cases
is act on their own to raise funds to pay for fumigation in their
neighborhood.

Implied in this complaint, apparently, is the suspicion that
fumigation and other efforts to eradicate mosquito larvae might
be a profitable business for at least some of those in charge of
health affairs at the subdistrict or district level. In short,
the public cannot rely on the authorities to combat dengue
outbreaks.

One doctor in Jakarta revealed that in 2001 the government set
aside only Rp 2 billion (approximately US$225,000) for fumigation
to eradicate mosquitoes. The ideal amount was Rp 9 billion to Rp
10 billion. That is why it is important that the public is made
aware that it cannot rely on the authorities for prevention of
the disease, but that they must take the initiative themselves.

It is imperative that everyone in the city be aware of the
danger of the disease and thus maintain the cleanliness of their
environment. In the meantime, we can only hope that the
authorities will be more proactive and vigorous in their efforts
to prevent the scourge by improving their databases on everything
related to the disease.