There is a nation-wide concern over the dengue outbreak that has, at last count, affected at least 5,000 people all over India and claimed several lives in regions as far apart as south Kerala and New Delhi, where some 800 cases have been reported. This has even provoked an unprecedented suo motu intervention from the National Human Rights Commission which has demanded to know of the Delhi authorities as to what measures they had taken to prevent such an outbreak. The step underlines the recognition that the right of citizens to good health is part of their human rights. The truth is that the standard approach to disease in India is knee-jerk and symptomatic. We go into a tailspin once an epidemic descends. But the big message that diseases like SARS, or indeed dengue, send out can be couched in the familiar adage: prevention is better than cure. Indeed, in the last two instances, there are no established cures. In the case of dengue, for instance, an attenuated candidate vaccine has been developed in Thailand, although efficacy trials are yet to begin. It can then be safely assumed that a dengue vaccine for public health use will not be available for at least another five years. There is then no scope for complacency with regard to handling diseases like dengue. It means that we have to depend entirely on disease prevention and mosquito control. The familiar routine of ensuring timely garbage collection and the removal of stagnant water may sound old-fashioned in these days of instant solutions but there is just no escaping it. At the same time, it may be useful to remember that the days when the entire burden of achieving a clean urban environment was left on the government are over. The burgeoning numbers and the great pressure that already exists on civic infrastructure mean that the citizen can no longer afford to keep aloof. Gandhi, in a different era, had tried to instil a civic sense in citizens by highlighting the virtues of shram daan, or self-help. We need to imbibe this old lesson in a new manner. If we don’t help ourselves, it is we who will suffer. Dengue is a reminder that disease prevention should never be allowed to go off the national radar.
