Preventing disease

Mosquitoes and other vectors annually bring disease to our country, especially since mechanisms for prevention are weak and we spend huge amounts on treatment and care that could be avoided by ensuring disease does not occur in the first place. The Islamabad-based National Institute of Health has warned the country could be under threat from three diseases, dengue fever, chikungunya, and Primary Amoebic Meningoencephalitis (PAM) or Naegleria fowleri. The institute has said that raised awareness and preventive work could check outbreaks. Last year, Pakistan reported 3,204 cases of dengue fever, an outbreak of chikungunya was reported in Karachi in 2017 and while PAM is globally a rare disease, deaths have been reported regularly from Karachi since 2008. Since the Naegleria fowleri amoeba is transmitted through water and attacks the central nervous system, the increased use of water means there is a greater risk. This year, three deaths associated with the amoeba have already been reported from Karachi. Improving preventive health would be of immense benefit to a country that spends less than two percent of its GDP on healthcare. Experts argue that if even this meagre amount was properly utilised, with a focus on prevention, lives could be saved and costs limited. Safe water for drinking and other purposes could alone prevent thousands of deaths and tens of thousands of cases of sickness each year. So could better pest control. Both dengue and chikungunya fever are spread by mosquitoes. There have been attempts to wipe out these pests from our cities, but with only limited success. Spraying is insufficient and pools of water in many outdoor locations contribute to the breeding of mosquitoes.

As a country, we need to attach far greater importance to preventive health and to treating illness when it occurs, as soon as possible. This means it is essential that primary care facilities be made available to people everywhere in the country. We must examine the reasons behind the non-functioning of so many basic health units and rural health centres and the lack of availability of doctors at many government hospitals. If citizens could be better educated about health issues, they would be better placed to ward off disease before it reached them. This education needs to come from primary health carers as does initial diagnosis and treatment, with health teams working in cooperation with agencies responsible for sanitation, waste collection and the provision of water to households.