Dengue outbreak

With confirmed cases of dengue in Peshawar now numbering more than a thousand, it is safe to say the city faces a potential endemic on its hands. The provincial government in Khyber Pakhtunkhwa appears to have been caught unawares by the problem, despite dengue being an annual problem in Pakistan. Dengue mosquitoes breed in urban areas and, as the largest city in the province, Peshawar was always likely to bear the brunt of the problem. International organisations like Unicef had provided the Khyber Pakhtunkhwa government with tens of thousands of mosquito nets but those appear to have been unused. This is in stark contrast to Punjab, which declared an emergency in hospitals and was largely able to control the spread of the virus. In a welcome gesture of inter-provincial cooperation, the Punjab government offered help to Peshawar and health teams have been sent to the city to assist the KP government. Initially hesitant, the KP government has accepted the offer. This is the best possible method: setting aside political differences to work for the benefit of public health. At least 10 people have lost their lives in Peshawar due to complications caused by the virus. Any future fatalities need to now be minimised. Punjab’s efforts to control dengue in the past few years have been impressive and the rest of the country could stand to learn from its experience.

Part of the problem in Peshawar is that of government complacency. The only way to prevent an epidemic is by taking action long before it becomes a problem. As was done in Punjab, the Khyber Pakhtunkhwa government should have fumigated areas to kill dengue mosquitoes. This was done only on a limited scale in Peshawar and there are reports that the chemicals used were substandard. Health worker teams should have been dispatched throughout the city to distribute mosquito tents and educate people about avoiding dengue. Since dengue mosquitoes breed in standing water they pose the greatest risk in areas where sanitation facilities are scarce. But health teams were not sent to the rural outskirts of Peshawar and it is now areas like Tehkal which are reporting the highest number of dengue cases. Dengue is a virus that is controllable even if it is not outright eliminated. Punjab has already shown how that can be done and resources are available to replicate that success around the country. All that is required now is the will to do so.