Dengue is a mosquito-borne disease caused mainly by the female Aedes aegypti. Some other species including Aedes albopictus, Aedes polynesiensis, and Aedes scutellaris are also vectors of dengue. Dengue has been rising over the last half-century due to factors, including global trade and travel, urbanization, population growth, and climate change, that provides conditions for the proliferation of the vectors and viruses.
Mosquito, the vector, mostly lays eggs on clean and stored water, especially in water containers. In Nepal, it is nearing an epidemic situation – Sunsari, Jhapa, Makawanpur, and Chitwan districts have been mostly affected by this disease. Almost 4,932 people have been infected by dengue, and many are yet to be recorded. The Ministry of Health has called every stakeholder to come and help contain this disease as it has become impossible to prevent by Health Ministry alone. The chief research officer at the Nepal Health Research Council, Meghanath Dhimal said, “Climate change in the Hindu Kush Himalayan Region is the major cause for the increasing dengue cases. The dengue virus sustains in temperature above 18 degrees Celsius. As the temperature exceeds 18 degrees Celsius in many areas of the country, the risk of the virus has gone up.” Rise in temperature as a result of climate change is helping these mosquitoes to expand their geographic ranges. Earlier, this disease was common in Terai, but now, it has started to be seen in the hilly regions as well.
Dharan has been declared as a crisis-hit region after rampant incidents of dengue. The rise in temperature and change in rainfall pattern cannot just be deemed the reasons for the outbreak of this disease, but water scarcity is also another major cause. Due to water scarcity, people are compelled to store water or rainwater in vessels; most people are unaware of the mosquito and keep the vessels uncovered. Since these species of mosquitoes breed in stored water, they lay eggs wherever they find clean water. Dharan sub-metropolitan city requested the citizens to throw the collected water, but people couldn’t do that because they have to rely on rainwater for daily usages, especially during the monsoon. The administration blamed local people for their carelessness in the spread of the disease. People’s living standards like proper housing, access to clean and adequate water source, and awareness about health care have also exacerbated the cases of dengue.
Now with the disease seen even in the hilly region of Karnali Province, it is essential that every stakeholder, especially, the provincial government pays attention to it and contain the disease before it gets out of hand. It would be worse there than in other regions because of the lack of medical facilities and low socio-economic status of people.
Dengue is no longer a personal or sanitation issue but a nationwide health concern. However, the government is yet to pay ample attention to control it. It has not come up with any effective action plans to fight the dengue spread but has launched ‘mosquito search and destroy’ program. The government doesn’t have sufficient financial support and human resources to conduct such a door-to-door program across the country. Similarly, mosquitos have never been completely destroyed by such programs before.
Lack of accessible and affordable health care services, awareness, poverty, inefficiency of governing bodies, and the effects of climate change becoming intense with every passing decade are some of the reasons pushing the disease out of control in a poor country like Nepal, which cannot cope with these effects easily.
Climate change has become one of the greatest threats to Nepal as it has been facing heavy impacts of climate change in recent years. The rise in temperature, heavy rainfall, flooding, drought, drinking water shortage, and tornado are some climatic problems Nepal has been going through. The tornado and flood massively affect the Terai region while water scarcity hits most of the hill region. To top it, dengue has come as an epidemic. The spread of dengue has increased in terms of geographical region. The effects of climate change may be worse in the coming days with the spread of this disease in places which otherwise had not seen or heard of it before. With lessons from the disaster, including tornadoes, floods, water scarcity, and dengue, the government of Nepal has to make an action plan and policies immediately.
The government should not only prioritize regular development but need to focus more on human security, food and water security, and environmental sustainability. In the name of physical development and urbanization, human beings have already disregarded environment, but it is high time that we take action for a sustainable world for all.
Author: Prabha Poudel
 पहाड उक्लियो लामखुट्टे, Nagarik Dainik, page-1, September 5, 2019