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Public health officials employ “time-honoured” tactics to combat dengue in Ivory Coast

Two people have died and 130 have fallen ill since the fever returned to the country last month.

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Health workers fumigate an area to prevent mosquitos from breeding, in Abidjan, as part of a campaign against the mosquito borne virus dengue

“Cover your goods,” Diakaria Fofana, a doctor of public health charged with combating dengue, warns food vendors as a thick cloud of insecticide spray wafts down a street in Abidjan, Ivory Coast’s economic capital. Men in protective clothes, goggles and masks are disgorging plumes of mosquito-killing chemicals in a bid to roll back an outbreak of dengue.

Two people have died and 130 have fallen ill since the fever returned to the country last month. The toll, so far, is tiny compared with other tropical countries, especially in Southeast Asia, where the painful and sometimes deadly disease is an entrenched peril.

But tackling the outbreak is a major challenge for Ivory Coast, having to resort to time-honoured, labour-intensive methods of spraying and neighbourhood awareness campaigns to prevent its spread. Female mosquitoes carrying the dengue virus transfer the pathogen when they tuck into a blood meal from someone.

 National institute for public hygiene (INHP) are at work to fumigate an area as part of efforts to fight Dengue in Ivory Coast
In this file photo taken on June 3, 2019 officers of the National institute for public hygiene (INHP) are at work to fumigate an area to prevent mosquitos from breeding, in Abidjan, as part of a campaign against the mosquito borne virus dengue. (Photo by Sia KAMBOU / AFP)

Related: 18,000 tonnes of ‘dangerous Myanmar rice’ destroyed in Ivory Coast

A vaccine does exist, but is not available in Ivory Coast because “it has many secondary effects (and) it’s expensive”, explained Joseph Vroh Benie Bi, director of the National Institute for Public Hygiene (INHP). Developed by French pharmaceutical group Sanofi Pasteur, the vaccine is recommended for use in people aged nine and older, and only for individuals who have already been infected.

Usually accompanied by flu-like symptoms, dengue makes some people very sick indeed, developing into a haemorrhagic fever that can cause difficulty breathing, heavy bleeding or even organ failure. While the first bout of dengue is rarely fatal, subsequent infections are usually worse.

Fighting the mosquitoes equals combating dengue

The UN’s World Health Organization (WHO) says there are up to 100 million cases of dengue worldwide every year, and almost half the world’s population lives in countries where the disease is endemic. It kills more than 20,000 people each year. Southeast Asia and the Western Pacific are the worst-hit areas.

There is no cure and the WHO recommends that patients take paracetamol, rest and drinking plenty of fluids. Five new vaccines are in development, but in the meantime, Fofana says: “The only effective means of fighting (dengue) is fighting the mosquito.”

In Ivory Coast, most recorded cases have occurred in Abidjan. Health workers are striving to enlist the public in tackling the mosquito, targeting its life cycle. “The larvae multiply in stagnant water, for example inside used tyres,” said Fofana, deputy director of the vector control unit at the INHP.

“People should never store water in buckets in the open air and they should regularly throw out the water in plates under houseplants.” But he faces an uphill job in a sprawling port city of 4.4 million people in the middle of the rainy season.

National institute for public hygiene (INHP) are at work to fumigate an area as part of efforts to fight the spread of Dengue in Ivory Coast
(FILES) In this file photo taken on June 3, 2019 an officer of the National institute for public hygiene (INHP) is at work to fumigate an area to prevent mosquitos from breeding, in Abidjan, as part of a campaign against the mosquito borne virus dengue. (Photo by SIA KAMBOU / AFP)

Related: The endangered reality of traditional priestesses in Ivory Coast

What’s more, people who are infected, even without knowing it, and can bring the virus to new areas when they are bitten by local mosquitoes. The WHO has set a goal to halve the number of dengue deaths by 2020, but, the incidence of the disease has increased 30-fold in the last 50 years.

“Before 1970, only nine countries had experienced severe dengue epidemics. The disease is now endemic in more than 100 countries,” it says.

Dengue – Malaria’s big brother

In Ivory Coast, where malaria accounts for a third of all medical consultations, many people self-medicate when they experience symptoms such as high fever, vomiting, nausea or aches and pains. “This is a real problem, because the symptoms of malaria, dengue, typhus and yellow fever are similar. Doing a blood test is absolutely indispensable,” said Fofana.

Treatment with the wrong medicines can worsen the situation, he stressed – aspirin or ibuprofen can increase the risk of bleeding, for example. In the meantime, the spraying goes on.

“We know the risks,” said Bamba Segbe, an Abidjan resident watching the masked men in action. “It’s not for nothing that we call dengue malaria’s big brother.”

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Malawi’s parliament elects opposition MP as first-ever female speaker

Catherine Gotani Hara from the opposition Malawi Congress Party (MCP) gathered 97 votes to defeat her opponent from the ruling party

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Malawi's parliament elects opposition MP as first-ever female speaker
Newly elected speaker of Malawi parliament, Catherine Gotani Hara.

History has been made in Malawi as lawmakers on Wednesday elected a female member of parliament as speaker for the first time in the country’s history.

Catherine Gotani Hara from the opposition Malawi Congress Party (MCP) gathered 97 votes against 93 of Esther Mcheka Chilenje of the ruling Democratic Progressive Party (DPP).

The Malawian parliament which has 193 seats, was dissolved in March this year, ahead of the fresh elections held on 21st May.

After announcement of the voting results, Eisenhower Mkaka, MCP lawmaker and party spokesperson said; “the victory of Hara as first-ever female speaker of parliament is what every Malawian hoped for. Her election should encourage women that if you invest in girls, they can also become leaders.”  

Viwemi Chavula, who is the team leader of the 50-50 campaign, a consortium of civil rights group which campaigns for 50% representation of women in public offices, has described Hara’s election into office as a milestone for Malawi.

“It has been our aim to increase women’s representation in leadership and decision making positions. The election of the first female speaker of parliament is a huge achievement for Malawi,” Chavula said.

Hara has previously held several ministerial positions including that of health and gender under Joyce Banda, Malawi’s first women president.

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Morsi: Egyptian authorities accuse UN of trying to “politicise a case of natural death”

The spokesman for the UN High Commissioner for Human Rights had called for an independent investigation into Morsi’s death

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Morsi: Egyptian authorities accuse UN of trying to "politicise a case of natural death"
A man hangs a poster of Egyptian President Mohamed Morsi. (Photo by - / AFP)

Egypt accused the United Nations on Wednesday of seeking to “politicise” the death of the country’s first democratically elected president Mohamed Morsi by calling for an “independent inquiry”.

Foreign ministry spokesman, Ahmed Hafez said he condemned “in the strongest terms” the call by the spokesman for the UN High Commissioner for Human Rights, Rupert Colville, for an independent investigation into Morsi’s death during a court hearing on Monday. 

Related: Jailed Egyptian ex-president Morsi dies after collapsing in court

Hafez said it was a “deliberate attempt to politicise a case of natural death.”

Colville called Tuesday for a probe into whether the conditions Morsi faced during his nearly six years in custody had contributed to his death.

“Any sudden death in custody must be followed by a prompt, impartial, thorough and transparent investigation carried out by an independent body to clarify the cause of death,” he said.

“Concerns have been raised regarding the conditions of Mr. Morsi’s detention, including access to adequate medical care, as well as sufficient access to his lawyers and family,” Colville added.  

People hold picture of Egyptian President Mohamed Morsi during a symbolic funeral ceremony on June 18, 2019 at Fatih mosque in Istanbul. (Photo by – / AFP)

Related: Mohammed Morsi, former Egypt’s president laid to rest in Cairo

He said the investigation must “encompass all aspects of the authorities’ treatment of Mr. Morsi to examine whether the conditions of his detention had an impact on his death.”

Morsi was toppled by then army chief, now President Abdel Fattah al-Sisi in 2013 after a single divisive year in power. He was later charged with an array of offences including espionage.

Related: Morsi’s death: Timeline of events in Egypt since 2011 post-Mubarak era

Since his ouster, authorities have waged an ongoing crackdown on dissent of all kinds that has seen thousands of Brotherhood supporters jailed and hundreds facing death sentences.

A group of British parliamentarians in March 2018 warned Morsi’s detention conditions, particularly inadequate treatment for his diabetes and liver disease, could trigger “premature death”. 

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Tunisia fishermen are the lifesavers of the Mediterranean

Fishermen from Zarzis have saved the lives of hundreds of migrants in recent years,

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Tunisian fishermen are finding themselves more and more involved in rescuing illegal boats leaving Libya for Italy,

The Tunisian trawler radioed in for help as it passed the migrant boat in distress out at sea. But with the packed craft still adrift two days later, captain Chamseddine Bourassine took direct action. Fishermen from Tunisia are spending more and more time pulling in stranded migrants after a sharp decline in humanitarian and European naval patrols along the stretch of water between war-wracked Libya and Italy.

Bourassine, his crew and three other fishing boats ferried the 69 migrants back to shore on May 11, five days after their boat pushed off from Zuwara on the western Libyan coast. “The area where we fish is a crossing point” between Zuwara and the Italian island of Lampedusa, said Badreddine Mecherek, a Tunisian fisherman from Zarzis near the border with Libya.

Fishermen from Zarzis have saved the lives of hundreds of migrants in recent years, and as the number of boats leaving western Libya for Europe spikes with the return of calmer summer seas, they will probably have to save even more. “First we warn the authorities, but in the end, we end up saving them ourselves,” Mecherek grumbled as he tinkered with his rusting sardine boat.

European countries in the northern Mediterranean are trying to stem the number of migrants landing on their shores, and the Tunisian navy with its limited resources only rescues boats inside the country’s territorial waters.

Since May 31, Tunisia itself has barred 75 migrants from coming ashore after they were saved in international waters by a Tunisian-Egyptian tug boat. Contacted multiple times by journalists, Tunisian authorities have refused to comment.

Angel

“Everyone has disengaged” from the issue, said Mecherek, adding it was hampering his work. Fishermen who run across migrants on their second day out at sea are at least able to have done a day’s work, he added, “but if we find them on the first night, we have to go back”.

“It’s very complicated to finish the job with people on board.” The complexity of the rescues grows when fishermen find migrants adrift closer to Italy.

When Bourassine and his crew last year tugged a boat towards Lampedusa which was adrift without a motor, they were jailed in Sicily for four weeks for helping the migrants. It took months to recover their boat.

Humanitarian boats and those of the European Union’s “Operation Sophia” anti-piracy force had scooped up most stranded migrants in recent years, but rescue operations dropped in 2019. “Now most often we are the first to arrive… if we aren’t there, the migrants die,” Mecherek said.

On May 10, a Tunisian trawler just barely saved the lives of 16 migrants after they had spent eight hours in the water. Sixty others drowned before the ship arrived.

Survivor Ahmed Sijur said the boat’s appearance at dawn was like that of “an angel”. “I was losing hope myself, but God sent the fishermen to save us,” the 30-year-old from Bangladesh said.

Police of the sea

Mecherek is more worried than proud. “We don’t want to see all these corpses anymore. We want to catch fish, not people,” he said, adding his crew was growing uneasy. “I have 20 seamen on board asking, ‘Who will feed our families?'” he added.

“But local fishermen will never let people die at sea.” For Tunisian Red Crescent official Mongi Slim, the fishermen “are practically the police of the sea”, adding that many migrants say large ships won’t stop to help.

Under pressure to catch their quota during a short annual season, big tuna boats out of Zarzis often call the coast guard instead of stopping themselves to help. “We report the migrants, but we can’t bring them back to shore… We only have a few weeks to fish,” said one crew member. For Chamseddine, the summer months look difficult.

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