Pakistan: Dengue Outbreak Khyber Pakhtunkhwa Emergency Plan of Action DREF Operation MDRPK014

A. Situation analysis

Description of Disaster

The rains during the recent Monsoon season have been quite heavy resulting in the emergence of dengue cases from Peshawar by the mid-August 2017. These cases continued to rise and by 24th August a sudden surge was noticed with a number of patients admitted in the major government hospitals of Peshawar.

According to the provincial Health Department in Peshawar, as of September 14, the death toll from dengue, in Khyber Pakhtunkhwa (KP), reached 25. So far, 12552 people have been tested for Dengue and out of these 2492 people have been found positive for Dengue. Although 781 people have been discharged after treatment, 2907 are still being treated in the government hospitals as the majority of them suffer from high grade fever, headache and muscular pain i.e. the symptoms close to dengue fever. It is estimated that there is an increasing trend of dengue cases as well as spread of Dengue to other areas as the cases have started to come from areas adjoining those from where initial cases were reported, thus the Commissioner of Peshawar has sent a request on September 13, requesting Pakistan Red Crescent Society (PRCS) to provide assistance in raising awareness, printing materials and setting up medical camps in the Peshawar.

The PRCS KP provincial branch responded to the situation with the deployment of medical teams (Screening Camps) where people from the areas mainly affected by Dengue were provided with medical consultations, those with suspected signs and symptoms were tested and cases needing referral were referred to the government hospitals. Medicine were also provided to those consulting these camps. These camps were conducted by PRCS KP Provincial branch staff and volunteers in collaboration with professional volunteers from North-West Hospital in Peshawar and in the District,
Headquarter Hospitals in Mardan and Mansehra districts.

Alongside, the awareness campaign was conducted in the areas where Dengue was prevalent focusing on creating awareness about the situation and disease as well as protective measures against it. LLINs were also distributed along with the IEC Materials (brochures) regarding Dengue. More than 60 Volunteers were utilized for conducting these doorto-door awareness campaigns in Peshawar (with usually 5-10 volunteers conducting the door-to-door awareness campaign in each locality) as well as in other districts along with the district branch staff. More than 3100 houses have been visited during these door-to-door Awareness campaign so far.

The activities were slowed down during the Eid ul Adha festival but immediately after the Eid, there were reports of Chikungunya cases from districts Mansehra and Abbottabad although this was not declared officially. Very recently, there were reports of a sudden increase in the number of cases of Malaria from district Charsadda which also needs declaration by the government authorities.
With the monsoon rains in the last phase of their spell and a lot of movement by the population during the Eid ul Adha holidays, the cases were very likely to spread to the neighboring districts. Even for the Chikungunya and Malaria, the vector remains the same i.e. Mosquito and measures carried-out to stop the multiplication of mosquitoes will have a positive effect in controlling the spread of not only Dengue but also the others. Similarly, this provides the Public Health professionals with an excellent opportunity to create awareness among the general public regarding the threat posed by mosquitoes with three very threatening diseases visible all around. The screening camps along with the awareness campaigns in 15 districts of KP should help in limiting the spread of Dengue through enabling people adopt healthy practices like understanding the issue and adopting protective measures.

The situation is still evolving and with contradicting reports from media and government agencies it is very difficult to ascertain the exact situation, nevertheless, the important thing is to be prepared for and be able to respond to any type of situation. PRCS, being auxiliary to the government, will have to be proactive and ready in terms of staff, volunteers, resources and mechanisms to carry-out the response in a smooth and organized manned. This has been guaranteed so far with very good coordination in the forms of communication, sharing of information and meetings with all the RCRC Movement partners as well as proposed Emergency Plan of Action focusing on providing screening services and medicines to those needing it along with distribution of LLINs, Mosquito repellents and IEC Materials (brochures) in order to aware the general public about the diseases and the ways to be safe from them.

In the coming days PRCS plans to:

• Establish 6 Screening in collaboration with the Government authorities in the districts from where Dengue cases are reported

• Provision of medicines, 4,000 Long Lasting Insecticide-treated (Mosquito) Nets (LLINs), 18,000 Mosquito repellents and referral services to those in most need of these

• Awareness Campaign in the 15 districts where there are chances of spread of Dengue