Sunday, February 26, 2017
Malaysia - Turn hygiene into a culture
A health worker fumigating a residential area in Penang. People must take the threat of dengue and Zika seriously. FILE PIC
25 February 2017
KUDOS to the Terengganu Health Department for its proactive approach in containing the spread of dengue and Zika virus by Aedes Aegypti mosquitoes.
But, the war is not over yet and it never will be until the public adopts hygiene as a way of life. The threat will remain, but will be kept at bay through the efforts of health officers who risk themselves being exposed to mosquito bites.
These workers need to react to any signs of the disease before it reaches an outbreak proportion. They have to continue reminding the people to keep themselves and their surroundings clean to maintain good health.
Starting this month, health officers will be mobilised to step up inspections in urban areas that have been identified as breeding grounds for Aedes Aegypti mosquitoes.
Although in the past 65 days, Terengganu had no cases of dengue and Zika infection, the change in climate conditions, from wet to warm, may trigger an explosion in the mosquito population in small pools of water in discarded containers or in stagnant rainwater.
The Aedes Aegypti mosquitoes have a lifespan of about eight days, but their proliferation may cause an outbreak. This disease is life-threatening and the only time control measures such as fumigation can be carried out is when there is a confirmed case of infection.
Terengganu recorded five deaths with 343 dengue cases in January last year (1,935 cases in 2016), which was a 290 per cent increase compared with 92 cases in the same period in 2015. Dengue fatalities in Terengganu continued to increase last year, and by November, the state had registered its 19th case following the death of a 49-year-old woman from Hiliran Binjai, a sub-urban area in Kuala Terengganu.
She was among four who died due to dengue haemorrhagic fever. With no outbreak in the past four months, it could mean that the eggs of the Aedes Aegypti mosquitoes could have been flushed away by the floods during the monsoon season, but some may survive desiccation in concealed containers for several months,
However, State Health Department director Dr Mohamad Omar said while the floods explained why there had been no dengue outbreak for a record period, this did not mean that the mosquito eggs were gone.
Some of the eggs could be trapped in containers and there was no way of controlling the hatching of the larvae, which take less than three days to grow into adult mosquitoes. The authorities will only know if there are dengue and Zika outbreaks when someone is hospitalised and diagnosed with the diseases.
Only then will the Health Department assemble a team to fumigate the area where the victim lives. But, all these costly manoeuvres in organising clean-up exercises and awareness programmes, which involve manpower from the various agencies, can be minimised if people take the threat of dengue and Zika seriously.
Community leaders, especially, can take the lead in organising fortnightly or monthly gotong-royong in areas under their jurisdiction and areas known to record high number of dengue cases with help from local authorities and health officers.
However, it was observed in several campaigns in Kuala Terengganu that some residents became onlookers of clean-up campaigns and “mandors”, while some even took the opportunity to request municipal council workers to clear their clogged drains.
It irked the municipal council workers and health officers who felt ridiculed by the residents, who were mostly from the working class and felt no shame or guilt about the mess they created for others to clean up.
This is the mindset that needs to be changed. It may take a few generations and more deaths before everyone gives priority to prevention than cure. The kindergarten is a good place to inculcate this habit and it must not stop until the child leaves school at 18. The Japanese have done it and they turned hygiene and cleanliness into a culture.