Monsoon woes

Tackling diseases during the rainy season is critical

The monsoon has set in relatively early this year. So have the seasonal diseases associated with it. Earlier, diseases caused by food contamination, such as cholera, typhoid, gastroenteritis and jaundice, used to afflict the masses during the rainy season. Drinking of unclean water and lack of general hygiene were the main causes. Now, many dreaded vector-borne diseases, some of which were unheard of until a few decades ago, have become a major threat. These include dengue, chikungunya, meningitis and viral fever, apart from malaria. Though their outbreaks are usually predictable and largely preventable as well, these recur with unfailing regularity year after year. Health authorities, regrettably, rarely wake up before people actually begin to die of these ailments. Even in the metro cities, where municipal authorities are supposed to be more watchful, hundreds suffer every year from these illnesses during the rainy months. Last year’s experience in the country’s capital is difficult to overlook when the Delhi administration’s failure to control dengue on the eve of the Commonwealth Games had brought the country disrepute. Over 20 countries formally cautioned their athletes about the potential threat of vector-borne diseases due to the unabated breeding of mosquitoes around the Games venues.

 

Ironically, no lessons have been learnt. Dengue, malaria and other diseases have again begun to surface this year despite the claims by the authorities of adequate preparedness to check mosquito breeding. No different from Delhi is Mumbai, the financial hub of the nation, or any other big town, for that matter. With the monsoon having already arrived in Mumbai, the cases of viral fever, malaria, pneumonia and even dengue have been reported from various localities in recent days. The situation is worse in small towns and millions of villages where the public health infrastructure is either non-existent or a shambles. It is not too difficult to keep the monsoon-related ailments at bay. The strategy to do so has to be three-pronged: clearing waterlogged areas to prevent breeding of mosquitoes and other insects; killing their larvae where they have already bred; and destroying adult vector populations through regular sprays and fogging. Public health authorities cannot be unaware of this. But the will to act and the wherewithal needed for this purpose are usually wanting. Though the country’s entire public health infrastructure is in bad shape, the preventive health care system is, regrettably, worse. A severe jolt was served to it by the ban, largely under international pressure, on DDT, which was, by far, the cheapest and most effective pesticide available for vector control. Its extensive use in the public health programme had helped to almost eradicate malaria decades ago. The need for an equally inexpensive, and yet effective, alternative to DDT has since been sorely felt. Endosulfan, the next best alternative, is several times more costly and is also on its way out. But there are other chemical and biological means of vector control that are still available, though at a higher cost. When the issue at stake is as vital as public health, paucity of funds should not be allowed to come in the way.