‘Physician’ heal thyself

Sri Lanka may be rid of the scourge of terror, but the country is facing a different kind of war now - epidemics of Leptospirosis (Rat fever), Dengue fever and last but not the least, Swine fever.

The Dengue epidemic, in particular, had been predicted in Medical circles for many months. But Health Minister Nimal Siripala de Silva and some of his equally inefficient top officials were lackadaisical in their approach, until the crisis reached alarming proportions: over a 130 dead, most of them children, and we are only in the first half of the year yet. In contrast, in the previous worst epidemic 88 died in a year.

And when the epidemic reached a peak, what do the Ministry mandarins do? The Epidemiologists gleefully hog the media limelight to enlighten us with their pearls of wisdom - ghastly statistics of an ever rising death toll! What they did, to prevent this outbreak, is anybody’s guess.

And, what of Minister de Silva himself? Of course, this being Sri Lanka, we don’t expect him to rush to President Mahinda Rajapaksa, resignation letter in hand, because we know he is too enamoured with his Ministry. The least we expect of him is some dignity and decorum in discussing the predicament, but he turns it into lighthearted, lascivious banter, claiming that Dengue spreads because Dengue mosquitoes are attracted by those wearing short dresses!

What, we wonder, would have been the feelings of those who are bereaved by the deaths of family members due to Dengue.
The latest scandal to hit the headlines is the appearance of Swine fever in the country. At a time when the Dengue epidemic is reaching dizzy heights, Minister de Silva’s proud but premature boast was that he and his Ministry was doing the right thing, which is why Swine fever did not spread to Sri Lanka. We wonder what ridiculous explanation de Silva now has for the entry of the Swine fever virus into the country.

In this day and age, when international travel is routine, it was a matter of time, before the disease appeared in Sri Lanka. Nevertheless, we must question whether adequate precautions were taken to detect the disease and treat those affected. And the answers to these questions point in a different direction.

Then, it has been found that half the passengers aboard the flight that brought the first Swine fever victim to the country have evaded medical screening - nor have they filled out their disembarkation cards properly; so, they cannot be traced now. Surely, these are all basic preventive measures that could have been put in place, had the Health Ministry’s Epidemiologists and other responsible officials had an iota of common sense and an ounce of commitment.

This appears to be what is lacking, even in the control of Dengue. While we were treated to the spectacle of Minister de Silva rolling up his shirt sleeves (exposing himself to the Dengue mosquito in the process!) and doing ‘shramadana’ to clear areas of mosquito breeding, that type of activity appears to be still the exception, rather than the rule.

Mountains of garbage keep on accumulating, drainage systems are blocked and stagnant, and our environment is as dirty as ever. The vital coordination between the Ministries of Health, Environment and Local Government that is essential, if we are to keep our surroundings clean and thereby, prevent the dengue mosquito from spreading its kind, is simply non-existent. So, the death toll keeps on rising.

The Ministry’s response has been to enact new regulations to prosecute those who encourage places of mosquito breeding. But will prosecuting individuals stem the tide, especially when an epidemic is raging? And, who then is to be prosecuted for all the clogged drains and mountains of dirt that are an integral feature of our urban landscape? Can the local authorities and other agencies, whose responsibility it is to maintain services of garbage and water disposal, be put in the dock? That would be the day!
Maybe Minister de Silva should learn a bit of history from his Cabinet colleague Dinesh Gunawardena, whose father, Philip, was instrumental in fighting Malaria through the ‘Suriya Mal’ movement, along with the likes of S.A. Wickremasinghe and N.M. Perera. Those were the halcyon days, when politicians put country before self, and worked for a cause!

The strategies adopted to contain Malaria and Filaria have been largely successful in this country, and have been hailed as role models for other nations in the region. Why then are we so inept at curbing the Dengue epidemic, at a time when Medical Science is progressing by leaps and bounds? Is it because the Dengue mosquito is becoming increasingly ingenious or should the Ministry of Health turn the searchlight inwards?

It is a month since the war against terror was won, and as a nation, we take justifiable pride in that achievement. In retrospect, it was said that a major contributory factor in that victory was President Mahinda Rajapaksa’s knack for picking the right man for the right job in the Defence establishment, and then giving them a free hand, free from any political encumbrances.
Maybe it is time then, that the President adopts the same strategy in the wars against Dengue, Swine fever and Leptospirosis, because, obviously, we do not seem to be having the right men for the right job right now.