A short, feverish war

The Jakarta Post , Jakarta | Tue, 01/30/2007 4:00 PM | Opinion

While the war on bird flu is far from being won, dengue fever has sneaked in almost unnoticed. Within a few weeks, the disease has infected almost 1,500 people and killed at least eight in Jakarta alone.

Outside the capital, the virus has spread fear in Lampung, West Java, Central Java, East Java and other provinces. The resurgence has prompted provincial governments to take all necessary measures to fight the disease, which has claimed at least 51 lives nationwide.

Dengue outbreaks have been routine in Indonesia for decades. The virus strikes during rainy season, and subsides during dry season.

So routine are the outbreaks that nothing has changed in the efforts to eradicate the mosquito-borne disease. The government sings the same old song when it orders fogging in residential areas, calls for people to clean their neighborhoods and promises funds to pay for anti-dengue measures.

People quickly lose their steam, however, when it comes to carrying out the best defense against dengue hemorrhagic fever and other communicable diseases: good sanitation. Once the dengue outbreak eases, things go back to business as usual.

It comes as no surprise, therefore, if the virus spreads quickly once an aedes aegypti mosquito transmits it to a human. Neither the government nor the community is prepared. This happens despite the fact that Law No. 23/92 on health which says the government is responsible for totally eradicating preventable diseases.

This unchanged mindset is probably the reason why we have been unable to get rid of the disease. Chronic complacency might have played a role in the resurgence of polio in 2004, too, after the country saw no cases for a decade, or the unabated spread of avian flu, which has so far killed more than 60 people.

Lack of commitment has reduced to mere rhetoric the government's pledge to send 10,000 village medical workers across the country in 2005. The program was aimed at training people and raising their awareness of various common diseases, such as dengue, TB and bird flu.

Some patients are confused by the different standard operating procedures adopted by different hospitals in dealing with dengue fever. One hospital may require a patient to undergo intensive treatment once symptoms of the disease appear, while another may take a few days before diagnosing and treating dengue fever.

Changes in the way we fight dengue fever are imperative, too, now that some patients may not display the usual symptoms found in the past. The characteristic bright red rashes have not appeared in some infected people, which may prompt doctors to diagnose them with ordinary flu. Regular dissemination of information to the public pertaining to new developments in dengue fever is therefore a must, in a bid to further raise awareness of the disease.

There is also a need for a sense of urgency among government and medical workers in this fight against dengue fever. Needless to say, dengue is as dangerous as bird flu or other communicable diseases, so a campaign against one of them must not weaken efforts against the other.

In view of the fact that late admission to the hospital is responsible for most of the fatalities in dengue fever, the government should equip community health centers (Puskesmas) with necessary first aid medicines. If possible, the government should require the Puskesmas to share the burden of providing treatment for dengue patients, since hospitals may lack room and resources to save the lives of infected people.

With dengue fever coming on the heels of the natural disasters that have struck the country almost relentlessly, such a sense of crisis is the minimum effort the country can make. The government may have spent a lot, and will continue to dig deeper into its pockets to help thousands of survivors of natural disasters, but it cannot ignore thousands more whose lives are threatened by dengue fever.

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