Local governments rely on themselves in fighting dengue

Leony Aurora, The Jakarta Post, Pekalongan, Central Java

Rini, a student at Podosugih 1 elementary school here, answers a question about the Aedes aegypti mosquitoes that carry the dengue fever virus.

"They breed in clean water that does not come in contact with the ground," she says in a timid voice.

Her friend, Ardi, adds: "We use flashlights to find them, as they like dark places."

Minister of Health Achmad Sujudi pinned jumantik (mosquito larvae monitoring officer) badges on their chests during a ceremony on Tuesday to mark their school's victory in this year's school cleanliness competition in Pekalongan mayoralty.

"The presence or absence of larvae was one of the criteria used to assess the schools," the head of the Pekalongan Health Agency, Dwi Heri Wibawa, said.

He said students had conducted a weekly larvae inspection of their school since the dengue fever outbreak in February.

In Pekalongan, the larvae-free rate is 86.6 percent, still below the ideal rate of 95 percent. Although the rate is lower than ideal, the number of dengue fever cases here has declined from 122 in 1997 to 79 in 2000, 59 in 2003 and 14 with zero deaths in this year's outbreak.

Nationwide, there have been 49,167 dengue infections and 558 deaths since the beginning of the year.

The students' efforts have contributed to dengue prevention in Pekalongan, Heri said.

The provincial government has also hired three jumantik to help the mayoralty fight dengue fever, with each officer receiving Rp 500,000 (US$58.82) a month. The government has plans to hire 10,000 jumantik to work for six months,

Heri said the health agency had also employed 1,429 volunteers, each earning Rp 7,500 for every 20 houses they inspected for mosquito larvae.

"We have to use this outbreak as a momentum to intensify our preventative and educational measures," said the director of communicable diseases at the health ministry, Umar Fahmi Achmadi.

The ministry is preparing a presidential decree as the legal basis for the recruitment of field workers who will assist in the government's efforts to fight communicable diseases, including dengue fever.

Umar said the field workers, who must be high school graduates, will be placed in public health centers at the district level.

"They will work according to the priority of their respective areas, whether it is dengue, malaria or other communicable diseases," said Umar.

The central and local governments will share the burden of paying these workers, said Umar.

However, not all areas are taking the necessary steps to fight dengue fever.

Health officials in the town of Batang, which neighbors Pekalongan, said they had only two jumantik on their payroll and were taking few steps to encourage public participation in fighting dengue.

When questioned, the jumantik said they had monitored mosquito larvae between July and December of last year, but now that they were not being paid on a monthly basis, their work consisted only of doing fumigation on request.

Confronted with this, the head of the local health agency, Sutarno, said: "We don't have a high number of dengue fever cases anyway."

This year, 18 people in the regency have been infected with the virus, with one death. Last year, 108 people were infected, with two deaths.

"It is a small area and we are lucky that we do not have diseases," said Sutarno. "Let's just hope it stays this way."