Tony DeyalIN THE midst of raging dengue epidemics, the cry goes out throughout the lands of the Caribbean, "Let us spray!" And there goes forth the word from Ministries of Health that the whole world should be sprayed and their sprayers wend their way through the Lands of Canaan, Judea and elsewhere. And they drag forth vehicles that make noises and send out fumes and vapours so that the faithful would know that the Ministries of Health are interested in their health and are saving their lives. And the birds of the air and the fishes of the lake are set upon and they fall by the wayside, whereas the mosquitoes continue to thrive.
The faithful, their windows closed against the toxic substances, praise those on high for heeding their pleas for help. The mosquitoes, safe inside the houses, especially the larvae and little ones in vases and flower pots, with no Herods in sight, live happily ever after. And the faithful continue to indulge in their sprayers until the wet season ends and they, too, live happily until the next rains cometh. For such is life. And such is death. Especially the death of children from Dengue Haemor-rhagic Fever.
Every year we go through the same cycle of bored indifference by the health sector and householders during the dry season, sudden interest on the part of householders when the rainy season comes, pressure on the Ministers of Health after the mosquitoes start biting, resort to spraying and, fortunately, the wet season ends with only a few dengue deaths. This is in spite of the fact that all Ministries of Health, and all Medical Officers of Health, know that the best means of dealing with dengue is source reduction of mosquitoes by the householders.
This means getting people to understand that health is everybody's business, not just the responsibility of the Ministry of Health. This means not providing mosquitoes with breeding places and so preventing the deposition and hatching of larvae. This means ensuring that your water tanks and storage containers are sealed; that your backyards are clear of sources of stagnant water. Since the Aedes Aegypti is fastidious and likes clean water, and since it dines on people, the mosquito is like a household pet. It is always very close to us.
Health sector officials know that the noxious sprays are effective only against those adult mosquitoes that are foolish enough to be outside when the sprayers pass. Aedes Aegypti are the mosquitoes that bite at early daylight, just after dawn, and at twilight. The sprayers are not around at that time and certainly, not inside your home where the mosquito lives and hides. However, knowing they would be saved when the rainy season ends and the dry season starts, these officials hope that deaths would be minimal.
This time they have all been caught out in the rain, literally. Intermittent rainfall in July and August is triggering a spiralling breeding cycle of Aedes Aegypti that is now out of control with no dry spell in sight to save the reputations of the health sector big-shots who have taken responsibility for the disease and the lives of the people, particularly children, who are dying from dengue.
I thought of all this as I lay shivering, my skin burning up with dengue fever. Dengue makes it very difficult to eat anything. Dengue does not seem to like you to eat, attacking your salivary glands and taste buds, mugging them into submission. This was last year when after four nights with dengue, my condition necessitated more professional assistance.
I checked myself into the hospital and, after waiting vainly for assistance, was about ready to check myself out. Dengue and patience do not go together. It is a virus that wages a relentless attack on your system. It feels like a gang of juvenile delinquents armed with chainsaws and blowtorches prowling your estate for anything that could be chopped down, slaughtered and destroyed. There is constant pain behind the eyes and in the joints. Some muscles, even the large frontal thigh muscles, become cramped and virtually useless. The non-aspirin tablets buy a little time and space in the ongoing drama of pain but as the hours pass, the pain returns in waves and the fever once more tops the charts.
You should never take aspirin if you suspect you have dengue because the aspirin thins out your blood and makes you even more susceptible to Dengue Haemor-rhagic Fever (DHF). Dengue is appropriately called "break-bone" fever by my Jamaican friends. It leaves you "mash-up" for periods up to three weeks. In fact, some people take much longer to recover from its effects. What I remember, even now, is the back pain that makes you "lumbar" around in agony looking for a comfortable sitting or sleeping position.
One nurse believed that not having eaten anything for five days, I should be forced to take in some solid sustenance. She decided to withhold my pain and fever medication until I did. My temperature shot up to 103 degrees. Dengue does not like threats. What it does like is people who have already experienced one of the four serotypes. The first time you get dengue, the effects are almost indistinguishable from the normal flu, except for the pain behind the eyes and in the joints. You would never get that same type again, but it makes you more susceptible to one of the other three serotypes and to dengue hemorrhagic fever (DHF), which can be fatal, particularly to infants.
One way to beat dengue is by not succumbing to depression induced by the combination of the disease and the medication. It can get you down after a while. What I did was to cling to the little joys of recollection. I also appreciated the irony. Having spent seven years throughout the Caribbean teaching people how to prevent dengue, I find it an interesting experience to change roles from hunter to hunted. It is like the story of the Englishman, clad in full hunting outfit and armed with a rifle who stumbled onto a totally naked lady in the forest. "What you doing?" she asked. "I'm looking for game," he replied. "Well, I'm game," she admitted. So he shot her.
Tony Deyal was last seen saying that with all the games the health officials are playing with people's lives, and the risks we are taking with our own while waiting for the Ministry of Health to do our work for us, what we need in the Caribbean is not more spray but more big game hunters.
