Dengue fight faltering

Eleven of the 12 city corporations across the country don't have any entomologists to help the authorities check mosquito-borne diseases, exposing their weakness in combatting dengue that has now become a year-round concern.

Moreover, civil surgeon offices in only 26 districts have approved posts of entomologist, with at least 12 of those remaining vacant as of September 27 this year.

The systemic flaws are further exposed by delays in conducting three periodic surveys -- pre-monsoon, monsoon, and post-monsoon -- which are essential to determine mosquito density and guide control measures.

The findings of this year's pre-monsoon survey were published in mid-June after the monsoon had already begun, leaving little time for the authorities concerned to take action. Last year, the health authorities could not conduct the monsoon survey due to a fund crunch and a shortage of manpower.

Experts said that even if the authorities manage to complete surveys, most of the recommendations remain unimplemented because of mismanagement, corruption, or a lack of manpower.

All these shortcomings highlight gaps in the authorities' preparation to control dengue that has claimed around 200 lives so far this year with more than 40,000 people hospitalised.

"Weaknesses and mismanagement in mosquito control come to the fore only when outbreaks turn severe and claim dozens of lives. But once the crisis eases, everything returns to its previous state -- until the next crisis emerges," said entomologist Prof GM Saifur Rahman.

"If the authorities truly want to save lives, they must take steps to control mosquitoes systematically, and address the existing shortcomings," he told The Daily Star.

FEW ENTOMOLOGISTS

Entomologists, who study the characteristics of insects and the diseases they transmit, can track when mosquito populations rise, how far they have spread, and by what means. They also apply specialised survey methods to identify hotspots.

"An entomologist knows how to devise plans to control mosquitoes, just like a doctor knows which tests are required for a patient," Rahman said.

Entomologists play a vital role in guiding insecticide use -- determining which insects are present, where they are breeding, which chemicals to apply and at what quantities, and by which methods, he said.

Out of the 12 city corporations in the country, only Dhaka North City Corporation has an entomologist, said officials, adding that the corporations sometimes bring in entomologists on deputation from other government departments or district administrations.

Mofizul Hoque Shah, divisional entomologist at the DGHS, said that only 26 civil surgeon offices across the country have approved posts of entomologist. Apart from that, there are four posts at divisional directors' offices of DGHS and three at its headquarters.

But at least 18 of the 33 posts remained vacant, he told The Daily Star on September 25.

WEAKNESSES

Three periodic surveys are required every year to identify mosquito hotspots and assess their density, guiding the authorities to take measures to destroy larvae.

The DGHS usually conducts the surveys in the two Dhaka city corporations and several districts, leaving most of the country out of surveillance.

The agency, however, was unable to carry out the three surveys last year as the programme that funded the surveys ended in June last year, a DGHS official said, seeking anonymity.

The Institute of Epidemiology, Disease Control and Research (IEDCR) stepped in and conducted last year's pre-monsoon and post-monsoon surveys in association with DGHS.

This year, there was a delay in conducting the pre-monsoon survey. As the findings of the survey were published in mid-June, just a few days after the start of monsoon, the authorities didn't get enough time to take necessary measures, said the official.

Many of the recommendations made in the survey remain unimplemented due to poor management and a lack of manpower.

According to officials at two Dhaka city corporations, a significant number of field workers involved in mosquito control drives do not perform their duties properly, leaving many hotspots active.

Moreover, most other city corporations as well as municipalities lack dedicated personnel to carry out such drives.

Mohammad Rahmant Ullah, health officer at Gazipur City Corporation, said that the corporation's proposed organogram, which includes posts of entomologist and technicians for mosquito control, remains pending with the LGRD ministry.

In the absence of dedicated manpower, the corporation has deployed staffers from waste management, engineering, and other departments to do the job.

Prof Mohammad Mushtuq Husain, a public health expert, said policymakers must recognise the importance of entomologists and other scientific experts and act accordingly if they want to build a healthcare system capable of responding to emergencies.

If it's not possible to create permanent posts and career structures immediately, entomologists should at least be engaged as consultants, he said.

When contacted on September 25, Abul Khair Mohammad Hafizullah Khan, joint secretary (Urban Development) of the Local Government Division, said the government has already taken up a World Bank-funded public health project, and one of its main components is vector management.

"In order to curb the spread of dengue, posts of specialists, including entomologists, have been created under the Improvement of Urban Public Health Preventive Services Project."

However, the recruitment of manpower under the project will take a considerable amount of time, he added.