Forgotten Public Responsibility

by Dr. Ananda Jayasinghe

(July 16, Kandy, Sri Lanka Guardian) Unlike the airborne viruses (spread by air, via respiratory droplets – common cold, chicken pox, swine flu, etc.), in theory, the control of mosquito borne diseases such as the dengue virus is believed to be easier.

The much spoken dengue epidemic has claimed over 160 deaths this year and continues to do so. It is a major public health issue. At present, most people hold the Ministry of Health responsible.

Of course the Ministry of Health has a responsibility in taking appropriate measures to control such epidemics. Is it only the Ministry of Health? In case of public health issues, the co-operation, commitment and responsible behaviour of the general public are essential in controlling or eliminating of such problems.

In my opinion, the Ministry of Health is doing its best with limited resources in the country. Before accusing it, let us please assess our own commitment.

Do we have such public co-operation and responsible behaviour?

The common myth is that the garbage collections have no bearing on the epidemic. True that the mosquito concerned, the dengue mosquitoes (Aedes species) lay eggs in clear water, but with rains, there are plenty of places where such clean water is collected, as there are plastic containers, tins, polythene pockets, etc., etc., in those piles of garbage collections which are seen everywhere in the country.

If we study the number of deaths due to dengue fever, we observe that the most urbanized areas are at higher risk. It is a common knowledge that Colombo and the suburbs, Gampaha, Kandy, etc., have the biggest collections of garbage. Therefore, please do not subscribe to this theory of garbage not being related to the spread of dengue fever. In fact it is perhaps the major contributor. It is not the poor man who throws his own waste to public places. In fact it is done by the rich and the so called educated people. It is a common sight to witness such people throw their waste out of their vehicles while driving. It is a shame ! Over the past 4 to 5 years, the general household waste has exponentially risen many folds.

To win the war on dengue, as I mentioned earlier, public co-operation and responsibility are absolutely essential. The Ministries of Health and Environment simply cannot do the job unless we as the public do not understand our responsibility.

This is a golden opportunity to address the issue of waste disposal particularly in urbanized areas. I am sure if the people of this country take a little personal interest to cut down our own garbage, it will help in controlling or eliminating dengue from our country. If we develop the right attitude, a 50% reduction in our personal waste is easily achievable. It means a 50 % reduction of national garbage collection.

However small our home garden is, we should not throw our kitchen waste to the road side. Instead, we can bury it. It will give you good fertilizer in a week or two and at the same time, help in having a clean environment. This is also an indirect help to the dengue problem.

I would say our national pride is health and education. We are a success story in those spheres. We are also proud of achieving the best health indices in the South East Asia and the world as a developing country. (when one considers our per capita income) we have over 90% literacy as such and it is difficult to understand why we cannot develop little more responsible behaviour in waste disposal.

I am concerned that if the present mortality trend due to dengue fever continues, the people might be insensitive towards the issue. As a result, an unacceptable norm may be established eg., next year if we experience a reduction in mortality to around 100 deaths, we might be happy, where as the number of deaths should ideally be almost zero.

The dengue mosquito has relatively a narrow flying range being perhaps 150 to 300 meters. Therefore, having a clean environment around you, devoid of unsafe water collections, we would be able to reduce the dengue issue to a very large extent.

All what we need is little commitment and responsible behaviour in keeping a clean environment.

(The writer,head, Department of Community Medicine,Faculty of Medicine, Peradeniya )