Dengue prevention: How to obtain human

resources for a massive campaign

June 12, 2014, 7:54 pm
By Dr. Pradeep Kariyawasam,
Deputy Municipal Commissioner (Health), Colombo Municipal Council
A o!!in! pro!ramme in pro!ress (ile photo)
"he City o Colombo, li#e many other cities in the de$elopin! world was !rowin! rapidly
posin! many comple% problems to its city Council. &apid de$elopment wor# is !oin! on these
days mainly to up!rade the housin! stoc#, impro$e inrastructure in the city with re!ard to
drains, roads sewera!e etc. "hereore, the Municipal Council to!ether with 'rban De$elopment
Authority ha$e ta#en up the challen!e to impro$e li$in! standards to ensure ade(uate health in
all dimensions to the citi)ens in !eneral and to the urban poor in particular throu!h impro$ed
mana!ement eiciency. "he $ision o all should be to create an *co+riendly en$ironment in
the city by reducin! the unhealthy en$ironment+borne diseases.
Den!ue and other mos(uito+borne diseases ha$e become a ma,or urban health problem in the
city mainly due to lac# o appropriate mana!ement o solid waste by all concerned. "he bi+
annual monsoon periods in May+-uly and .o$ember+-anuary create hea$y rains and result in
loods and spread o diseases. "he rain pattern has chan!ed nowadays and as a result den!ue
e$er outbrea#s are e$ident e$en durin! inter+monsoonal periods. /t causes the !o$ernment and
the municipality to spend a lar!e amount o resources on medication and correcti$e actions. /n
addition, it causes loss o producti$ity amon! city dwellers particularly amon! the urban poor,
ma,ority o whom are daily+wa!e earners, orcin! them !et in to the $icious cycle o po$erty,
which e$entually destroys the poor en$ironment urther causin! more problems.
*$en thou!h Den!ue e$er has e%isted in the city or o$er 01 years with ma,or out brea#s
occurrin! periodically e$ery 2 to 0 years in the be!innin!, o$er the recent past the numbers o
patients !ettin! den!ue e$er has increased and in 3143 the worst epidemic occurred. "he
numbers ha$e !one up steadily in 5ri 6an#a and !lobally. All eorts to control it ha$e not
wor#ed out and the main problem has been sustainability o the pro!ramme and the capacity to
carry out such pro!rammes.
"he Public Health Department, Colombo Municipal Council was controllin! the outbrea#s o
mos(uito+borne diseases throu!h these routine operations by payin! attention to inspection o
land parcels and clearin! the 7containers8 in which mos(uitoes breed and sprayin! roadside
drains, ultra+low $olume sprayin! o residences and institutions with B"i in den!ue hi!h+ris#
areas, o!!in! o under!round drains and open thic# spaces where ran# $e!etation was
obser$ed. "hereore, any attempt to reduce and inally eradicate the incidence o Den!ue and
other $ector controlled diseases in the city will not be comprehensi$e unless concurrent action
or solid waste and storm water draina!e mana!ement in lar!e drains and canals !o hand in
hand with this social mobili)ation and education initiati$e. "he CMC mobili)ed this concurrent
action assisted by le!al threats as the municipalities are usually blamed and not the indi$idual
homeowners, !o$ernment and pri$ate or!ani)ations. "hereore, o$er the years the Municipal
9icials too# a decision that homeowners rom hi!h, middle and lower income !roups should
,oin hands with the municipality to eradicate this menace rom society. "he only way to curb
the epidemic is to clear den!ue mos(uito breedin! sites in these homes and pri$ate lands.
Hence, the Public Health Department o the Colombo Municipal Council came up with an
inno$ati$e idea ourteen years a!o on my directi$e, o house+to+house inspection and issuin! o
a 7:reen 5tar Home8 stic#er to homes compliant with the si% criteria, which are necessary to
eradicate mos(uito+breedin! sites inside homes and, in !ardens.
'nder this pro,ect, the Colombo Municipal Council (CMC) aimed at !ettin! health related
Departments o the Council, other state related or!ani)ations, the pri$ate sector and the
community in$ol$ed throu!h a participatory process whereby homeowners and the authorities
to!ether i!ht the den!ue and other mos(uito+borne diseases epidemic beore it aects the city.
Public, Pri$ate and .:9 sector partnerships
/t was our belie which is pro$en time and a!ain that the health sector alone cannot win the war
a!ainst den!ue epidemics. Durin! the pro!ramme sta o se$eral health related departments
wor#ed as $olunteers to carry out the pro,ect. "he pro!ramme also had the ser$ices o the youth
rom the .:9 sector, the &otarians, and $olunteers rom uni$ersities and schools. "he oicers
o the our di$isions o the Public health Department and sta o other departments !ot an
insi!ht into aspects o *n$ironmental Health and 5anitation. "his same orce can be en!a!ed in
similar health or en$ironment impro$ement campai!ns in the uture. "he enthusiasm shown by
the public was o$erwhelmin! in the be!innin! and there was competiti$eness amon! the
nei!hbours to win the :reen 5tar stic#er, which they proudly displayed on their walls or !ates.
"he Mayors o Colombo participated in the launchin!s o pro!rammes and this helped buildin!
o public relations between the Council and the ratepayers.
/mpro$ed inormation collection to increase awareness.
5ta members were mobili)ed to $isit households with $olunteers and student and ad$ise
citi)ens on pre$entati$e action and ma#in! their homes mos(uito+ree. /t is essential that ield
resource personnel pro$ide more inormation re!ardin! the epidemic itsel and collect
inormation about the situation in each land plot and chec# on the home en$ironment. "oday
most o the Medical 9icers o Health o the Ministry o Health in other towns use this
concept o House to House inspections initiated by us in their wor#. 5ocial mobili)ation and
mass+education eorts o these pro!rammes !enerated supporti$e actions at the community
le$el.
"o be continued tomorrow