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The Man In The Mirror

November 23
14:30 2019

The Man In The Mirror

By: Dr. Abigail Joseph

It’s nothing new to hear a disgruntled society use the blame game. We throw blame on everything and anything we can, rarely ever ourselves. It is so unfortunate that in my line of work we are blamed for A LOT of things, including many things that are not in our control – expired medication, shortage of medication, lack of resources, short staff, death of a patient….and the list of things go on and on. Most of the time these things go unrebutted due to a sworn oath, due to fear of the repercussions from the “higher ups” and also due to smearing a personal image (it doesn’t affect me so why bother defending him/her).

I’ve been following the news for some time now and we have seen quite a number of unfortunate deaths that are supposedly due to this Dengue “situation” we have on our hands. Like most of you, scrolling on Facebook is an essential part of my day, and reading comments from disgruntled people on BBR (Belize Business Review) is quite the norm for most. One of the things that has caught my attention over the days is how people seem to be blaming the Ministry of Health and the “hospitals” for the death of persons with dengue and blaming them for the reason dengue has been difficult to control. A repetitive quote: “The Ministry doesn’t seem to care!” is one that I have found beneath news feeds and complaints on this ailment.

Unfortunately Dengue is not one of those diseases for which we can solely blame the government. In order to completely irradiate Dengue or at least get the numbers under control, it will take the entire country. Sadly, there is not enough societal effort being made to completely reduce the spread of this infection. The announcements are on the radio, the advertisements are on the TV, the products we need to assist ourselves are readily available for purchase at the stores – yet, what do we do? We flip the channel when health advertisements are showing between news, we close our doors and windows when the vector control truck passes at night, we choose to not use repellent when we go out – thinking that it’s a quick trip and it won’t be necessary to apply repellent. After we are diagnosed with dengue, we still travel or we choose to not sleep under a net, and the list of delinquencies continues.

If there was a scale to weigh the efforts of the Ministry of Health versus what we are doing collectively, we would be found lacking as a society. Dengue is not a disease like the flu that we breathe in the air or catch by touching infected surfaces. It is a mosquito-borne virus, meaning we get it from the bite of an infected mosquito. If we genuinely want to irradiate Dengue then we start with the vector. The key is understanding.

Understand that there are 4 strains of Dengue: DEN-1, DEN-2, DEN-3 and DEN-4. There has been debate about a discovery made in 2013 where it is implied that there may be a DEN -5 strain. However, here in Belize we still educate 4 strains. What does this mean? It means that you can catch dengue four times given that all strains exist in your region. What happens is that once you get one strain of the virus you develop immunity to that strain for life, and a temporary immunity to the others. Each time you catch the virus the complications and risk increase, making the symptoms a lot worse than the first time.

THIS concept is one that is misunderstood and not enough efforts are made for patients to understand. People are walking around with total disregard for the virus after having contracted it once, (saying, “oh dengue, me dun ketch dat!”) oblivious to the fact that they can get it again if bitten by the right mosquito. It is important for persons to know that mosquitos do not fly long distances and generally stay within a particular radius. Migration of persons makes it particularly hard to confine and isolate the disease. Sometimes persons have mild symptoms and do not know they are infected and travel. Others are aware that they are sick and still travel. What happens is that a healthy mosquito (one that does not have the virus) bites an infected person and becomes part of the infectious cycle even after the person leaves. A female aedes aegypti mosquito has a lifespan of 2 weeks to a month depending on the environment. Within that lifetime she can lay up to 5 batches of eggs – each batch contains 1-200 eggs. So the life is short but imagine that from one mosquito you can have over 500 eggs! IF the conditions of our environment are not conducive for growth, the cycle would end there. What does this mean? It means that if we don’t have anywhere for the mosquito to lay her eggs or if we get rid of the fresh water around our yard we wouldn’t have more mosquitos and when her time comes to die the cycle ends.

Take time out, walk around your yard, and clean up or overturn containers that hold water. Replace animal reservoirs regularly. Use fish coil in the house to ward off mosquitos and be sure to re-apply repellent every 4 hours. Close windows and doors early and be sure to use or carry repellent with you even if you are only going out for a little bit. All it takes is one bite from an infected mosquito to make you sick. IF you are infected, please make the effort to sleep under a net, still use repellent and take precautionary measures. The purpose of this is so that you do not infect more mosquitos and place others at risk. Understand that dengue is a disease that lowers your platelets. Platelets are important for the formation of scabs and stopping bleeding. Having a low level of platelets can make it easier to bleed. If you find that you are febrile, it is imperative that you avoid your usual ibuprofen and aspirin as these may cause the blood to thin more and increase your risk of bleeding. Several people are recommending Papaya leaf as treatment for Dengue. The entire fruit is useful, as it has antioxidants and improves the body’s immunity. Papaya also naturally increases blood platelets and as such makes the symptoms of dengue less and more tolerant for the patient.

Do your part in delivering Belize from DENGUE. Stay hydrated, stay protected and keep your yards clean! More importantly, if you or someone you know suspect dengue, go to your nearest health center and get tested. Do not wait until it is too late to be saved. Fight the bite!

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