I have tried to make my own little mark in this world. My career as a Medical Educator and Clinician in Gastroenterology (see www.gastroindia.net) and my flirtations with Health Promotion, especially amongst school children (see www.hope.org.in) are shown elsewhere.This blog contains my attempts at creative writing, most being write-ups for Health Adda column of HT City of Hindustan Times (also see www.healthaddaindia.blogspot.com) as well as a few others, and some reflections and thoughts that have struck me from time to time on my life journey.Please leave your footprint on this blog with your comment.


Wednesday, July 22, 2009

Mosquitoes are Back!

The only silver lining I could see to the recent dry hot spell was respite from the droning and stings of blood sucking mosquitoes. Now that the monsoons have finally arrived, mosquitoes and malaria cannot be far behind.
                These little “animals” can be deadly; 40 million people suffered from mosquito diseases last year in India of whom malaria comprised 2 million. Of 247 million people who suffered from this disease globally (2006 data), 8 lac died, 85% being children, amounting to 2000 children dying each day. The other diseases spread by mosquitoes include Dengue fever, encephalitis, Chickungunya, filariasis and yellow fever.The number is increasing due to deteriorating health systems, growing resistance to drugs and pesticides, and climate change.
                There are 2 tragic aspects to the story of malaria: first, most who succumb to the illness do so because of delay in treatment, and second, malaria is not difficult to prevent as most developed countries have shown.
                Research in Africa revealed that during outbreaks of malaria, lives were lost largely due to delay. It took few days for a febrile person to consult a doctor, go through blood tests for malaria, and then receive medications for the infection.By providing anti-malarials emperically through a network of paramedics, to anyone having fever, many lives could be saved. Our experience in India is similar: many who reach us in their terminal stages have often been febrile for several days, seeing several doctors, travelling many miles, but not getting a dose of anti-malarials. The test results often come in a few hours too late.Treatment delayed is treatment denied!!
                How can we prevent malaria?  The female Anophelese mosquito can fly only a few hundred meters, needs a drink of human blood ( during which it transmits the malaria germs) and lays its eggs in water. If stagnant water from flower pots, coolers, buckets etc are drained and kept clean in the house and vicinity, mosquitoes can’t breed. A major problem today is water collecting in polythene bags thrown on the roadside or stagnant drains choked with them. Local community groups can help clean these up. Periodic fogging with Malathion and pouring kerosene in stagnant ditches usually require some help from the government. Mosquito nets and repellents (coils, mats or creams) form our last but least effective defence. Concerted action aimed at keeping the locality clean is far more beneficial than individual protection.
                Mosquitoes have played their role in history.  They delayed the construction of the Suez and Panama canals by striking many workers with malaria and yellow fever, and brought many mighty people to their knees (Alexander the great, and recently the thespian Dilip Kumar). Wise rulers of the Mohenjodaro days ensured that water in the canals they built kept flowing, preventing mosquitoes from breeding, and the Gates Foundation has identified malaria as one of its 4 thrust areas for support.
                The rains have come. Can we prepare ourselves better than the mosquitoes this year?
     As published in HT City ( Hindustan Times) dated 19 july, 2009.           

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