Trin | Surviving life in Trinidad and Tobago

Dengue demands action

Today's Trinidad Guardian Editorial rightly says "Far more effective than treatment is prevention and efforts at managing dengue outbreaks have been pathetic in 2008." Yet our loser Health Minister Narace gets to stay on the payroll! I think the PNM's new slogan should be something like:

PNM: Ministers Guaranteed Payroll no matter how spectacularly we fail! The best job security in T&T! Absolutely no accountability!

Dengue demands aggressive action

Efforts at managing dengue outbreaks have been pathetic in 2008. The crucial vector for dengue transmission is the aedes aegypti mosquito, and efforts at controlling this insect have been poorly implemented even in areas known to be at risk.

The viruses that cause dengue haemorrhagic fever are notorious for their subtle diversity and the complexities of diagnosis and treatment.

For that reason, the precise identification of dengue has proven to be a challenging matter and misdiagnosis is one of the issues that make identification of an outbreak challenging. It is also possible for multiple variations of the virus family responsible for dengue to be active in a single outbreak, each of which responds differently to treatment.

The fugitive nature of these flavivirus serotypes has made it possible for successive Ministers of Health to argue with passion that dengue is not a problem in T&T.

Health Minister Jerry Narace argued for long weeks that eight-year-old Sasha Bickram did not die of dengue fever until a blood report showed unequivocally that she had tested positive for dengue antibodies.

The residents of Frederick Settlement, Caroni, were certainly furious after the recent death of UWI student Camille Ramcharan and the positive diagnosis of Ramcharan’s parents and two other residents of the area. Camille’s father, Freddy Ramcharan, claims that 50 other people have been diagnosed with dengue in the area for the year. The community was finally sprayed to suppress mosquitoes last week.

It is one of the curiosities of the disease that it cannot be positively identified until the suspected victim’s body responds to the flavivirus with antibodies, which takes time and sometimes repeated testing to confirm.

There is no vaccine for the variations on flavivirus and long before formal confirmation through blood testing can confirm its presence, patients are put through a physical wringer, suffering fevers, bladder problems, potentially fatal loss of blood platelets, bleeding and plasma leakage. Dengue attacks human blood to devastating effect and early, decisive treatment is critical.

Far more effective than treatment is prevention and efforts at managing dengue outbreaks have been pathetic in 2008.

There have been reports that the Insect Vector Control Division has been poorly supplied with insecticides and has been unable to respond to the need to suppress mosquito breeding.

In place of decisive action on the part of the Government, the nation has, instead, been treated to an ancient television advertisement encouraging citizens to clean up their environment. While the sentiment and advice are legitimate, the ad itself is so weather-beaten and overused that it is, to all intents and purposes, invisible.

Surely, the Government’s information services can find the time to update this useful bit of information when it isn’t working on public relations newscasts.

The Ministry of Health should further be mindful that even one death attributable to the spread of dengue fever is one fatality too many in a nation that hopes to deliver on its goals for 2020.

Decisive action on insect vector suppression, refreshed public information and more open acknowledgement of the real status of dengue infection in T&T are long overdue.

Editorial 
The Trinidad Guardian
Tuesday 23rd December, 2008   

Another death - Caroni residents implore Health Ministry to admit there's a Dengue outbreak!

'Admit dengue outbreak'...Caroni residents protest latest death.

In mourning: Freddy Ramcharan displays his daughter's death certificate yesterday at Frederick Settlement in Caroni. -Photo: DEXTER PHILIP

RESIDENTS of Frederick Settlement in Caroni want the Health Ministry to admit that there is a dengue outbreak in the country, and vow that they are willing to do whatever it takes to make their case.

They erected several banners at the entrance to their community, off the Southern Main Road, to highlight the latest dengue fatality, Camille Ramcharan, a promising 22-year-old engineering student who died last week.

Her father, Freddy Ramcharan, says his family would spend the Christmas holidays mourning the death of his daughter, who died after losing the battle with dengue haemorrhagic fever. But that loss is not all he has to bear, as his wife, Shakera Mohammed, is now in hospital also stricken with the illness.

Now, Ramcharan and other residents say they are prepared to go to whatever lengths in order to get the authorities to tackle what they describe as a "deadly dengue outbreak" in their community.

The residents also charged that Health Minister Jerry Narace should not keep denying that there was a dengue outbreak in the country when, in reality, scores of persons in the community and neighbouring areas, and others around the country, were being admitted to hospitals for treatment of the disease almost on a daily basis.

The residents also cast blame on the authorities for the situation, saying that they have failed to clean the drains in and around their communities for several years now and, as a result, they have now become the breeding ground for mosquitoes.

Residents said most of the drains in the area were filled with silt and stagnant water due to years of neglect, and claimed the Insect Vector Control Unit of the Ministry of Health has not responded to their requests to spray the area.

Following the death of the UWI student, the residents say they have decided that "enough is enough", and were now determined to get the authorities to do something about the situation. One banner at the entrance leading into Frederick Settlement stated: "Help, dengue killing meh family". Another read: "Who's next in line for dengue?".

Ramcharan said his wife had also tested positive for dengue and is now warded at the Mt Hope Hospital where she is being treated. "I am hoping she pulls through. She was in hospital when my daughter took in, so I had both of them in the hospital at one time."

He also said that there were more that 50 persons in the village who have tested positive for dengue for the year.

Ramcharan said his daughter, who up to the time of death was a student at the University of the West Indies (UWI), St Augustine campus, had initially been misdiagnosed by doctors at a private health institution. He described his daughter as a vibrant, promising, young woman who had a bright future ahead of her.

"Right now, our hearts mash up like cabbage because of what happened with her. We want the authorities to deal with this situation," he said.

Professor of Marine and Environmental Sciences at UWI St Augustine, John Agard, said recently there was an increase in dengue fever throughout the region because of climate change.
Rohandra John rohjohn@trinidadexpress.com
Thursday, December 18th 2008

"Imaginary" Dengue outbreak in Trinidad

With a straight face, Finance Minister Karen Nunez-Tesheira at the start of her Budget presentation said, “Our vision commits us to the nurturing of a caring society.”

The response of Opposition MP Kamla Persad-Bissessar better reflected the expenditure patterns of the Government: “The Prime Minister and his government have clearly shown that they subscribe to the view, ‘Keep them poor, keep them ignorant, keep them in fear.” - Trinidad Newsday September 30th, 2008.

There has been extensive flooding recently in Diego Martin, Port of Spain, Cascade and other areas in North Trinidad. This week commuters in Port of Spain recounted being scared and shocked at the way people cursed and threatened one another to grab a bus ride out of the flooded city. We have been reduced to living like savages, threatening one another to obtain a basic reliable ride home without fear, no matter the weather.

I wonder if the Ministry of Health has clued in to the connection between rain, flooding, large pools of water, mosquito breeding grounds or Dengue Fever. I haven’t heard of any announcements that the Ministry plans to increase the frequency of spraying mosquitoes given all the rain. Is this because Health Minister Jerry Narace still believes that there are no dengue cases in Trinidad and Tobago? What exactly is Jerry Narace doing everyday? Does he even work? Three months ago Narace informed the nation that there were no "confirmed deaths" from dengue after the death of eight year old Sasha Bickram.

By September there were numerous deaths and reported cases of dengue. At a Ministry of Health function at the Hyatt on September 20th 2008 Narace was asked to comment on the dengue issue. As expected he gave the generic "updates will be coming" response and then asked with a smile if we shouldn't be "speculating on what is in the budget" instead. Pardon me while I say what the fuck does an  outbreak of dengue have to do with speculating about the budget?

Narace is close to Prime Minister Patrick manning and is also the Public Relations Officer of the PNM. The Integrity Commission has launched an investigation into the dealings of Minister Narace based on a complaint from Caroni East MP Dr. Tim Gopeesingh, who claims that Narace’s family's business has been receiving state contracts. In September Gopeesingh told Parliament Narace and his family were receiving million-dollar contracts from State bodies through the family company, Reinsurance Company of Trinidad and Tobago Limited (Trinre).

"I received a letter today indicating that the commission was grateful for the information I provided to them. They had written asking for further information which I also provided and they indicated they are investigating the matter," Gopeesingh said. HotLikePepperRadio December 4th,2008.

Children, adults and senior citizens are dying from dengue, no preventative measures are being taken to deal with the flooding, much less the increased mosquito breeding from flooding and Minister Narace is smiling and dismissing a very serious question.

Tell us, Karen Nunez-Tesheira, Jerry Narace and Patrick Manning, are exhausted people resorting to threats of violence to escape a sinking city or Trinbagonians dying from an imaginary dengue outbreak part of your vacuous plan of action for "nurturing a caring society"?