SPRAY FOR US SINNERS

Dec 08, 2008 Features / Columnists, Tony Deyal column

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In the midst of raging dengue epidemics, the cry goes out throughout the lands of the Caribbean, “Let us spray!” And there goes forth the word from Ministries of Health that the whole world should be sprayed; and their sprayers wend their ways through the Lands of Canaan, Judea and elsewhere. And they drag forth vehicles that make noises and send out fumes and vapours so that the faithful would know that the Ministries of Health are interested in their well-being and are saving their lives.

And the birds of the air and the fishes of the lake are set upon, and they fall by the wayside, whereas the mosquitoes continue to thrive. The faithful, their windows closed against the toxic substances, praise those on high for heeding their pleas for help.

The mosquitoes, safe inside the houses, especially the larvae and little ones in vases and flower pots, with no Herods in sight, live happily ever after. And the faithful continue to indulge in their sprayers until the wet season ends and they, too, live happily until the next rains cometh. For such is life. And such is death.

Especially the death of children from dengue haemorrhagic fever.
Every year, we go through the same cycle of bored indifference by the health sector and householders during the dry season, sudden interest on the part of householders when the rainy season comes and there are dengue epidemics, pressure on the Ministers of Health after the mosquitoes start biting, resort to spraying and, fortunately, the wet season ends with only a few dengue deaths. 

Now, with climate change, there is no dry or wet season.  What we have are major changes in the rainfall patterns, resulting in several periods of intense rainfall. With each of these, there is a new mosquito season. 

Worse, since in many of the countries — including Trinidad, where the lack of a guarantee of a continuous flow of pipe-borne water forces people to store water in cisterns, barrels, buckets and tanks — the dreaded and dangerous dengue transmitting mosquito Aedes aegypti breeds and multiplies, spreading illness and death,  they have permanent housing.

All Ministries of Health and all medical officers of health know that the best means of dealing with dengue is source reduction of mosquitoes.  This means not providing them with breeding places, and dealing with the larvae before they are hatched. The health sector officials know that the sprays are ineffective. 

They know that mosquitoes live near their food supplies, which is us, and so they prefer to be right in your house if you allow them to.

A few years ago, in Belize, my daughter got dengue haemorrhagic fever (DHF), and now my adult son, George, has it.  His illness took me back to my own almost fatal bout with DHF a few years ago in Trinidad.  As I lay shivering, my skin burning up with dengue fever, I went through all that I had learnt about it in a sort of half-daze.

Dengue makes it very difficult to eat anything. Dengue does not seem to like you to eat, attacking your salivary glands and taste buds, mugging them into submission.  After four nights with dengue battering down my resistance, my deteriorating condition had necessitated more professional assistance.

I told my wife it was like the story of the butler of the rural English Lord who, on awakening his master one morning, discovered much cause for celebration. “Shall I summon Madam for you, your Lordship?” he asked smoothly. “No, dammit James, this one is too good for Madam,” his Lordship replied. “Pack my bags, I’m taking it up to London.”

I checked myself into the hospital and, after waiting vainly for assistance, was about ready to check myself out. Dengue and patience do not go together.  It is a virus that wages a relentless attack on your system. It feels like a gang of juvenile delinquents armed with chainsaws and blowtorches, prowling your estate for anything that could be chopped down, slaughtered and destroyed. 

There is constant pain behind the eyes and in the joints. Some muscles, even the large frontal thigh muscles, become cramped and virtually useless. The tablets buy a little time and space in the ongoing drama of pain, but as the hours pass, the pain returns in waves and the fever once more tops the charts.  If the tablets are anything with aspirin or its derivatives, like ibuprofen, they thin out the blood even more, and that can kill you or your child, particularly your child. 

The problem is some doctors routinely prescribe aspirin for all fevers, and some parents give their children aspirin without thinking.

Dengue is appropriately called “break-bone” fever by my Jamaican friends. It leaves you “mash-up” for periods of up to three weeks. In fact, some people take much longer to recover from its effects. 

There is also a relapse period. You feel better, you increase your physical workload and then it hits you, most times worse than the original attack. 

One nurse believed that, not having eaten anything for five days, I should be forced to take in some solid sustenance. She decided to withhold my pain and fever medication until I did. My temperature shot up to 103 degrees.

Dengue does not like threats. What it does like are people who have already experienced one of the four serotypes. The first time you get dengue, the effects are almost indistinguishable from the normal flu, except for the pain behind the eyes and in the joints. 

You would never get that same type again, but it makes you more susceptible to one of the other three serotypes and to dengue hemorrhagic fever (DHF), which can be fatal, particularly to infants. One way to beat dengue is by not succumbing to depression induced by the combination of the disease and the medication. It can get you down after a while.

What I did was to cling to the little joys of recollection.  I also appreciated the irony. Having spent seven years throughout the Caribbean teaching people how to prevent dengue, it is an interesting experience to change roles from hunter to hunted.  

It is like the story of the Englishman, clad in full hunting outfit and armed with a rifle, who stumbled onto a totally naked lady in the forest. “What you doing?” she asked. “I’m looking for game,” he replied. “Well, I’m game,” she admitted. So he shot her. 

*Tony Deyal was last seen saying that he eventually bought an “insecticide impregnated” mosquito net.  He is still curious about the reproductive habits of insecticide and whether the mosquito nets would reproduce and save him the cost of buying more.

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