Curbing the menace of dengue in the Solomon Islands

Publié: 3 juillet 2013 12:38 CET

By Patrick Fuller, IFRC

Since February 2013, Randy Solomon has been fighting a lonely battle. Working with a small staff and a handful of volunteers, she has been given the job of combating the scourge of dengue fever in her hometown of Gizo, in the Western Province of the Solomon Islands. As the environmental health officer for Gizo she heads the ministry of health’s dengue task force, which is attempting to curb the epidemic that has been sweeping across the Solomon Islands in recent months.

By May, the epidemic had peaked at over 5,000 reported cases and six fatalities. While over 80 per cent of infections occurred in the capital Honiara, cases in the larger provinces – particularly Malaita and Western Province – saw a steady increase up to mid-May.

With a population of over 7,000, Gizo has grown rapidly in recent decades to become the second largest town in the Solomon Islands. But unchecked urbanization and a soaring growth rate of 12 per cent each year has meant that a quarter of the population live in informal or unplanned settlements with little or no access to municipal services.

“These settlements are high-risk areas for dengue transmission,” Solomon says. “They have sprung up in unsuitable locations such as steep slopes and swampy areas, and they lack basic services such as water, sanitation and garbage collection.”

Over 30 dengue cases have been admitted to Gizo’s referral hospital and although the epidemic has peaked, the priority for Solomon’s team is to continue tackling the problem at its source, which means getting out to high-risk areas and educate communities on how they can prevent the disease.

Unsurprisingly, Gizo’s dengue hot-spot is located in a settlement adjacent to the town’s rubbish dump – a foetid landfill site where tractor-trailers dump the town’s waste each day. Fresh rains have turned the area into a stinking swamp, creating a perfect breeding ground for the Aedes Aegypti mosquitoes that carry the disease. 

Solomon is accompanied on her house visits by 26-year-old Matalita Zama, a volunteer with the Solomon Islands Red Cross. The Gizo branch of the Red Cross is a member of the provincial task force on dengue, and volunteers play a key role in social mobilization and raising community awareness about the disease. They clamber up a steep path to visit a number of wooden houses perched precariously on the hillside overlooking the dump. Discarded rubbish is strewn everywhere.

“In this area there is a cluster of five homes, where three people were recently hospitalized with dengue,” explains Matalita. “We do a census of each home and check for hazards, making sure backyards are not overgrown and are free from garbage such as cans and coconut shells which collect water.”

49-year-old Anna Sina’s home is first on their list. Her son lies upstairs under a mosquito net recovering from dengue. He was recently discharged from Gizo Hospital having spent three days attached to a saline drip. Anna takes the team on a tour around the back of her home where she and her children have been clearing the overgrown vegetation. Pleased with her efforts to keep her environment clean, Solomon and the team continue to her neighbour’s house, leaving Anna with sacks to help in her garbage collection.

Although the first cases of dengue were recorded in Solomon Islands in 1983, this year’s epidemic is unprecedented. In recent months, the Red Cross has played an important role in the government’s national task force on the disease. In the capital Honiara, teams of volunteers have been deployed to conduct health awareness sessions within high-risk communities. The Red Cross blood bank team also increased the number of blood donor events around the city to ensure that the Honiara’s hospital had adequate supplies for dengue patients.

Solomon says a variety of factors have been driving the epidemic. “In Gizo, the main problem is solid waste management. Drains are blocked, there is garbage everywhere, more people and a lot of building activity. We have to focus on eradicating breeding sites and helping communities to take responsibility for their own environment.”

But less obvious factors such as climate change could also be exacerbating the problem. More intense periods of rainfall and higher temperatures are worsening existing environmental hazards. “There is no doubt that it is much hotter now. The increase in temperature might also be affecting people’s immune systems, making it more difficult for them to adapt to fight the disease,” Solomon says.  

It is anticipated that by 2020, 26 per cent of the Solomon Island’s population will be living in urban and peri-urban areas. Increasing urban migration is taking its toll, but for Red Cross volunteer Matalita Zama, stopping dengue needs to be every person’s responsibility.

Her message is simple. “Just look around, all of Gizo will be covered in dengue if we don’t get serious about cleaning up the town.”