Friday, January 01, 2010


It has always amaze me, since the start of the so called A H1N1 pandemic, how the MOH could spend so much money, time and effort on A H1N1 and yet ignore the deadly Dengue Fever. Why? The DG of Health reported yesterday that in the month of December 2009, there were 84 deaths in Malaysia, the last victim was a lady in Sarawak.
I remember clearly, when I was in medical school, and when the present DG of Health was in medical school ( we are classmates ), the University of Malaysia medical school, brought an expert from Thailand to lecture us about dengue fever. This was in 1971 ( 38 years ago ). He taught us about the dengue virus ( virus 1,2,3,4 ), the mosquito vector ( aedes eguipti ), the disease presentation and the therapy. At that time, we already understood a fair amount. Yet 30 years later, it is still killing 84 people a month ( about 1,000 a year ). We rush to do all kinds of publicity and panic with A H1N1 which killed 70 odd people in 6 months or 140 people per year. Of course there was great financial gain for some parties from pharmas, and detergents makers and masks maker and the like.
But if you think of it, dengue can also make money for the decision makers. I have reasoned and concluded that dengue is still deadly in Malaysia, because there is no one taking charge of this problem. The deaths are quietly disposed off and no one make a fuss. Our own research institute ( the old IMR used to be instrumental in helping eradicate malaria ) use to be very good, until the Mahathir years came, and priorities change. You see, since dengue is a developing country problem, the USA CDC has no priority program to research dengue. We are not Africa, which has attracted alot of US dollars to do research in malaria and HIV. So we have to research for our selves. So far, our great local innovators have not risen to the challenge. Many have been sent overseas to study the issues, but all have come to not. Mosquito ( the aedes mosquito ) larvae thrives in pools of water, which are abundant all over Malaysia, varying from housing estates, developed and being developed, government department compounds, including drains in Putrajaya, private compounds, etc. Every now and then, there is a campaign ( usually so that "orang besar" can have some publicity ), and then all is forgotten. Sporadically spray here and there and then when the show is over, life goes back to normal. With the raining weather, puddles of water form, virtually overnight.
When I was in medical school, we were taught that Malaysia had a very good strategy to eradicate Malaria, another mosquito borne disease. I remember that we had very distinguished physicians, like Dr Sandosham, who with the help of the British administration ( those were the days before and just after independence, was able to eradicate malaria and also tuberculosis. They set targets and met the targets. We had a strong social and preventive medicine department, to study the issues of eradication of the mosquitoes. I am convinced that to eradicate dengue, we must attack the mosquito larva. I am sure that MOH agrees, but I cannot understand why they still have not done it? 1,000 deaths a year do not seem important enough? Why?
I can only conclude after 30 years, that there is no political will. When a death occurs, we feel bad for awhile, then we forget. Why? Maybe I should think of how money can be made. Perhaps then some ears will perk up and some will take on the deadly killer.


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