Monday, 18 June 2012

The Dengue Menace In Sri Lanka

Rich or poor, dengue kills
  • Two deaths in Colombo's business circles send shockwaves
  • 56 deaths, 11,403 cases reported islandwide for first 5 months of this year
  • Colombo, most vulnerable district
By Nadia Fazlulhaq
Damith Amarasuriya, 28, was a designer in a firm that produces annual reports. During his leisure hours, he spent time outdoors. Little did he realize that one day he will be bitten by a dengue mosquito. Damith is the youngest son of the Chairman of Singer and National Development Bank (NDB) Hemaka Amarasuriya.
Damith: Victim of dengue.
Grieving parents: Hemaka Amarasuriya and wife Anoma (below)
Alastair Senanayake, 23, who had completed graduate studies in Singapore was in the country heeding wishes from his father to get familiar with family business. With much enthusiasm he left for Europe to meet his old school friends. Whilst in Sri Lanka he has been bitten by a dengue mosquito. Sadly he never returned home alive.
He was the only son of Chairman of IWS Holdings and former Chairman of Sampath Bank Arthur Senanayake, who is left in shock and grief. That dengue, which is reaching epidemic proportions, is taking a heavy toll irrespective of whether the victim is rich or poor, has now become a disturbing reality.
What is worse is the fact that actions by governmental agencies and local authorities to curb the menace have shown far little progress in combating this menace.
According to Damith's mother Anoma, on May 22, the day prior to his death, her son as usual had gone to work at Smart Media and attended communication classes in the evening. "There were no severe symptoms but he told me of a mild headache. I touched his forehead and felt a slight temperature. He ate a few mouthfuls, then vomited twice before going to bed," she said.
For Anoma, her son's request to feed the fish, which he had been doing daily for many years, came as a surprise. It was next morning that Damith showed severe symptoms including chills with accompanied sweating, vomiting, unsettled behaviour and passing of stools and urine dark in colour. They rushed him to hospital by ambulance.
"He was immediately put on life support. As the symptoms were complicated he was treated for meningitis, encephalitis and dengue. Losing a child is unbearable to any parent. He looked at me with pleading eyes and said, "Thaatha let's go now," and those were his last words," lamented Mr. Amarasuriya.
He said, medical reports stated that he had died of DHF (Dengue Haemorrhage Fever). His sister Dileeka (36) and Thushan (32) are mourning the untimely death of their younger brother. The other sudden death was that of 23-year-old Alastair, the only son of Arthur Senanayake.
Alastair, who had completed graduate studies in Singapore and joined Singapore's National Service, came to the country in August last year following requests from his father to familiarize himself with business operations here.
"He wanted to join Singapore's Special Forces but I was concerned and as he is my only son I convinced him to take over the businesses here gradually. He was to leave to the University of Brunei to follow an honours degree in corporate law and business management," he said.
Before leaving for his post graduate studies, he wanted to meet his friends in Europe. "He was to join me on a trip to Sellakataragama to help out schoolchildren in the area, which we do annually during Poson. But his flight was delayed and he was in Rome when he complained of a sore throat which later turned into bouts of severe coughing with blood. He complained of a severe stomach ache too," he said. Alastair was immediately admitted to one of the leading hospitals in Rome and Mr. Senanayake flew to Rome.
He said a team of doctors who had treated a number of Sri Lankan dengue patients in Italy were attending to Alastair. Blood tests and blood transfusions were done, but he had started haemorrhaging. According to his father, medical reports revealed that he had been infected with the dengue virus before leaving for Europe.
Another parent in shock: Arthur Senanayake
A recent photograph of his son Alastair: Another victim of dengue
Alastair's mother Edna is and sisters Annika and Alexandria are in shock over his sudden and tragic death. "The house was full of life when he was around, with wires everywhere. We used to cycle together and in fact we cycled to Yala," Mr.Senananyake said, showing the last photograph taken by Alastair on his mobile phone.
"If I die please close the coffin and place a picture wall showing happier times. I don't want my loved ones to live with a sad memory of me," Alastair had told his father, a few weeks before his death and his wish was granted and the cremation took place last Sunday.
Dengue mosquitoes have claimed 56 lives with 11,403 cases being reported island-wide during the first five months of this year. Colombo district leads the list with 23 deaths and 2800 cases and the Western province accounting for 34 deaths. "Dengue is not only a poor man's disease; it is a deadly threat to all those in urban and sub-urban areas.
But eradication comes only through coordination and commitment by both health and local authorities and the public," National Dengue Control Unit Director Dr. R.Batuwantudawe said. He said that the central government's Health Ministry can only issue guidelines and laws while the implementation has to be carried out through local authorities.
Western Province Health Director Dr. Amal Harsha de Silva said a new Public Nuisance Prevention Convention of the Western Province will be implemented in a week's time where the owner of a house or institution, head of a local authority, state institutions such as the Road Development Authority can be made accountable for failing in maintenance. The guilty party will be fined Rs.50, 000 as well as a maximum of a Rs.3000 spot fine.
"Abandoned houses and lands have become a growing menace in the province. Therefore under this new convention, local authorities will clean the premises using volunteers and add a 50 percent surcharge to the bill," he said.
Dr. Silva said the public can complain to him about the failure of local authorities. The shortage of qualified health inspectors has affected the anti-dengue programmes severely, the Sunday Times learns. The Western province has 300 Public Health Inspectors (PHI)'s for 5.7 million people. "Colombo district is not only the most vulnerable when it comes to dengue cases, it is also struggling with the shortage of officers and people show little enthusiasm about cleaning their immediate environment," Colombo's Chief Medical Officer Dr. Pradeep Kariyawasam said.
Fumigation taking place in Beruwala. Pic by S. Siriwardene
He said 50 PHI's are deployed to inspect 120,000 houses and 50 labourers to carryout fogging.. Colombo city reported 80 dengue cases from highly residential areas to low income settlements in the first eight days of this month which is about 10 dengue cases a day.
"From coconut shells, empty tins and containers, tyres and gutters, dump yards to bird baths, ponds, artificial water falls, hardly used swimming pools, gardens, dengue breeding spots can be found everywhere and the public should actively get involved in anti-dengue work," Dr. Kariyawasam urged.
Symptoms of dengue fever
  • Sudden onset of high fever
  • Severe headache (mostly in the forehead area)
  • Pain behind the eyes which worsens with eye movement
  • Body aches and joint pains
  • Nausea or vomiting
  • Dengue haemorrhagic fever and shock
  • Symptoms similar to dengue fever plus, any one of the following:
  • Severe and continuous pain in the abdomen
  • Bleeding from the nose, mouth and gums or skin bruising
  • Frequent vomiting with or without blood
  • Black stools, like coal tar
  • Excessive thirst (dry mouth)
  • Pale, cold skin
  • Restlessness, or sleepiness
Facts at a glance
Dengue is transmitted by the dengue mosquito, Aedes aegypti, a daytime biter and the primary vector. It occurs in two forms: Dengue Fever and Dengue Haemorrhagic Fever(DHF), the severe form. Mosquito biting time : Mornings and evenings. Highest biting intensity is about two hours after sunrise and before sunset.
The best preventive action is to eliminate all potential mosquito breeding sites. Water typically collects and stagnates in discarded rubber tyres, coconut shells, blocked gutters, bird baths, barrels, jars, pots, buckets, flower pots, plant saucers, tanks, discarded bottles, water coolers, etc. and places where rain-water collects or is stored.
Mosquito bites can be avoided with the use of mosquito repellents, mosquito coils, nets, ointments and protective clothing,
Important health tips
  • A patient with fever should get maximum rest and plenty of liquids.
  • Dengue strikes people with low levels of immunity. It is possible to get dengue fever multiple times
  • Drugs containing Paracetamol may be given, but not Asprin.
  • The patient should be taken to the nearest hospital as early as possible.
  • Severe abdominal pains (black stools), bleeding on the skin or from the nose or gums, sweating, cold skin are danger signs. If any one of them is noticed take the patient to a hospital immediately. Give fluids to drink during transfer to the hospital.

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