Truth and official lies about dengue in Burma’s hot spots

Wednesday, 14 July 2010 22:18 Special Health Report – Mizzima News

Chiang Mai (Mizzima) – The spread of dengue fever is posing a serious health risk to people in Burma, especially as it spreads through the epidemic hot spots of Irrawaddy and Pegu divisions and Karen and Mon states.

Since Tuesday, Mizzima’s Kyaw Kha has been speaking with residents and health authorities in these worst-hit regions to see how they are coping with the often fatal mosquito-borne disease.

Irrawaddy Division

The total number of dengue cases reported in the division from January to the middle of this year was 1,221 and the death toll was 18, according to combined figures from the divisional health department, the state-run run Pathein People’s Hospital, and Mawlamyeinkyun Township Hospital and People’s Clinic.

The fever had a particular impact on Pathein Township and nearby villages. The number of victims treated at Pathein People’s Hospital until July 3 was 561, nine of whom were children between the ages of six and 14 who died, according to the divisional health department. Dengue has spread through 27 townships, affecting victims from villages in Pathein, Mawlamyinekyun, Laputta, Kangyihtount, Thapaung, Kyaungkone, Einmae and Phyarpon, a senior departmental official said.

In the dengue affected area of Mawlamyeinkyun, local authorities were preparing to use anti-mosquito spray and educate residents about the fever, but in unaffected areas, such preventative measures had been neglected until now, a township health department spokesman said.

A doctor from a People’s Clinic said, “The most obvious symptoms are high body temperature, joint pain and swelling of the blood vessels. Some patients were able to recover simply by taking medicines regularly for about three days but some required injections [for the pain]. We give injections to patients free of charge.”

In the dengue season, health departments should spray anti-mosquito chemicals in the potential areas of dengue transmission and the public should be educated about the fever, the doctor said. He advised the public to eliminate standing water, the main place mosquitoes breed, and to take care of environmental hygiene.

Mon State

The total number of cases reported in the state’s 10 townships from January to July 3 was 1,236 and the death toll was 11, according to the state health department.

The most seriously affected areas were villages in Moulmein Township, in which 222 people suffered but none died of the fever. In Thanphyuzayat Township, 211 people contracted dengue and one died. In Mudon and Paung townships, respectively 179 and 145 people contracted the disease.

One of 124 patients who contracted the fever in Chaungsone died, four of 99 in Thaton, three of 93 in Beling Township, one of 66 in Yay Township and one of the five in Kyaikhto Township died after contracting dengue. In Kyaikmayaw, 91 people contracted the disease. Most of the fatalities were children between the ages of four and 12, according to the state health department.

A doctor at the infectious diseases department of Thaton Hospital told Mizzima: “In our region, patients have been presenting at the hospital for treatment since April and most … are from rural areas. The children who died … were also from the villages.”

“They [parents and sufferers] thought that it was just a normal fever and presented after suffering for three days, with severe joint pain. I think more people were infected this month and more still will contract the fever next month,” the doctor said.

A Thaton health authority staff member said it was implementing protection measures such as spraying repellant in mosquito-breeding areas, pruning bushes and educating people about dengue, but residents said the protection measures had been either ineffective or non-existent.

“They never came to us even to speak or educate people so we can’t hope that they will carry out labour-intensive work such as pruning bushes,” a Nankhae villager said.

“They did come few days ago to spray mosquito repellant for a little while but it was all just for show and they never came again. I think that they came to take photos to publish in newspapers to show they were taking action,” the villager said.

Thaton General Hospital staff said there were dengue victims at Chaungsone Hospital in the state, but Mizzima was unable to contact the hospital.

Pegu Division

The total number of cases reported in the division’s 11 townships from March to July was 188 and two died in that period, according to the divisional health department.

The most severely affected area was Pegu Township, in which 67 people suffered the fever, but there were no fatalities. One of 45 patients in Nyaunglaypin and one of the 27 victims in Dike Oo died of the fever. Ten people from Thanappin, 10 in Waw, seven in Shwekyin, seven in Taungoo, four in Kyaukdaga, four in Htandapin, four in Kawa and three in Kyaukkyi contracted the fever.

The contagious disease has been present in the division since March and case numbers rose sharply in June. Division- and township-level health teams said they were implementing protection measures such as repellant spraying and educating the people about the fever, but again local residents rejected the claims.

A high-school teacher from Minnyi Quarter in Taungoo told Mizzima: “I have lived in this quarter for 10 years. Whatever the season, dengue or malaria, they have never come to educate the public or spread mosquito-repellent spray.”

Because Pegu health teams had failed to educate the public about this infectious disease, transmission was out of control, a doctor at Pegu General Hospital said.

During the monsoon’s heavy rains, mosquitoes breed in stagnant water that collects, so people should take care of environmental hygiene at ponds and water tanks around the home, the doctor said.

“Health departments of these regions know dengue fever is very common … during the rainy season. So, if they are dutiful to control the transmission of the disease, the transmission rate will be low. Otherwise, the rate will double”, he told Mizzima.

Karen State

As many as 516 people from six townships in the state contracted dengue fever in the first half of this year, and of those two from Hlaingbwe Township died. State health officials said cases have increased since last year.

The worst-hit township was Pa-an, with 208 patient admissions. There were 137 such cases in Kawkereik, 85 in Myawaddy, 12 in Kyainseikyi and two in Papon.

Outbreaks in the state started in February and 261 cases have been recorded up to May. Last month alone there were 255 more cases, officials said.

The state health department this month launched an awareness campaign and preventative measures including pest control in wells and ponds, Karen State Indigenous Medicine (alternative medicine) department head Aung Aung said.

“These cases are increasing as it is a seasonal disease. The signs and symptoms of this disease cannot be detected immediately but take time. Most of the cases are found in rural areas”, he told Mizzima.

A local farmer from Myainggalay village in Karen State said: “Our locality is a mosquito-infested area. They [Aedes, the genus of two types of mosquito that carry dengue] are too big. It made us itch and was painful. Those who got the fever visited Pa-an hospital for treatment but no one [official] came here and gave treatment to us.”

Lack of proper preventative health care measures by the government in these rural areas and poor transport and infrastructure may lead to many more deaths from dengue, a staff member from the Pa-an social welfare departmental dispensary said.

“Most of the villagers are unaware of the deadly nature of this disease and don’t take the fevers seriously when the signs and symptoms arise,” he said. “There are no clinics or dispensaries in rural areas for them to receive treatment even if they are aware … the health department never sends health workers to these places.”