Tuesday 27 September 2016

Dengue: Ads only after outbreak

Dengue: Ads only after outbreak
Durgesh Nandan JhaSep 27, 2016, 12.30 AM IST
New Delhi: The under-reporting of dengue cases, highlighted in the CAG report—carried in TOI on Monday—is merely a symptom of the chronic illness Delhi's government and civic bodies suffer from. An analysis of the audit reveals a rot at all levels of planning and action as far as containment of mosquito-borne diseases by the corporations is concerned. The state, too, wakes up only when the crisis hits home.

The CAG report says that dengue cases peak from June to November every year and publicity campaigns relating to prevention of the disease have to be released before that. However, the Delhi government issued advertisements worth Rs 10.04 crore between September and November over the past three years (from 2013-14 to 2015-16) only after the outbreak of dengue. Thus, the very objective of spending to create awareness of the measures to prevent an outbreak was defeated.

This year, too, epidemiologists point out the issuing of advertisements has followed a similar trend. The publicity campaigns of municipal corporations also started in the month of October in the past three years. CAG says launching of a public awareness campaign after monsoon has little justification.

But the story doesn't end here. The federal auditor has criticised the corporations for lack of effective surveillance, first critical element of dengue prevention. According to the audit, none of the civic bodies has a standard operating procedure for this purpose and only 287 out of 967 private and public health institutions report on dengue patients. This undermines the objective of meaningful surveillance to provide early warning of an impending outbreak. In November 2012, the Delhi government constituted a dengue task force under the chairmanship of the state health secretary to formulate an action plan for containment of dengue and other vector-borne diseases in the city. However, the CAG audit has revealed this task force did not meet even once in 2014 and 2015.

The lack of manpower is another key concern voiced by the federal auditor. The malaria department was formed in the early fifties. Though the inhabited area and the population of Delhi have increased manifold since then, points out the CAG report, the sanctioned posts in the malaria department have not been reviewed.

The corporations suffer from shortage of supervisory staff, ranging from 46% to 97%, and in the workmen cadre, from 20% to 36%. In NDMC, there is no sanctioned post of entomologist (scientists who study insects) while the sanctioned posts of epidemiologist and sanitation officers are lying vacant as of January 2016. There is a 12% shortage of anti-malaria jamadaars. The CAG points out that despite this situation, many malaria inspectors, assistant malaria inspectors and field workers are still deployed on ministerial work.


Chemical control measures of vector management are undertaken with the help of various types of pumps. The audit noted 26% of the available pumps/machines in the corporations were not working while 65% of the available pumps/machines in NDMC were non-functional.


The federal auditor has suggested constituting an inter-agency coordinating mechanism, given the multiplicity of agencies dealing with dengue prevention and control in Delhi.



"The CAG report exposes civic agencies, the state and the centre that often get into a blame game over the cause of such a crisis. They should now act on the gaps in dengue prevention mechanism to ensure that more lives are not lost," said Dr K K Aggarwal, president-election, Indian Medical Association.

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