The latest Dengue epidemic has produced the usual spectacle of passing the buck- from the Delhi government to the multiple civic bodies, to the Indian Medical Council and the private hospitals. Surprisingly, the Union Health Ministry, I &B Ministry and the Union Home Ministry have been let off the hook. The media debates on the epidemic have failed to look at the long -term measures needed for prevention not only of dengue but also other preventable illnesses which affect the poor.
The recurring post monsoon outbreak of Dengue is preventable. And if preventive intervention is effective, then the actual outbreak lends itself to be managed. The following narration of what was done in 1996 illustrates the effectiveness anticipatory administrative action by the central government.The Delhi government was controlled by BJP and its bitter opponenet-Janata Dal- was in power at the centre.Yet no politics came in the way the noral administrative machinery doint its mandated job of Dengue prevention.
In 1996, I was instrumental in alerting the government sometime in July about a possible outbreak of Dengue. As a daily routine in my capacity as the government spokesman I used to scan dozens of newspapers-big,small and 'rags'- and also get feedback from field units. A few very small publications coming from NCT areas had reported suspected Dengue cases in several unauthorized colonies in the periphery of Delhi. Noticing such repeated reports, I sent a note to the Cabinet Secretary, T.S.R.Subramaniam, requesting him to consider convening a meeting of his Crisis Management Group for taking coordinated steps to contain the Dengue outbreak. The Cabinet Secretary held a meeting of this Group and set up a control room in the health ministry and set up a Coordination Committee under the Additional Secretary Shailaja Chandra (she later served as Delhi's chief Secretary) in the union health ministry.The Committee was asked to have a daily review meeting and send me reports for daily media briefings. The Delhi government was also asked to hold daily media briefings.
In the meanwhile, I had asked DAVP to initiate a public education campaign on Dengue prevention with the help of CHEB or central health education bureau (now it is defunct). The I&B media units including DAVP have standing instructions for carrying out public awareness campaigns on seasonal diseases prevention campaigns. For example, it was mandated that DAVP, DFP and PIB would launch media campaigns relating to water borne and water related diseases before the Monsoon. Similarly , they were required to undertake pre-winter campaigns on infections likely to be contracted during the cold season .
In this case a very strange thing happened. The WHO Delhi sent a Dengue Alert to the government a fortnight after the Cabinet Secretary had set up a Dengue monitoring body. Needless to say,the government was on top of the situation as it took coordinated advance action. One does not know why the Cabinet Secretary or the union health Secretary allowed things to get worse this time. Perhaps this time politics has been allowed to play with peoples health and lives.
The media has not so far grilled the union health minister and the home minister who have not shown the initiative to make the civic bodies under their charge to do their work.
The Delhi governor ,who is otherwise extra active in pulling up the Delhi government has not taken any steps to coordinate the Dengue control measures.
Diseases Breeding Grounds Everywhere
Another aspect not receiving media attention is the mushrooming of illegal colonies. These vote banks enjoy political patronage and tend to expand all the time. When they come up right under the nose of central and state administrations, no one takes interest in ensuring that yehyare equipped with proper drainage and sanitation. Such illegal habitations are regularly regularized as part of electoral politics. As such regularization takes place in a hurry before a poll schedule, once again civic amenities like drainage or sanitation take a back seat. The absence of such basic facilities in these (erstwhile) illegal habitations get media attention only when there is an outbreak of Malaria, Dengue or even Plague and the civic bodies get blamed .It is not just Delhi that is affected by Dengue. Bangalore is experiencing one of the worst Dengue outbreaks .In future every 'Smart City' will be ringed by illegal colonies which will be the breeding grounds of Malaria,Dengue,Cholera, and, god forbid, even Plague.One hopes that the much hyped Smart City programme planning is sensitive to this endemic threat.
(S Narendra is an Indian Information Service officer who retired as the Principal Information Officer and media advisor to prime minister Atal Behari Vajpayee. He also served under prime minister Narasimha Rao and held various positions at the I&B ministry.)