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Pakistan is currently seeing a huge surge in dengue cases. The disease has been around since early 2000 and the incidence has increased over time. We saw large occurrences over the years.
Several research articles from Pakistan are available on the disease prevalence, incidence, severity, age distribution, effect of environmental factors and effect of changes in weather patterns. The summary of situation as follows.
- Dengue is common in three provinces: Punjab, KPK, and Sindh. Balochistan and Gilgit Baltistan appears to have a smaller incidence.
- Several factors have contributed to the spread and increase of dengue. Climate change, virus evolution, societal factors, rapid urbanization, population growth, diminishing hygiene conditions, domestic and global travel and trade may be counted among significant factors.
- The remedial strategies are intermittent and therefore produce short term results.
- Public awareness campaigns are run and stopped probably due to cost factor. Our population growth has created enormous pressure on civic utilities for which no planning is there.
- Rural-urban migration is happening at an alarming speed, partly because people without landholding do not get adequate subsistence through working as farm labor, and partly because the property mafia is gobbling up agriculture land in the interest of making money.
- The construction craze created due to present government’s declaration of ‘construction as industry’ has given rise to a whole new set of problems not considered during policy making. Every piece of available land is being constructed which means the entire ecosystem of cities and villages is being disrupted at the core.
- The government efforts for control of dengue are entirely reactive. These start after the outbreak and even at a commendable speed it is only firefighting, not disease prevention.
- Public health facilities are already bursting at seams due to constant stream of COVID cases, although their reporting has probably taken off media. We do not hear much publicly, but news of COVID infections and deaths are constantly heard personally. Putting up separate wards for dengue patients in every public hospital is a tall order.
- Government does not have enough money to spend on anything, including dengue prevention through large scale sprays, setting up of inspection teams, running awareness campaigns on media, and involvement of all stakeholders.
- Political situation of country is getting more and more fragmented thereby further weakening government’s capability and resolve.
- People are under unprecedented burden of inflation and spiraling prices. Their ability to spend on disease prevention does not exist anymore. If they fall prey to dengue or COVID, they will not afford treatment. This factor adds to the higher incidence of deaths and morbidity.
- Due to economic conditions, most people do not consult a doctor until they become seriously ill. By that time, they may need hospitalization urgently. If the treatment is started at an earlier stage, it may help to reduce the development of more serious condition.
Overall, the dengue situation is grim, alarming, and worrying.
National Institute of Health – NIH Islamabad reports that since 8 October 2021, Islamabad has been facing a continuous rise in dengue cases and has been marked as a hotspot after Punjab. Dengue larvae were found at 53 different points during the anti-dengue surveillance activity.
There are additional problems.
The medicines for reducing fever – paracetamol tablets, syrup, infusion – has gone into short supply. Our Muslim brothers who run medicine businesses have found a new opportunity for black-marketing of these products. It is not as interesting as black-marketing COVID drugs which were high-priced, but something is always better than nothing. Our religious orientation and commitment make us to look more and more Islamic, but our deeds are not aligned. We are still comfortable with this contradiction and sleep peacefully.
The hospitals have also found new ways of fleecing patients. We should not be surprised though, but the ever-rising callousness keeps creating new levels of amazement.
The water wastage on car-washings, home-washings, lawns-watering, and so makes new habitats for Dengue mosquito which has a difficult name. Most of these people are aware of the hazard of these activities, but do not care. After all, they have the means to keep their nice homes tidy and disinfected. No one cares if the other people get dengue.
The summary is that we are in a very tight corner currently. All of us, everyone, must take steps to stop, eradicate, prevent dengue from spreading further.
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