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Opinion

Dengue outbreak: The quest for cleanliness

The surveys and online polls that throw up dismal figures in terms of the success of Swachh Bharat Abhiyan may well give the opposition a handle to criticise the pet project of Prime Minister Narendra Modi.

But sadly, what they do not realise is that the cleanliness programme that the prime minister initiated on the Gandhi Jayanti last year is something we urgently need. 

The project revolves around the fact that several diseases can be stamped out simply by improving sanitation in India. All sorts of disease-causing bugs, viruses, bacteria, protozoa and parasitic worms found in the faeces of infected people find their way into our bodies through contaminated soil and water and food handled by infected people.

Added to that is mosquitoes breeding in stagnant and fresh waters -- the primary reason for the thriving of the dengue-transmitting Aedes Aegypti mosquitoes. Not to mention, of course, the algae and fungi in neglected surroundings, lack of safe water and the absence of toilets and sewerage facilities. 

Over years, India has been a witness to the outbreak of several diseases. Some of these include Ascariasis (roundworm infection), campylobacteriosis (diarrhoea triggered by gastrointestinal tract), cholera and cyanobacteria toxins and, last but not the least, dengue.

Virologists say that the current outbreak is the worst in five years because of the combination of Strain 2 and Strain 4 of dengue in circulation. Dengue Type-4 is a rarer and stronger strain that has not gripped the national capital since 2003. Its symptoms include fever with shock and a drop in platelet count.

While it is pertinent to contain the spread of dengue and seek modalities to be charted out to improve sanitation, the crisis is being politicised. The veteran politicians have conveniently given the sanitation factor a miss and are on a blame game. Everyone seems to be pitching a battle against each other rather than fighting dengue that has resulted in deaths.

If a portion of the several thousand crore rupees spent by political parties for publicity is diverted towards improving cleanliness, people could be free of sanitation-related diseases that have been devouring lives. 

One of the biggest complications in dengue is fever-induced dehydration that leads to seizures and needs admission to the ICU for the patient. While clean drinking water is a dire need, the water dispensing machines in public places are a sham. Although, the government functionaries have found it convenient to blame the hospitals for alleged negligence, not much of thought goes into their inadequacies. 

There is a need for the government machinery to improve the technology and upgrade its skills so as to improve the actual delivery of sanitation services at the ground level. As of now, there seems to be a huge gap in terms of those responsible for the collection, transportation and treatment of both solid and liquid waste in urban areas.

As per the latest government data, 1.42 lakh tonnes of solid waste was generated per day in urban areas in July. However, only 15.33 percent of it was processed, indicating how under-equipped the civic bodies are to handle the mammoth task.

The picture of the Syrian toddler who was washed ashore shook the entire world but the lives that are being lost in Delhi, unreasonably and due to preventable diseases, have failed to move those in the public health system. Caught amid the ineptness of the government machinery or those at the power centre are the hapless people who are fighting for their lives.

(Rajat Arora is an Interventional Cardiologist and Medical Director at Yashoda Hospitals in Delhi. The views expressed are personal)
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