Killer mosquitoes strike Pakistan again, this time in Khyber-Pakhtunkhwa. Anwar Zeb finds people increasingly frustrated with the local authorities' response
The streets of Tehkal in Peshawar seem haunted. Moving through these streets today, one is likely to encounter dejected inhabitants everywhere, discussing dengue fever – a mosquito-borne tropical disease. In mosques, hujras, milk shops, fruit markets or elsewhere, people of all ages and sexes are discussing the same ailment – the most burning issue at least for this locality.
Dengue was first reported in Karachi, the financial hub of Pakistan in 1949. A total number of 145 diagnosed patients were admitted in hospitals – in that early outbreak, one patient died whilst the others recovered after treatment. Since then, Baluchistan, various cities of Punjab and the Federally Administered Tribal Areas (FATA) were hit by dengue outbreaks multiple times. In 2011, Lahore was badly hit by dengue – at least 257 people died.
As for Khyber-Pakhtunkhwa, dengue emerged in district Haripur in 2003, claiming six lives, followed by Swat where in 2013 some 22 people died.
Water collecting inside discarded tires is an ideal breeding ground for the dengue mosquitoes
And now, the latest wave has struck Tehkal, an area Located almost 5 km form Peshawar main city, in the west – between the University of Peshawar and the Cantonment Board. In this area, according to the district administration, more than 1,500 dengue-positive cases were reported as of the 22nd of August this year.
The first dengue-affected patient from Tehkal died on the 1st of August at Khyber Teaching Hospital. To control the outbreak, the district administration and the Khyber Pakhtunkhwa Health Department adopted precautionary measures and launched a dengue awareness and fumigation campaign in the area. These measures failed to curb it.
To investigate the outbreak, the Khyber Pakhtunkhwa Health Department requested the World Health Organisation (WHO) for assistance. A survey conducted by the WHO revealed that In Tehkal, the first Dengue-positive case was reported in June 2017. Later on the virus spread through the whole area. A total of 4,320 suspected patients were screened at Khyber Teaching Hospital by the 17th of August: of whom 699 were Dengue-positive. Five of them died at KTH by that date, the WHO survey added.
The WHO team revealed that the main reason behind the outbreak in the area is the use of uncovered water containers in houses and workshops. A total of 100 samples were collected from two areas in Tehkal, the Dispensary area and Gujran Muhalla. 35 of them tested positive for dengue.
The WHO team revealed that the main reason behind the outbreak is the use of uncovered water containers in houses and in workshops
Niyamat Ullah, a 50-year-old resident of Tehkal, is shattered by the death of his 17-year-old daughter. He holds the government and hospital administration responsible for the death of his daughter. He says: “My daughter would have recovered if doctors had provided timely treatment to her. I took her two times to KTH as she was tested Dengue-positive, but the doctors refused to admit her in the facility. Three days ago when her condition worsened we took her again to the hospital. Seeing her condition, the doctors admitted her in the Insensitive Care Unit in KTH, but this time she lost the battle for life on the 21st of August.”
Another resident of the area, Taj Wali Khan, criticises the arrangements and preparation of the KP government. He believes “a single sting from a dengue mosquito brought down the tall claims of Sehat ka Insaf (justice in healthcare) made by Pakistan Tehreek-e-Insaf since 2013.” He also blames the government for a failed fumigation campaign in the area.
Measures taken so far have failed to curb the outbreak
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As the situation spiraled out of control, frustrated locals requested the Punjab government to help them, through the media. The Punjab government deployed three mobile health units along with medics and paramedics to help people with the dengue outbreak.
On the arrival teams were welcomed by residents of the area – given the circumstances, the Punjab government’s efforts were applauded.
Talking to the media in Peshawar, Punjab Health Minister Khawaja Imran Nazeer insisted that the teams sought simply to help people with the epidemic. “We are not playing politics on the lives of people!” he added. “Together with the KP government we have to control the dengue virus and protect precious lives.”
“The Dengue virus is transmitted to humans through the bite of an infected mosquito,” says Dr. Abid Khan Niyazi, an entomologist from Punjab working with the health unit. He has been in Peshawar since one week at the time of writing this report. “The most important thing in this situation is to screen people as soon as possible. And the aim of our team is to help the KP government in screening suspected patients. If someone is diagnosed with Dengue positive, we refer them to various local hospitals.”
In charge of the Punjab government’s mobile health unit, we find Dr. Matloob-ul-Hassan. He says that the team has been working from 8 am to late in the night. “By the 22nd of August, one health unit has screened thousands of patients and conducted more than 1,500 tests – in which 300 hundred tested positive for dengue.”
The placement of the Punjab government’s health units has remained a problem. On the 20th of August, a meeting was held in the Governor House and it was decided that these teams will work under the supervision of the KP health department. That department will provide accommodation and other facilities for the staff. But the health units’ members along with doctors are still functioning from Tehkal’s streets and are based in local hujras.
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The death toll so far has become a matter for some dispute too. On the 22nd of August, locals stated that the district administration is manipulating the numbers of dead. They allege that at least 11 people died in this outbreak but that the administration has been quoting a lower number to the media on purpose.
Meanwhile, many locals remain at the mercy of the killer mosquito. It was recommended by the WHO in its latest report that mosquito repellents in the form of special lotions or sprays ought to be provided to the locals and Indoor residual spraying (IRS) could then be carried out around the breeding areas for the insects – particularly in tire shops, workshops and other such facilities.
