Fighting dengue is nothing new to health care professionals across rural India. I am Saritha Purushothaman, a pediatrician at Sri Sathya Sai hospital in Andhra Pradesh, India. Sri Sathya Sai hospital is part of a medical mission established by Sathya Sai Baba delivering free medical care to all patients irrespective of area, country or economic status. The General Hospital’s Pediatrics Department takes care of the children and neonates from the surrounding villages, as well as visitors who come to the area.
We have a level 1a neonatal care unit and pediatric services – secondary level and have been actively promoting good practice in infant nutrition and health in the community. This has contributed to a considerably reduced neonatal and infant mortality, as well as serious childhood illness in the area.
The struggle against dengue affects all ages
This year, we treated 44 children with severe dengue, many of whom were treated for shock and hemorrhagic fever. In addition, innumerable children were treated on an outpatient basis. Since our hospital is 70km away from the nearest medical care center, we cannot transport children easily. Thankfully, we have availability of platelets and blood due to the presence of a super specialty hospital 5 km away. We have to conduct our own diagnosis based on clinical examination, blood count, and rapid card tests.
We were able to save all the children, and I feel the crucial steps were fluid management and lab services around the clock to check hydration levels and platelet counts, which we would record on a chart along with blood pressure and pulse.
To help address the problem of dengue in the community, we have informed the government system of every case and kept a record at the hospital to keep track of the propagation of the virus. We are counseling every parent coming to the hospital about the illness, and providing tips about keeping living areas clean. We also gave a presentation to children at the local school.
The most important thing missing to help address this issue in rural areas is educating the population about the disease itself and providing awareness regarding prevention. Our hospital takes care of the villagers, many of whom are illiterate – especially women – and unknowledgeable about these issues. There is a need to educate them in a way they can understand, and to get them motivated to change their habits in hygiene, waste disposal, attending medical facilities, etc.
There is also a need to better train hospital staff doctors and nurses about dengue fever symptoms and danger signs, and the natural course of the illness. Equipping hospitals with enough supplies to respond to fluid management needs and blood/platelets transfusion needs is crucial, as well as making the general treatment guidelines for dengue – such as the ones available on the Indian Government Ministry of Health website.
My greatest wish is not to see any more dengue epidemics!