Archive for February 2nd, 2009

Engage Engineers, Not Doctors, To Control Dengue

by M. Bakri Musa

Florida in the summer has the same hot and humid climate as Malaysia. Its topography too is like Malaysia, with plenty of swamps and other stagnant bodies of water. Unlike Malaysians however, Floridians are not regularly threatened with outbreaks of dengue.

The secret is not that Florida has more and better doctors than Malaysia (although that is true) rather that Florida engages its civil engineers and not medical doctors to control vector-driven diseases like dengue. That is much more effective as well as cheaper, both in financial costs and human suffering.

While it is commendable that Dr. Ismail Merican, the Ministry of Health’s Director-General, is spearheading public awareness of dengue during this latest outbreak – the most severe – he is not the best person to do that. Neither his professional background nor his regular duties prepares him for this awesome responsibility. His ministry is not the most appropriate agency to undertake this monumental task.

Like Florida, we should engage civil engineers in local councils and the Ministry of Works, instead of medical doctors in local hospitals and the Ministry of Health. If those engineers could get away from their air-conditioned offices, they would notice those stagnant drains, silted ponds, and ditches with overgrown weeds. If those officers could brave the stench and examine closer, they would see mosquito larva luxuriating in the stagnant waters.

The solution is not to pour toxic chemicals into the water or fog them into the air. Yes, that would be effective, but those same chemicals could eventually leach into our water tables and poison us, that is, if we have not already inhaled them. Get rid of the stagnant water and you would kill off the larva. No larva, no adult mosquitoes, and no vectors to spread the dengue virus.

There is of course a major role for the Ministry of Health. The most obvious is to educate the public and health professionals in recognizing and treating the disease early. The other is in collaborative research with international agencies for prevention (as in vaccine development) as well as treatment. Its Public Health Division could develop sophisticated surveillance strategies using the Internet, GPS, cell phones, and traps laced with chemicals to attract pregnant mosquitoes so as to get real-time information so we could initiate effective and immediate interventions, as the Brazilians are doing. Read the rest of this entry »