State of malaise

Although debilitating, fatality from dengue is rare. But the epidemic raging across Nepal’s cities has killed at least 12 people. The latest is a 29-year-old Nepali PhD student.

The current outbreak comes on top of the Covid pandemic, and is a reflection of everything that is wrong with Nepal: political negligence, governance failure, misplaced priorities, lack of accountability, state apathy. Dengue is the symptom, the disease is political.

A wetter than usual monsoon and climate change mean that dengue mosquitos have found ideal breeding grounds even in roadside pools outside the Sukraraj Tropical & Infectious Diseases Hospital at Teku (above) which is seeing 250 new dengue patients every day.

The virus-carrying female Aedes aegypti mosquito has a wide choice of places to lay her eggs: on water-filled bottle caps in garbage piles, inside discarded tyres, stagnant pools in open drains, and even balcony flowerpots. Kathmandu Valley is now a magnet for mosquitos.

We could have learnt from the 2019 dengue outbreak when there were 17,000 hospital cases, and at least 6 fatalities. The monsoon is not over, and this year we have already  surpassed those numbers.

Read also: Dengue days are here to stay, Sonia Awale

“Unfortunately we learned nothing from the 2019 outbreak, we allowed infected mosquitos to breed everywhere,” says Sher Bahadur Pun, a virologist at the Clinical Research Unit at Teku. “The problem has magnified this year. The mosquitoes are now inside our homes, offices, and schools making it difficult to avoid infection.”

The fact that local and central governments are gearing up to deploy a ‘search and destroy larvae’ two months into this large-scale outbreak is proof of slow-motion response. Fumigation is ineffective, and it is too late to drain breeding pools.

The dengue virus can remain in the larvae of infected mosquitos for several years. So, the only way to prevent next year’s outbreak is to search and destroy breeding grounds now. Next monsoon will be too late. As with the garbage crisis and the air pollution emergency, dengue is problem for which the only solution is political will.

Removing local breeding ground for the mosquito vector and spreading mass awareness about prevention is the responsibility of local governments. Federalism is supposed to make elected mayors accountable. They can start draining the swamps.

For now, physician Buddha Basnyat’s advice is: “Avoid mosquitos, particularly at dusk and dawn, use the most effective repellent and don’t take antibiotics.”

Read also: As Covid abates, Nepal sees dengue outbreak, Anita Shrestha