Dengue epidemic: Back to basics needed to prevent the spread

way track. So once they collected rain water and the grass gave enough shade and due to that the water never fully evaporated as sunlight never reached them; dengue mosquitoes laid their eggs safely.

The other main culprits were large land parcels owned by public institutions and private residences especially in Colombo 7 where the garden spaces were never ecologically managed. So were the schools and hospitals. To make things worse patients in the outstations ended up in Colombo making it a hospital city until the adults were sent to Angoda for specialized care. Still, the Lady Ridgeway hospital takes care of the serious child patients. There are many other private hospitals in the city which are also creating a hazard when it comes to dengue epidemics.

Dengue control and prevention is a duty of the local authority. The Public Health Department of the Colombo Municipal Council has a cadre of 1200: it should have around 55 Public Health Inspectors, 150 Midwives, 185 Health instructors, 55 Mosquito control Field Assistants who could have been used to inspect all the premises and land parcels in the city which number around 80,000. Unfortunately, instead of these 450 Field Officers we had only around 180 to do this work. Unfortunately all my requests to fill the vacancies fell on deaf ears at the CMC and also the Provincial Council. We still managed to use volunteers to join and allocated areas to each officer who was responsible for inspections and prevention of the spread of dengue in the area allocated to him. To supplement this work and to overcome the shortage of workers we purchased Ultra Low Volume (ULV) machines, fogging machines, spraying cans and used chemicals such as BTI, deltamethrin to spray against mosquito breeding or to get rid of adult mosquitoes. We sprayed the gabion walls which lined the canal system in Colombo with BTi. These mosquito control programmes started at 5 a.m. daily and ended around 7 p.m. It was done according to a plan and covered the whole city operating from six administrative areas and centrally.

We conducted the Green star house to house inspection programme which was an innovative idea at that time winning an international award and also written and published as a ‘Best Practice’ by UNCHS and WHO.

Unfortunately, all these programmes have been stopped due to some unknown reason. Only the interiors of houses are sprayed when 95 % of the breeding takes place outside the four walls. The PHI in the suburbs also have copied Colombo’s above idea and this may be one reason why we have so many dengue mosquitoes and patients today. Even the inspections have been done only when Mosquito control weeks have been announced by the Ministry of Health. Police and service personnel have been deployed to help but it is not an efficient way of handling the situation.

So what should we do now? 1) We must have dedicated staff (2 officers with at least 2 volunteers) say for around 50-75 premises in a street who will meet the residents, create awareness and check these same premises and lands throughout the year. They will know exactly where to look for mosquito breeding in their allocated area as it is difficult to find the larvae which could breed in one teaspoon full of water. “Detect & Destroy” should be their motto. This is far better than sending officers to unknown terrain to look for breeding spots which will be fruitless. 2) All vacancies for PHI, Midwives, Health Instructors and Field assistants should be filled immediately. There are enough A/L qualified youth who could fill these vacancies easily. This will enhance the capacity of the dengue control team. There may be vacancies for Solid Waste Management Overseers in The Municipal Engineer’s Department who also could be coopted for this work as waste is one of the main contributors for dengue mosquito breeding. 3) The chemical/BTI spraying programmes should be re-started. The internal spraying should be stopped as that strategy is used in Malaria control where the mosquitoes rest inside the houses. This internal spraying will cause more harm than good as the residents will be breathing the chemicals and that could create respiratory diseases and also the food could be contaminated. 4) The shramadana programmes of

yesteryear should be re started as soon as the waste dumping issue is settled in the country. This is very important in slum and shanty areas in the city where 60% of the city’s population live. 5) All yards and bus stands where public transport vehicles are parked should be fumigated and kept clear of mosquito breeding places. If we do these above mentioned things and keep the city clean I am sure we can prevent the spread of dengue from Colombo to other parts of the country. One must not forget that most of the permanent residents of Colombo by now would have been victims of dengue even without their knowledge as dengue fever can pass off as an ordinary fever. A study done in Wanathamulla a few years ago showed that 95% of the children under 5 years of age had dengue antibodies in their blood showing that they had already contracted dengue. This means they had immunity against the dengue virus circulating at that time. But in the distant and virgin areas and towns the people would not have come into contact with the dengue virus the disease yet and they are prone to going down with the disease easily.

The Ministries of Health, Housing, Urban Development & Transport, Western Provincial Council and the Colombo Municipal Council should get together to implement the above programme. Dr. Pradeep Kariyawasam Former Chief Medical Officer of Health, Colombo.

This is no fiction. The New Zealand Legislature passed Te Awa Tupua (Whanganui River Claims Settlement) Act No. 7 of 2017 which came into operation on receiving the Royal Assent as recently as March 20, 2017. Section 14 of the Act declares ‘Te Awa Tupa is a legal person and has all the rights, powers, duties and liabilities as a legal person.”

The Whanganui river is 180 miles long and some tribes of the Maori people who are the original settlers of New Zealand, contend that their rights are intrinsically interwoven with the rights of the river. They even think that the river is their ancestor. Section 12 of the Act defines Te Awa Tupua as “an indivisible and living whole, comprising the Whanganui river from the mountains to the sea, incorporating all its physical and metaphysical elements”.

The Act of Parliament is a sequel to a long drawn-out litigation and contentious issues which arose in several Royal Commissions of Inquiry between the Crown and the Maoris, at least from 1938.

The Act makes provision for the appointment of two guardians, one from the Crown and one from the Maori Groups for the effective implementataion of the provisions of the Act (Section 20).

If a river has human rights, it would naturaly have copyrights too. One would wonder if such a law was applicable in Austria, the Danube…er…should I call Mr. Danube would have successfully sued Johann Strauss for aping the melodious music springing from the running waters..! Justice Ranjit Dheeraratne Kalutara