Standing in a long queue (almost a hundred people) since 8: 30am waiting for her turn at Out Patient Department OPD, she was now tired and her immunity level decreasing to zero. It was Shahnaz Begum 59 year’s old lady, resident of Iqbal Town suffering with high fever, headache and nose bleed when she was brought to Benazir Bhutto Hospital (BBH) Rawalpindi by her daughter. She just fell down and her situation was getting worst .Her daughter call the staff for help.
Shehnaz Begum was there for her dengue blood test. She said that she is actually worried if her blood test shows the positive symptoms. She being a widow and mother of two young daughter is the only working person at home who bring bread & butter, while talking she express that the reason of being afraid is the recent news of a woman’s death because of dengue fever at Benazir Bhutto Hospital (BBH) .she heard in a news that Amana, 26, was a resident of Gulraiz II. She died in the hospital’s intensive care unit of BBH a few days ago.
In the wake of the recent outbreak of dengue fever in Punjab, an increasing number of patients have headed to the three government hospitals in the Rawalpindi – Holy Family Hospital (HFH), Benazir Bhutto Hospital (BBH) and District Headquarters (DHQ) Hospital – for treatment every day as the hospitals struggle to accommodate the sudden influx of patients. A record-breaking 44,000 people have been infected with mosquito-borne dengue in Pakistan this year, a senior health official said; as increased outbreaks linked to rising temperatures and erratic rainfall ravage other parts of Asia.
Transmitted mainly by the Aedes Aegyptus mosquito, which thrives in densely populated tropical climates and breeds in stagnant pools of water. Dengue Virus could be deadly if not cured timely. Mosquitoes pick up the virus from infected humans – even asymptomatic ones – and pass it along to other people through bites.
Rana Safdar, a senior official at the National Institute of Health (NIH), said the figure is a huge leap from the previous record of 27,000 infections in the year 2011.
According to the data shared by the National institute of Health ( NIH) with Media Approximately, 66 people died by dengue so far in 2019, compared with 370 in 2011. The southern province of Sindh had 10,142 cases and 26 deaths; the worse effected Province is Punjab with 9,260 reported cases
2011 was the year when the country, especially Punjab witness the deadly virus for the first time at large scale. Lahore was the worse effected city .It was the test of the Government and operation to defeat the epidemic by Shahbaz Sharif Controlled administration set a benchmark for the country and world to overcome and control the disease in the years to come.
Why dengue is out of control this year as with the increasing number of patients and death especially in twin cities and Punjab, question arises?
A set of detailed SOPs were published in the form of a book in Shahbaz government, But the SOPs book had a problem…. It had Shahbaz Sharif’s picture and a message. This year the dengue epidemic has hit different parts of the country including Islamabad and Rawalpindi.
SOPs were not shared timely and followed public awareness campaign at local, provincial and national level, with no thus leaving the present anti-dengue efforts rudderless, a correspondent of Ex- government of Sharif claimed.
“Compare the recent numbers at the larger scale as dengue outbreak after every four years and this year we are in this phase”, said Dr .Zafar Mirza, Prime minister‘s Special Assistant on Health.
“We are working according to the set sops and when I took charge just six response teams were working, now 96 teams are working hard to control the virus, create awareness and help the patience especially in twin cities”. He further added.
Mr. Zafar totally rejected the claims that government hospitals were with the shortage of medicine, dengue vaccines and trained paramedical staff.
A WAR-ROOM was setup by the Ex- Chief Minister Shahbaz Sharif in his office, where the professional team was working to monitor and ensure real time implementation of his directives, provide guidance to different departments and facilitated multi-agency, coordination and helped where needed, informed by the Social worker working in health sector in Lahore.
For 94 days the former chief minister headed early morning meetings at 6:00am wherein all 40-plus administrative secretaries were present along with almost all the 13 MNAS and 26 MPAs from Lahore. Former Chief Secretary of Punjab government, heads of Special Branch and IB used to be also present to give independent assessment of work being done in the field.
A team of senior professors led by late Prof .Faisal Masood was also present — which provided clinical guidance to doctors throughout Punjab.
Chef Minister Punjab Usman Buzdar visited Rawalpindi hospitals after the outbreak of dengue. Mrs. Dr, Yasmin Rashid , Health minister Punjab was satisfied with the efforts being done by the government and rejected the figures and increasing numbers of dengue patients this years, “if a hundred patients came for dengue treatment only one is in worse condition other 99 recovered at early stage ,so numbers are not a worried thing.” she claims while in an interview.
Yasmeen Rashid further added that dengue mosquito spray also has some side effects so we cannot spray it at every place but where ever we found dengue larva the team visits that place and fumigate the area with anti dengue spray.
But this official claim has fallen of its own weight as the rising number of dengue cases forced Punjab Chief Minister Sardar Usman Buzdar to order an inquiry to find out the reason and deputed the chief secretary to supervise the anti-dengue drive. When we see the conditions in government hospitals , they are even worst ,at BBH a special ward for dengue patients has been established which is facing shortage of medicines and trained staff , a source said.The federal government wrote a letter to Punjab government for help in providing the “Dextron”vaccine used to cure dengue, Dr Javed voice chancellor, University of Health sciences told while talking about the disease.
What SOP’s are being followed? How effective public campaigns were and at what time these campaigns were launched? Special secretary at Ministry of health in an interview reveal the truth that all the teams under the dengue control program became active just after dengue outbreak started this year In a National Assembly proceeding dated 05 October 2019, parliamentary secretary for national health services (NHS) Dr. Nusheen Hamid admitted that the government did not take timely precautionary measures to prevent dengue in the capital.“Unfortunately, spraying was not done in April this year. However, it is being ensured that timely sprays will be done from next year to control dengue,” it was true that fumigation should have begun in April, which is the season of larva development. She further added.
Shahbaz Sharif was particular about punctuality and wholehearted effort that he would harshly reprimand even senior political colleague was found backing his efforts. He was determined and focused in providing health facility to general people who would be witnessed through the actions of galvanized district administrations.
Agriculture Department field staff and entomologists were tasked with preventive spray all over Punjab. Cooperative Department was responsible for preventive measures in all the housing societies of big cities. Since the dengue virus as per public health experts was spreading through water accumulating in old truck and car tires, the Environment Department was tasked to scan and clear each and every tire shop and go down in Punjab.
Special campaigns at Schools and higher education departments were run too aware students & youth not to let dengue Larva grow in their surrounding, Fisheries Department introduced special variety of fish in water bonds which eliminated dengue mosquito and larva and a special IT programmed and mobile app was designed to monitor work of sanitary inspectors and public health workers. These field workers would take photographs of dengue larva where ever spotted and would upload it on the computer.
At the same time the government worked on the Capacity building of private clinics to treat dengue patients through special trainings and special incentive in remote areas. Government through law fixed the price of dengue diagnostic test at Rs90 for private clinics/hospitals. Presently private laboratories are charging Rs900 for this test.
This multi-agency effort, it is said, contained the deadly disease and as a result the Sri Lankan experts commented that the provincial government’s efforts “saved more than 20,000 citizens”.
Blame game is also on peak as vocal person of PML-N Miss Uzma bukhari believes that present government is totally failed to control dengue. The sources said that the whole plan of action of the Shahbaz government was available in files and archives of Punjab. It was the same SOP which was put in action every year after 2011 till 2017. “The PTI government can just pick the thread from where Shahbaz Sharif left it,” but the credit must be missed from both sides.
Potohar Town, the worst dengue-hit area of Rawalpindi division, after the death of a dengue patients people were panic and aggressive too but in a move to hide their incompetence or prevent public panic, the provincial and district administration has barred hospital administrations from providing numbers of dengue patients to media.
According to sources “To select appropriate and most effective interventions for dengue prevention and control and develop plans that become part of regular health care delivery system, it was desired that Standard Operating Procedures (Sops) are developed in way that Health Department assumes maximum responsibilities and Allied departments are clear about their role to play according to their domains. The Health Department Punjab had published a book on SOPs for “Prevention & Control of Dengue” in 2014 with having the long-term planning for dengue and control by defining the role and responsibilities of health and other allied departments.”
Dengue is cyclic virus that revisits a region after specific interval. Hence it is a seasonal disease, the health Official said. He informed that the current government functionaries are working hard on eradication of dengue larva from the areas that are been being identified as the worse effected and no stoned is left unturned in this regard. He said that there are a number of people who have been affected by dengue fever but, due to government efforts this number is far less than was in 2011 to 2017.
