There was no dearth of enthusiasm at the government level in country’s health sector over controlling malaria. Similarly the personnel of special consortium of 21 NGOs engaged in this work were floating in this tide of enthusiasm. Even many started jumping over the preparation for declaring the country malaria-free. Just at this time, upsetting everything, malaria has broken out in three hill districts which are at the top of malaria-prone areas. To bring the epidemic under control, the health department employees and officials involved in this work are spending sleepless time. A special type of mosquito nets distributed free of cost for protecting people from malaria are being blamed to be behind this epidemic. It is alleged that only to plunder money, these ‘illegal’ mosquito nets were pushed into the hands of the people of malaria-prone area. It is learned that question has now arisen in the government itself about the effectiveness of this special mosquito nets to protect people from mosquito’s spreading malaria. These are one kind of insecticide treated mosquito nets. Its name is LLIN (long lasting insecticidal nets) mosquito nets. In phases since 2011 as many as 65 lakh special mosquito nets were distributed in three hill districts while 7.5 lakh more are awaiting distribution. More than one source at health department said from earlier time question arose about the effectiveness of insecticides in the mosquito nets. But all were silenced in the face of the influence of a section of officials and suppliers of the mosquito nets. Nobody has further dare to say anything about it. Even some were on the brink of loosing jobs. Meanwhile, entomology department of agriculture ministry has claimed that taking into consideration the health risk they did not approve those insecticides treated mosquito nets. Lakh of mosquito nets have been brought illegally. But the division concerned of the health ministry has claimed that very much in consideration of public health they did not care for approval. Director of health department (disease control and chief executive for malaria control) Dr Benozir Ahmed told Kaler Kantho that since the beginning of the year 29,396 people have been attacked with malaria in three hill districts – Rangamati, Bandarban and Khagrachari and during this time 40 people died. In the meantime 22 died among the 10,994 people attacked in last July. And in the current month 3240 have been attacked and 7 have died. In view of rapid rise in attacks and deaths by malaria, departmental emergency has been declared by health department in three hill districts. Directive has been issued by health department to civil surgeons of Chittagong and Cox’s Bazar including three hill districts to undertake emergency programme to check malaria. The leave of all officials and employee of health department in those areas has been cancelled until further order. At the same time special team of health department has been sent to hill area to monitor malaria situation. Director of the Health Department said steps were taken to ensure the presence of doctors and others in Malaria stricken area. To control the situation, a team led by me visited the hilly areas. That time, meetings were held with local health and administrative officials. Special committee was formed to tackle the issue. Medicines were sent to hilly districts on emergency basis apart from distribution of insecticide treated mosquito nets. Replying to query as to why the controversial mosquito nets are being distributed, he said those are being sent to the affected areas on the temporary basis followed by an initiative to find out an alternative solution. About detrimental effect of the said mosquito net, Dr Mahmudur Rahman, Director of the Institute of Epidemiology, Disease Control and Research (IEDCR), said no research was conducted in this field. A question may be easily raised as to the effectiveness of the mosquito net amid the unbridled spread of Malaria. Sources said the said insecticide treated mosquito net is supposed to control 90 percent Malaria carrying mosquito. But a recent study shows that such power came down to 26 percent before expiry of date. Similarly, a mosquito is supposed to be knocked down if it comes in contact with such mosquito net. De facto, none of 100 mosquitoes inserted into a net was knocked down.” According to the Health Department, if one mosquito net causes the death of 100 mosquitoes per day, a total of 65 crore mosquitoes should be killed. In such case, the Malaria would not have turned into epidemic form. It is necessary to have prior permission from the Agriculture Ministry’s department concerned to import, produce and market the pesticides and other toxic items. But this obligation was not followed in case of importing the toxic mosquito nets. Besides, an insecticide named KO Tab distributed by the government to be used in the old mosquito nets in the hilly areas does not have such permission. Md Shah Alam, pesticide regulation officer of a department under the agriculture ministry, said “I am surprised to see as to how a department of the government is procuring, distributing and using lakhs of insecticide treated mosquito net violating the ban imposed by another department of the Republic. Taking into consideration its injurious effect, we did not permit the toxic mosquito net.” Dr Benazir Ahmed, director (disease control) and Malaria Control, said the expiry date is applicable to the insecticides too. He said 65 lakh insecticide treated mosquito nets were distributed from 2011 as of now with various global fund and Health Population and Nutrition Sector Development Program (HPNSDP) project. Sources at the Directorate of Health said each mosquito net was bought at $ 3 to be distributed in Malaria affected areas. The officials concerned with the project are seen to be very enthusiastic to distribute the mosquito nets. According to a report, as many as 37, 35, 905 long lasting insecticidal nets (LLIN) were distributed as of April. Besides, 5 lakh mosquito nets were replaced and 15,63,984 nets soaked with toxic water were distributed. Many officials concerned with the project said they have no confusion about the effectiveness of the nets but the problem lies with the environment of our country. In last year, number of Malaria affected people in Khangachari was 2261 which rose to 5,296 this year. Similarly, 3831 people were affected in Rangamati last year while the number is 7,148 this year. In Bandarban, the number of affected was 4,647 but it is 10,321 this year. Although 13 districts are identified as Malaria prone area, 80 percent patients are in 3 hill-tract districts in Chittagong. Mosquito breeding in the areas with water-logging, use of controversial mosquito net and slack in treatment are responsible for Malaria outbreak. (Courtesy: Kaler Kantho)
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