The past month has not been an easy one for Laos. One of its
provinces, Luang Prabang, has been suffering through a chronic food shortage
that began months ago and has resulted in over 15,000 people dealing with moderate
to severe food insecurity. A recent flash flood in Borikhamxay caused the Nam
Xan river to overflow, sweeping away livestock and destroying rice stores for
the families there. As the well-worn
joke goes, it’s a bit like living in the Old Testament here. If the sky opened
up today and rained frogs, I’m pretty sure my neighbours would just shrug and
buy bigger umbrellas.
But we now have a budding epidemic to deal with that has
dwarfed the natural disasters in terms of loss of life this year. Dengue is a
vector-borne illness transmitted by mosquitoes, just as malaria is. Unlike
malaria, there are no prophylactics to prevent or lessen the impact of the
disease and no antivirals or other medicines to specifically treat dengue once
a person gets the disease. Symptoms of the disease include a mild to high
fever, muscle and joint pain and rash. Though no treatment will cure the
disease, allowing the disease to continue without any form of medical response
could cause it to worsen and lead to death in some cases.
Dengue is endemic to Laos and the country deals with the
disease every year. But the numbers this year are off the charts for some
unknown reason. The season for Dengue generally runs from April to November,
with the number of cases to this point of the year usually around 1,500 people.
Three years ago was seen as an abnormally high year with 3,500 people affected.
By comparison, there have now been 15,000 people infected with Dengue so far this
year. Fifty-four people have died so far from the disease, compared to 22 for the
entire year in 2010. And things may only get worse from here. Dengue traditionally tends to reach its peak
only toward the end of the rainy season, in August and September, so the
numbers seem destined to rise.
As there is no vaccine to prevent the disease, the only way
to protect yourself is to keep from being bitten at dusk and dawn, the times
when the Aedes mosquito is most active. Long-sleeved shirts and mosquito
repellent are the order of the day. Even I’m becoming cautious in this respect.
I lived in Cameroon for 18 months on a half-bottle of Muskol, but I’m spraying
myself every day now if I expect to be out early or late.
As the numbers have risen, the Lao Government has been
working in conjunction with the World Health Organization (WHO) to find a way
to contain the problem and reverse the trends. Beyond raising awareness of the
problem, they are also attempting to address its cause by staging community
clean ups of the areas where the mosquitoes tend to breed. This means removing
the pools of water that collect as the rains come and cleaning areas that tend
to attract mosquitoes. Particularly vulnerable in this respect are the villages
around the country, so the focus has been placed on the eleven provinces
showing the highest rates of infection, with the hope that up to 6,000
volunteers can be mobilized to assist with the response there this month. As
the numbers rise, it is anticipated that medical students will be added to
hospital rosters to assist with case management. As might be expected, the
costs associated with making these responses are soaring to match the rising
rates of infection, with estimates now reaching into the millions of dollars.
To this point, I haven’t personally been affected by Dengue.
Vientiane Province has been impacted by the disease, with over 1200 cases and
one death reported, but to the best of my knowledge, none of my UN colleagues
have been infected. One friend outside of the UN did contract the disease
earlier in the year as did his neighbours, but all of them were able to recover
without incident. He informed me of this as we sat around his patio table that
was decorated with enough cans of Off mosquito repellent that each of the party
goers could have taken one home as a souvenir. “Dengue seems to be really bad
in this neighbourhood,” he said, as I checked the sun that was sinking below
the horizon and reached for my own spray bottle.
As the central hub for UN operations in the country, the
Resident Coordinator office that I head has been receiving regular updates from
WHO, as this is one of the main UN agencies in the country. A recent appeal from
them to assist with funding the response has left me at a loss, as the budget
for the RC Office is not broad enough to pitch in for such extraordinary efforts,
but we continue to explore the options for finding funding sources within and
outside of the UN. In a country that is prone to large-scale natural disasters
such as flooding and typhoons, the tiny mosquito may prove to have the most devastating
impact on Laos in 2013.
