Our misplaced priorities

We appear to be desensitised to dengue fever, compared to the complications caused by the Zika virus.

FOLLOWING the confirmation that Malaysia recorded its first Zika case in Klang about a week ago, awareness about the virus has increased among the public.

A few days later, a 61-year-old man from Likas, Sabah, died from heart-related complications not related to the infection of the Zika virus, despite having tested positive for Zika. And in Johor Baru, a mother-to-be has tested positive for the virus.

I raised concerns about the local transmission of the Zika virus earlier this year through my writings and lectures as this particular virus is transmitted by a vector Malay­sians are very familiar with, Aedes aegyptii.

Locally, we know this mosquito as the vector for dengue.

To date, statistics released by the Health Ministry show that there was a slight increase of new dengue cases in August (2,249 compared to 2,190 cases a fortnight before) while the cumulative number of cases is lower than that reported during the same period in 2015 (73,839 compared to 80,654).

The cumulative number of deaths due to dengue is also recorded to be slightly lower, with 166 cases in 2016, compared to 219 cases in 2015 during the same period (January to August).

The first patient apparently was infected while in Singapore where she visited her daughter living there who also tested positive for Zika. However, the second and third patients were reported to be locally transmitted infections.

A fellow scientist who recently migrated to Singapore observed that Singaporeans are nonchalant about the fact that our region records high numbers of dengue, but panicked over Zika to the extent of implementing policies to have vehicles sprayed with insecticide when crossing the Johor-Singapore border.

Personally, I think his observation is accurate and could be due to the fact that Malaysians (and Singaporeans) are already desensitised to dengue fever compared to the complications caused by the Zika virus and the hard conversations about sex, abortion and differently-abled children that are necessary when discussing Zika.

Observing the trending topics on social media on this matter, I was left feeling both shocked and sad. The conversation on Twitter revolved around conspiracy theories.

The most notable, if not outrageously irrational, is the claim that the Zika virus is a marketing strategy by a condom-making company to sell more condoms (for the record, this is not true).

The facts about Zika stand as such – that the infection is asymptomatic, i.e. most people would be healthy carriers.

The symptoms, if any, are similar to dengue: rash, fever, and joint pain; with conjunctivitis being the sole hint to a Zika infection in some cases.

Zika can be sexually transmitted, with a highly probable causal link to microcephaly in children of women infected by the virus, a condition of newborns having smaller head circumference and possible neurological disorders to a varying degree, with some causing miscarriages or stillbirths.

Zika is also linked to the Guillain-Barré syndrome, a condition of paralysis in adults.

Looking at the bigger picture, however, this is still a mosquito-borne disease.

Given Malaysia’s history with dengue, this news is bleak.

Partly to blame is our lax attitude towards health in general. To some extent, a review of our civic-mindedness and standard of cleanliness is also required.

As with any such outbreaks, it is always the poor – living in substandard conditions, having poor knowledge in planning pregnancies and lack of access to healthcare – who are most affected.

The way forward with mitigating the diseases borne by mosquitoes in our tropical weather should be multi-pronged.

On the one hand, there is a need to control the population of the Aedes mosquito, which requires increased civic-mindedness among the public to ensure there are no stagnant pools of water around compounds, to report and ensure local councils schedule and implement frequent fogging activities, and the need now to invest in mosquito nets for our houses and beds.

On the other hand, specifically for Zika, we must start talking about comprehensive sex education. There is a need for couples to plan pregnancies and the use of condoms during sex, even among married couples, to mitigate the transmission of the Zika virus.

The difficult discussion on abortion has thankfully begun with a statement by the Federal Territories Mufti that abortion is justified in cases where the mother is infected with the Zika virus that is linked to microcephaly; following consent from both parents who have obtained a clear understanding about the issue.

The Health Minister has since then called for a national fatwa on the issue, something that I am observing with interest as this marks an intersection between science and religion.

I wish to also highlight here that abortion is legal in Malaysia in cases of such pregnancies causing harm to the mother and/or foetus.

While such decisions should not be taken lightly, informed decisions and choices should be in the hands of women in consultation with their respective partners.

In light of a potential epidemic, we should all place our priorities on not just our individual health, but also that of the public and of future generations.

Lyana Khairuddin is an academic with a local public university who runs to keep being optimistic about Malaysia. The views expressed here are entirely her own.

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Opinion , Lyana Khairuddin , columnist


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