Dengue deaths, patients on the rise as local govt can’t control

A boy sits on the hospital bed as he has been hospitalised with dengue in the capital’s Mugda Medical College and Hospital on 11 July 2023.
Tanvir Ahammed

If Aedes mosquito larva is found in any building under construction anywhere in the country, at first the building owners will first be warned. They will face a fine the second time and, if needs be, construction of the building will be shut down.

This was the decision taken at an inter-ministerial meeting on the prevention of mosquito-borne disease across the country at the secretariat in Dhaka on 19 July with local government minister Tajul Islam in the chair. Since then, there has been no report on the implementation of the decision at any district or municipality in the country, nor has the ministry monitored the matter. No stern action on closing down any construction was seen either.

Funds are not being allocated either. The Local Government Division (LGD) allocated Tk 400 million for dengue prevention, as well as cleaning and campaigning in the 2023-24 fiscal, excluding the expenditure of the local government institutions. Altogether city corporations received Tk 100 million while municipalities received Tk 126,000 to Tk 180,000 based on their category on 16 August. However, experts and local representatives said the allocation is too little.

It is the responsibility of city corporations, district administrations, municipalities and union parishads under the Ministry of Local Government, Rural Development and Co-operatives to prevent dengue that broke out across the country. The LGD is tasked with monitoring the mosquito-killing operation, but it has been learned the activities of the LGD is limited to holding meetings and giving instructions, and whether the decisions taken at the meeting have been implemented are not being monitored.

It has also been learned that decisions are not being implemented at the grassroots, and as mosquitoes are not being controlled, dengue has spread and claimed people’s lives. As of 15 September, 790 people died of dengue this year and September alone saw an average death of over 13 people in the first 15 days of the month.

The additional secretary of the Local Government Division, Malay Chowdhury, told Prothom Alo, “City corporations report to the ministry daily on dengue prevention activities, and we depend on this data. Summations, our officials go to the city corporation on inspection, but it has not been possible to visit everywhere due to the shortage of human resources.”

There were more dengue cases in Dhaka at the beginning of the monsoon. Since more dengue cases are being reported outside Dhaka, it has become urgent to control the mosquito population outside the capital where activities are very low. Experts said it is not possible for the Local Government Division to control dengue because their main duty is to build roads and bridges.

16 points to control dengue

The LGD prepared national guidelines in 2021 to control mosquote-borne diseases. It states prevalence of dengue usually rises during the rainy season, but dengue may occur anytime throughout the year in a favourable environment, which is why the theme of the national guidelines is “from January to December, mosquito eradication throughout the year.”

The national guidelines set 16 activities for the LGD. This includes coordination between government and private stakeholders, instructing and observing local government institutions, procuring pesticides and monitoring training for its use and awarding the local government institutions that become successful in controlling mosquitoes.

This correspondent visited the LGD office in Dhaka six times from 10 September to 12 September to observe how far the LDG does its duty. Each time, this correspondent talked to several officials of the LGD, but most of the officials were busy with regular duties and the celebration of the Local Government Day, which was celebrated in Dhaka on 14 September with the participation of 8,000 local representatives.

As part of its dengue prevention operation, the LGD opened a control room in August to monitor the activities of the city corporations and LGD senior assistant secretary Md. Shameem Bepari is in charge of it.

Prothom Alo could not reach Shameem Bepari after visiting his office several times. When he was reached over the mobile phone, he replied he was busy and hung up the phone. Later it was learned that Shameem Bepari was mainly busy with the viva voce of recruitment test at the Local Government Engineering Department, as well as the celebration of the Local Government Day.

City corporations report to the LGD on their daily operation on dengue prevention. Records of a city corporation show a list of areas where pesticide was sprayed. However, an LGD official told Prothom Alo on condition of anonymity that city corporations report to the LGD on their daily operation just to maintain formalities and there is enough doubt over whether city corporations do this work. The minister does not have the capacity to monitor the city corporations’ daily operations.

Visiting several areas, Prothom Alo found workers of the city corporations neglecting their duties. Workers of Dhaka South City Corporation were supposed to spray mosquito repellents for two hours to kill flying mosquitoes but were seen completing this task in just half an hour.

What about the committee

According to the national guidelines of the LGD, committees will be formed at the national, city corporation, municipality and union levels. The committee will hold meetings once a month, as well as take all activities to prevent mosquito-borne disease and implement it.

The LDG said the national committee has so far held five meetings on this and taken several decisions, but those were not that successful.

There are dengue prevention committees in eight districts, but no committee has been formed in most of the municipalities and unions in those districts. Besides, district committees do not function well.

Other than Dhaka, Barishal saw the highest number of deaths from dengue. Barishal deputy commissioner Shahidul Islam said though a dengue prevention committee has been formed at the district, no committee has been formed at the union level. He told Prohom Alo an order has been given to set up a committee at the union level and it will be possible to form all committees within this month.

Activities of dengue prevention are limited to miking at the upazila level. Ashrafuzzaman, chairman of Bahrpasha union parishad of Barishal’s Bakerganj, told Prothom Alo, “At the meeting of the upazila parishad, instruction has been given to conduct miking at all unions to raise awareness, and we are doing it, nothing else.” In Patuakhali district, no dengue prevention committee has been formed at the union level yet.

There is no dengue prevention committee at the union level in Lakshmipur. A committee has been formed in Lakshmipur municipality - one of the district’s four municipalities. Lakshmipur municipality mayor Mozammel Hidar Masum Bhuyain is the committee’s president. The committee holds no meeting, but the mayor claimed they spray mosquito insecticides and run awareness campaigns.

This correspondent met Sylhet City Corporation mayor Ariful Haque at the LGD office. He told Prothom Alo they implement as much as they get instructions from the centre, but none monitors it. He gave an example saying many city corporation workers do not even know how much water will have to be mixed with mosquito repellent.

Implementation of four decisions

Presided over by local government minister Tajul Islam, a meeting was held on 5 January to formulate a long-term action plan and effective measures to prevent mosquito-borne diseases including dengue. Several decisions were taken at the meeting. Those include seeking recommendations from the country’s research organisations, entomologists and science officers on the prevention of dengue; inclusion of the matter on the prevention of mosquito-borne diseases including dengue in textbooks; arranging meetings of committees formed at districts, upazilas and municipalities and reporting to LDG; strengthening research on mosquito-borne diseases including dengue and finalising integrated vector management activities through a combined initiative undertaken by LGD.

Replying to a query on whether the LGD has sought any advice on the prevention of dengue, entomologist and National River Conservation Commission chairman Manzur Ahmed Chowdhury said, “There are six renowned entomologists in the country, but so far I know none of them has been contacted.” He further said advice is sought from those who have no experience in mosquito killing or dengue control.

Entomologist and professor of zoology at Jahangirnagar University, Kabirul Bashar said he has been with an LGD committee, which held meetings sometimes, and they listen to his speeches. As to whether his speeches yield any result, he said, “In physics, when a force causes a displacement of an object, it is called work. There is lots of talk about work on dengue, but I don’t see any result.”

In the meantime, work on the inclusion of the matter of prevention of mosquito-borne diseases in textbooks saw little progress while integrated vector management activity through a combined initiative by LGD is yet to be finalised, though the ministry said a project is being undertaken with the funds from World Bank.

Less allocation

The LGD said they allocated Tk 1.89 billion to 12 city corporations over the past four fiscal and Tk 400 million in the 2023-24 fiscal. Besides these, city corporations and municipalities have their own allocations for controlling mosquitoes.

Municipal Association of Bangladesh (MAB) general secretary and Madaripur municipality mayor Khalid Hossain told Prothom Alo they conduct mosquito killing drives with the municipality’s funds and receive a small amount from the local government ministry, which does not help much.

They couldn't do it and will not

When dengue cases are surging across Bangladesh, Kolkata, the capital of the neighbouring Indian state of West Bengal, has been very successful in controlling the mosquito population. They did not kill mosquitoes with fogger machines, instated they aimed at sources to destroy the mosquito population and prevent their breeding, as well emphasized research. When a dengue case is reported in Kolkata, authorities look for its origins. They then monitor the neighbouring 50 houses and if any mosquito larva is found, effective mosquito repellent is used.

Indian Bengali-language daily Anandabazar Patrika quoted Kolkata deputy mayor Atin Ghosh as saying 1,400 dengue cases have been reported this year so far since January. Prothom Alo Kolkata correspondent Shuvojit Bagchi said seven people reportedly died of dengue in this session though no official tally on dengue deaths and cases was released by the government.

Former director of the Disease Control Wing Be-Nazir Ahmed told Prothom Alo that the construction of roads, bridges and buildings is the main duty of the local government ministry and it is not their duty to control Aedes mosquito as they have no experience with it. It is necessary to have a team of entomologists and pathologists, but there is a severe lack in this aspect, he added.

Be-Nazir Ahmed said the task that the local government ministry could not do in the past 20 years, so it will not be possible for them to control dengue in the next 20 years. He suggests the health ministry should be tasked with eradicating the mosquito population.

Prothom Alo’s Staff Correspondents from Faridpur, Barishal and Cumilla, Correspondents from Chandpur, Pirojpur, Lakshimpur and Patuakhali, and Chattagram office contributed reporting.

This report appeared in the print and online edition of Prothom Alo and has been rewritten in English by Hasanul Banna