Same old sad song
In the midst of raging dengue epidemics, the cry goes out throughout the lands of the Caribbean, "Let us spray!" And there goes forth the word from ministries of health that the whole world should be sprayed and their sprayers wend their way through the lands of Barbados, Jamaica, Trinidad, and elsewhere.
And they drag forth vehicles that make noises and send out fumes and vapours so that the faithful would know that the ministries of health are interested in their health and are saving their lives. And the birds of the air and the fishes of the lake are set upon and they fall by the wayside, whereas the mosquitoes continue to thrive.
The faithful, their windows closed against the toxic substances, praise those on high for heeding their pleas for help. The Aedes aegypti mosquitoes, safe inside the houses, especially the larvae and little ones in vases and flower pots, with no Herods in sight, live happily ever after. And the faithful continue to indulge in their sprayers until the wet season ends, and they, too, live happily until the next rains cometh. For such is life. And such is death. Especially the death of children from dengue haemorrhagic fever.
This was then. This is now, before Zika and before climate change modified our weather patterns, so instead of one dry season and one wet season - which we knew as cricket and football season - there are several periods per year of heavy rainfall followed by drought. This means there are many mosquito-breeding periods instead of just one extended wet season per year.
Every year, we go through the same cycle of bored indifference by the health sector and householders during the dry season, sudden interest on the part of householders when there is a fresh epidemic, pressure on the ministers of health after the mosquitoes start biting, frantic resort to spraying and assurances all round.
In the old days, the wet season ended with only a few dengue and related deaths, but now the situation is different. Zika is the game-changer. All ministries of health, and all medical officers of health, know that the best means of dealing with Aedes is source reduction of mosquitoes. This means not providing them with breeding places and ensuring that you keep the larvae from hatching.
The health-sector officials know that the sprays are ineffective. However, they resort to the same fallback hope that when the rainy season ends and the dry season starts, deaths would be minimal. But we now have sporadic heavy showers, and every time there is a big one, the mosquitoes outside breed again and again. Those inside your house, Aedes and its family, live with and dine off you. They lived happily before and continue ever after.
I thought of all this as I lay shivering, my skin burning up with dengue fever. Dengue makes it very difficult to eat anything. Dengue does not seem to like you to eat, attacking your salivary glands and taste buds, mugging them into submission. This was many years ago when, after four nights with dengue, my condition necessitated more professional assistance.
I told my wife it was like the story of the butler of the rural English Lord who, on awakening his master one morning, discovered much cause for celebration. "Shall I summon Madam for you, your Lordship?" he asked smoothly.
"No, dammit James, this one is too good for Madam," His Lordship replied. "Pack my bags, I'm taking it up to London."
I checked myself into the hospital and, after waiting vainly for assistance, was about ready to check myself out. Dengue and patience do not go together. It is a virus that wages a relentless attack on your system. It feels like a gang of juvenile delinquents armed with chainsaws and blow torches prowling your estate for anything that could be chopped down, slaughtered and destroyed.
There is constant pain behind the eyes and in the joints. Some muscles, even the large frontal thigh muscles, become cramped and virtually useless. The tablets buy a little time and space in the ongoing drama of pain, but as the hours pass, the pain returns in waves and the fever once more tops the hit parade.
Dengue is appropriately called 'break-bone' fever by my Jamaican friends. It leaves you 'mash-up' for periods up to three weeks. In fact, some people take much longer to recover from its effects. Aedes albopictus, which, among its many accomplishments spreads DIKA, is a scary bastard. When I was at PAHO and involved in a 16-country 'source reduction' project, we had been warned about it and passed on our fears to the region. Unfortunately, the people paid for vector control never did anything.
One way to beat dengue and other mosquito-borne diseases is by not succumbing to depression induced by the combination of the disease and the medication. It can get you down after a while. The other is not bothering with the health ministers and dealing with your own source reduction knowing that family health is everybody's business. In my case, I appreciated the irony.
Having spent seven years throughout the Caribbean teaching people how to prevent dengue, I found it an interesting experience to change roles from hunter to hunted. It is like the story of the Englishman, clad in full hunting outfit and armed with a rifle who stumbled on to a totally naked lady in the forest. "What are you doing?" she asked. "I'm looking for game," he replied. "Well, I'm game," she admitted. So he shot her.
n Tony Deyal was last seen saying that with all the games the health officials are playing with people's lives, what we need in the Caribbean is not more spray but more big game hunters.