hile weather patterns are changing all over the country, nowhere are the adverse impacts of this shift in rainfall patterns and temperatures more pronounced than in Khyber-Pakhtunkhwa (KP). The province is more climate-sensitive than other regions because of its altitude and topography.

Last month, Peshawar was one of the cities that received excess rainfall. The heavy downpour raised the probability of an early dengue fever outbreak.

Urban centres in KP such as Peshawar are already susceptible to mosquito-borne disease.

Rainfall drives dengue transmission by adding to the number of stagnant water pools in an area. The pools are then used by mosquitos as their breeding grounds. As the mosquito population grows, the risk of a dengue fever outbreak also increases.

Unplanned urbanisation results in stretches of densely populated areas. A mesh of social and environmental factors contributes to dengue fever transmission in these pockets, present in all large cities of the country, including Peshawar.

This will not be the province’s first dengue fever outbreak. According to various reports, around 23,000 cases of dengue fever were recorded in KP last year. Peshawar was one of the epicentres of the epidemic.

According to Health Department officials, 18 dengue fever patients have been reported in the province this year. Out of those three have been from Peshawar and 10 from Mardan.

Bajaur has reported three cases and Kohat and Lower Chitral one case each. The officials say that three of the patients had recently travelled to Saudi Arabia.

Past reporting reveals a pattern; a surge in dengue fever cases is reported from the province every year. The outbreaks are more likely to occur between April and May but this year the disease has hit the province sooner due to early rains. The first few cases were detected in March.

Another cause of concern is the overall rise in temperatures this summer. Data from the Met Office shows that the monthly average temperature in KP in March has risen by 2.01°C, compared to last year.

Hot and humid environments are perfect breeding places for mosquitos. As we head into the scorching summers, the temperature is only going to rise.

As the mercury rises, the authorities have also sprung into action. Field staff has been directed to remain vigilant, intensify surveillance and eliminate pools and puddles that can serve as breeding sites for mosquitos in 13 union councils (UCs) of the provincial capital. These sites were identified as potential hotbeds for seasonal disease.

The Peshawar administration claims that it started working on a Dengue Fever Action Plan (DAP) as early as January this year and the tehsil municipal administrations (TMAs), Health Department, Information Department and other relevant authorities have been assigned tasks in this regard. The DAP aims to introduce anti-dengue fever measures and reduce the spread of the vector-borne disease.

Additional Deputy Commissioner (Relief and Human Rights) Muhammad Imran Khan says that efforts are under way to contain the spread of dengue fever in Peshawar. “We have established dedicated ‘dengue wards’ at all the Rural Health Centres (RHCs), Lady Reading Hospital Peshawar (LRH) and Category D hospitals on a needs basis,” says Khan. “Dengue control rooms have been established in the hotspot districts,” he adds.

“We are visiting the mosques for awareness sessions and community mobilisation,” he says. “We have also engaged the ulema (clerics) to deliver special sermons to educate people on the precautions they can take to protect themselves. The Auqaf Department is overseeing that,” adds Khan.

What is dengue fever?

Dengue fever is caused by a viral infection transmitted through the bite of infected mosquitoes, primarily Aedes aegypti which are also known as the yellow fever mosquitos.

The vector-borne disease is common in regions with tropical or sub-tropical climates. It causes high fever, severe headache and muscle and joint pains and has no specific treatment.

According to the World Health Organisation, half of the world’s population is at risk of dengue feer, with roughly 100 to 400 million cases annually.

The Aedes aegypti mosquitos go through four major life stages which span eight to ten days. First, they lay eggs, which hatch when submerged in water. The aquatic larva develops into pupa, which matures into adult mosquito in two to three days. In their adult form, the female mosquitos carry the dengue fever virus.

Khan says the district administration’s main focus is on the identification of larvae. “First, the entomologists identify larvae and destroy them. This is followed by an awareness session about the preventive measures against dengue fever,” says Khan.

According to Khan, one of the main challenges the anti-dengue fever field teams face is during the inspection and screening phase. “It is sometimes difficult to access the identified houses,” he says, “but the district administration has completed the screening of about 45,000 houses,” he tells TNS.

Khan maintains that hundreds of houses are being inspected daily, “Lady health workers, TMA staff and representatives of the Local Government and other relevant departments have been deployed to perform these duties,” says the official.

“Polio staff have also been engaged for the house inspections, larvacidal activities and dengue awareness campaigns,” says the official. “These teams are being supervised by the medical officers of the respective Basic Health Units (BHUs),” he adds.

Challenges

Last month, Caretaker Chief Minister Muhammad Azam Khan directed the Finance Department to provide funds for the procurement of emergency medicines and other essential medical supplies in hospitals in connection with DAP 2023.

Recently, the government has approved an allocation of Rs 171 million to control the dengue fever epidemic. Building resource capacity amidst a serious financial crisis is proving to be difficult, and preventing the authorities from making a comprehensive effort to curb the epidemic.

In the past years, social media and FM radio stations had played an important role in spreading dengue fever awareness, communicating public service messages about dengue fever prevention, and where to seek treatment.

But for the last two weeks, the entire staff of KP government’s Directorate General of Information and Public Relations, including the radio staff, has been on a pen-down strike against an allegedly ‘illegal’ appointment. The strike has also affected the ongoing DAP.

Citing a report released last month by the Inter-governmental Panel on Climate Change, Dr Muhammad Fahim, deputy director of the Regional Meteorological Centre (RMC) Peshawar, says that the frequency of extreme weather events will increase in Pakistan and the rest of South Asia.

The writer is a multimedia journalist. He tweets @daudpasaney