Shafaqna Pakistan:Dengue had hit Lahore in 2011 followed by such an unprecedented war like combat operation to defeat the epidemic by Shahbaz Sharif government that Pakistan set a benchmark for the world to overcome and control the disease.
A set of detailed SOPs were published in the form of a book to avert the epidemic in future. But theSOPs book had a problem…. It had Shahbaz Sharif’s picture and a message. This year the dengue epidemic has hit different parts of the country including Islamabad and Rawalpindi as the SOPs were not shared and followed thus leaving the present anti-dengue efforts rudderless.
Dozens of lives have already been lost and there are thousands of dengue patients, whose number is on the rise, but still there is no activity seen as per the SOPs to prevent more deaths by controlling the epidemic.
A review of the publication — Control and Surveillance of Dengue – A Case Study of Lahore — published by Punjab Disaster Management Authority gave extraordinary insights into coordinated and unique response that the government of Punjab had galvanised under the leadership of Shahbaz Sharif.
Those who have been involved in this fight against dengue told The News that the former chief minister had set up a crisis management centre at chief minister’s office- modelled like “a war room” where his staff would monitor and ensure real time implementation of his directives, provide guidance to different departments and facilitated multi-agency coordination and where needed spur up laggards and lethargic functionaries.
According to a source, for 94 days at a stretch, the former chief minister presided over 6:00am meeting wherein all 40-plus administrative secretaries were present along with almost all the 13 MNAS and 26 MPAs from Lahore.
Chief secretary, heads of Special Branch and IB used to be also present to give independent assessment of work being done in the field. A team of senior professors led by late Prof Faisal Masood was also present — which provided clinical guidance to doctors throughout Punjab.
These 6 o’clock meetings would continue till 8:00am — wherein directives given in last meeting were reviewed and modalities about future work were fine-tuned and decided. All departments were kept on their toes since special branch and IB provided independent verification of activities being reported to the CM.
Shahbaz Sharif was particular about punctuality and wholehearted effort that he would harshly reprimand even if a senior political colleague was found lacking in his efforts.
Other than health department and district administration each and every department was galvanized into action. Agriculture Department field staff and entomologists were tasked with preventive spray all over Punjab. Cooperative Department was responsible for preventive measures in all the housing societies of big cities. Since the dengue victor as per public health experts was spreading through water accumulating in old truck and car tires, the Environment Department was tasked to scan and clear each and every tire shop and godown in Punjab.
Schools and higher education departments were made to run mosquito free campaigns, Fisheries Department introduced special variety of fish in water bonds which eliminated dengue mosquito and larva and a special IT programme and mobile app was designed to monitor work of sanitary inspectors and public health workers. These field workers would take photographs of dengue larva where ever spotted and would upload it on the computer.
Capacity of private clinics to treat dengue patients was built through special trainings. Government through law fixed the price of dengue diagnostic test at Rs90 for private clinics/hospitals. Presently private laboratories are charging Rs900 for this test.
Apart from the 6:00am meetings, Shahbaz Sharif used to hovering around the city making spike inspections. He visited each and every hospital and ward in the city. Normally his last field inspection would be around midnight but next day early morning meeting was always on time.
It is said that the civil administration led and guided by the then chief secretary Nasir Khosa delivered like never before. So much so that couple of civil servants themselves fall victim to dengue — one young officer developed renal failure (a major complication of dengue) and lost his kidneys. All task teams had government officials and elected representative and civil society activists.
This multi-agency effort, it is said, contained the deadly disease and as a result the Sri Lankan experts commented that the provincial government’s efforts “saved more than 20,000 citizens”.
These sources said that the whole plan of action is available in files and archives of Punjab. It was the same SOP which was put in action every year after 2011 till 2017. “Can the PTI government just pick the thread from where Shahbaz Sharif left it,” a source said.
The sources said that the publication titled “Dengue Prevention and Control – Lahore a Model of Success” is waiting for the federal and provincial governments to look at it. The sources said that the officers doctors, nurses, politicians, municipal staff, field workers went beyond the call of duty as they relentlessly served others while engendering their own lives by exposing themselves to the deadly vector. All these officials are there only thing missing is the political leadership, a source said, lamenting it pains to see in hospitals of Rawalpindi and Islamabad where public is left helpless and poor citizens are dying by dozens. Hardly any preventive measures are taken in Islamabad.
“You cannot tweet away dengue, it calls for sweat, toil and blood,” an official, who was deeply involved in the fight against dengue during Shahbaz Sharif’s rule, commented.
According to sources, the Health Department Punjab also published a book on SOPs for “Prevention & Control of Dengue” in 2014. Its executive summary says that since the country has entered in the state of endemicity, hence requires long-term planning for dengue prevention and control by redefining the role and responsibilities of health and other allied departments.
It added, “To select appropriate and most effective interventions for dengue prevention and control and develop plans that become part of regular health care delivery system, it was desired that Standard Operating Procedures (SoPs) are developed in way that Health Department assumes maximum responsibilities and Allied departments are clear about their role to play according to their domains.”
“These SoPs have been developed to set a comprehensive system for dengue prevention and control right from policy and decision making bodies to implementation of activities at grass roots levels. Interventions, specific roles and responsibilities of individuals, institutions, departments, have been clearly defined with timelines. It is expected that with the implementation of action plans based on these SOPs, the province would start its journey towards gradual elimination of dengue menace,” the document reads, but remains ignored in the present situation.
A government official, however, said that dengue is cyclic virus that revisits a region after some specific period, so it is a seasonal disease. He said that the government functionaries were working hard on eradication of dengue larva from the areas and have left no stone unturned. He said that there are a number of people who have been affected by dengue fever but, due to government efforts this number is far less that that was in 2011.