MALARIA LOSING ITS STING IN MUMBAI

BUZZ GETS FAINTER

BMC's Stringent Steps Reduce Deaths & Positive Cases This Monsoon; Other Maladies Flourish

 Monsoon is not over yet, but civic health officials feel the worst of the monsoon maladies may just be behind us. The sting of malaria that usually hits the city in Julyend seems blunted this season.
    "The number of cases have come down drastically in comparison to the same period last year," said Manisha Mhaiskar, additional municipal commissioner in charge of health. If 4,626 patients tested positive for malaria last July, the number up to July 23 stood a little at 1,426. "The slide positivity rate that shows the parasite's presence in general population has fallen to 1.6 from 9 last July," Mhaiskar added.
    The BMC, not surprisingly, is ready to take a bow. After the city was infamously held up as the country's malaria capital last year, the civic authorities took up the massive task of changing this unhealthy equation. Not only were engineers brought in to make suggestions, but scientific surveys were undertaken to detect the presence of the malarial parasite in the general population. "It has been the culmination of almost 10 months of hard work by various BMC departments, including the building proposal cell," said Mhaiskar.
    Doctors in the private sector too acknowledge that the malaria assault this rainy season has been blunted. Dr Hemant Thacker, who consults at Jaslok & Bhatia hospitals, said: "It isn't as if malaria is not there. But it is true that we have so far this year seen only about 40% of the cases we saw in the same period last year."
    BMC officials feel it is due to their elaborate planning that malaria isn't a big menace so far. Every week, meetings were called that were attended by officials from the building proposal department along with the assistant municipal commissioner, the assistant engineer (maintenance), the health post volunteer, the pest control official and civic doctors.
    A senior health department official said the civic body adopted a five-step agenda. The first phase was to repair and spruce up BMC properties to check water stagnation. "Our engineers suggested we add a slope to most of the BMC buildings so that water would flow down," said Mhaiskar. Stagnant water is the ideal breeding ground for mosquitoes.
    The next step was to force others to get their act together. In March 2011, civic officials went around 2,500 construction sites in the city and identified 1.5 lakh labourers. Builders were told to ensure that water did not stagnate on their properties. "Only 10% of the builders were issued stop-work notices. The remaining complied readily."
    In April, the BMC called a meeting of all government bodies that own properties across the city. This included the railways, the airport authority, the port trust, the National Textiles Corporation, the Central Public Works Department and the state Public Works Department. "We had carried out surveys of their structures and pointed out specifically to each of them about what was needed to be done," said a public health department official.
    Every ward officer was told to find out the positive cases in his or her ward and to study the area from where the infected patient came. This enabled the BMC to identify critical clusters. At the same time, community health volunteers were asked to get every fever case from their jurisdiction to the nearest civic dispensary. "This ensured early intervention," said a civic official.
    Civic officials have a theory about last year's outbreak. "The medical community had never insisted on malaria patients taking the full 15-day course of primaquine, which kills every trace of the parasite in the body," said a civic doctor.
    "So, over five years, the parasite load in the public had become high. This contributes to the cycle of infection: a malaria mosquito bites a patient with some parasite load and carried it to the next person," said Mhaiskar. But last year the BMC made it mandatory for all private and public sector doctors to insist on completion of the primaquine dosage.