Franz Chávez
LA PAZ, Mar 24 2009 (IPS) – Dengue fever has claimed 24 lives so far this year in Bolivia, in what experts are calling the worst epidemic in the country s history. The mosquito-borne disease has spread fast due to high summer temperatures combined with rainfall, a weak public health system and poor collection of garbage.
The epidemic has hit the eastern city of Santa Cruz and other lowlands areas that have a hot humid climate. The national head of epidemiology, Eddy Martinez, said more than 45,000 cases have been reported since January, and added that the epidemic is expected to reach its peak in April, with as many as 60,000 cases.
Health Minister Ramiro Tapia said the government prevention campaign includes spraying against mosquitoes in towns and cities and the clean-up of garbage dumps, with aid from Cuba, Venezuela and Ecuador.
But despite efforts by local and central governments, people in at-risk areas are living in a climate of fear.
Dengue is considered endemic in tropical zones, but the current epidemic is unprecedented, public health expert Franklin Alcaraz, director of the Latin American Centre for Scientific Research (CELIN), told IPS.
Spring and summer temperatures have been unusually high, averaging 37 degrees Celsius, similar to the levels seen in 1950, the head of the National Meteorology Service forecasting unit, Félix Trujillo, told IPS.
Related IPS Articles
The rains of the warm season (November through April) and the resulting accumulation of water, along with the high temperatures, have provided prime breeding ground for the Aedes aegypti mosquito, which transmits the disease, said Alcaraz.
The hardest-hit section of the population are poor families who have no running water and are forced to collect and store water in containers.
The Aedes aegypti mosquito prefers to lay its eggs in clean water that has accumulated in artificial containers like discarded tires, flower pots or old oil drums in shady areas close to human dwellings.
The problems have been compounded by a primary health network that is poorly equipped to detect and address the first symptoms, and by a lack of public awareness on how to prevent the spread of the disease, former health minister Joaquín Monasterios told IPS from Santa Cruz.
The lack of health clinics in villages and towns forces patients to go to the city hospitals, which have neither the staff nor the beds nor the medicine to deal with the flood of patients, he explained.
Monasterios did not conceal his fears that the epidemic would continue to get worse, because the rainy season is not yet over, and the mosquitoes breeding grounds in garbage dumps have not been fully eradicated.
The health service has collapsed, overwhelmed by this enormous problem. If the number of cases does not go down, with the fumigation and an increase in public awareness, things are going to get extremely serious, he said.
Monasterios pointed out that this particular strain can lead to hemorrhagic dengue, which can be fatal.
Dengue fever is a viral disease transmitted by the Aedes aegypti mosquito, which picks up the virus when it feeds on the blood of an infected person, and then goes on to infect other people. The symptoms are fever, headache and muscle pain.
But hemorrhagic dengue causes intense abdominal pain, nausea and bleeding under the skin and into mucous linings, and can be fatal. There is no cure, only treatment of symptoms.
Monasterios also pointed to the heavy flux of people moving over the border between Bolivia and Brazil, which in his view has driven up the number of cases.
The department (province) of Santa Cruz accounts for 70 percent of the cases.
I feel like the epidemic is not being eradicated because the collection of household waste is deficient, as is the clean-up of the city s canals and drains, all of which are the municipal government s responsibility, Yenny Carnero, who lives in Santa Cruz, told IPS.
We are in a country that is so poor that people even keep useless things, she said, describing the containers and junk that people hang on to, which collect water, providing ideal conditions for the mosquitoes to breed.
President Evo Morales himself has been out operating spraying equipment in poor neighbourhoods around the cities of Santa Cruz and Trinidad, the capital of the department of Beni, as part of mass clean-up and prevention campaigns.
This is the worst epidemic in this country s history, said Alcaraz.
World Health Organisation (WHO) representative Christian Darras told the press in Santa Cruz that I believe mosquito control efforts have been flagging, and they must be kept up continuously. The guard must never be let down.
Alcaraz regretted that the country s public health institutions have shown a lack of preparedness against situations like the rise in dengue cases.
In the overrun public hospitals, many patients have spent days in the hallways or have even been left outside, said Alcaraz.
