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People's Program to Halt Dengue  

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29 July 2016 12:48 WIB

Aedes aegypti mosquitoes larvae. REUTERS/Josue Decavele

TEMPO.CO, Jakarta - Arliansyah has always been vigilant during rainy season. He makes frequent checks around his house in Banjarmasin, South Kalimantan, for puddles that can be the perfect breeding ground for yellow fever mosquito (Aedes aegypti) larvae. He and his family clean the bathroom regularly and sprinkle larvicide to kill the mosquitos.

He admitted he never cared before, but he experienced the ordeal of having his whole family fall ill to the dengue virus in 2008. Arliansyah, his wife, and their two children had to get immediate medical treatment after they were bitten by the Aedes aegypti mosquitos.

"My youngest child and I were lucky. We only required outpatient care. But my wife and our first-born were hospitalized for a week at the general hospital," he said. At the time, he was the head of the neighborhood association, RT 19, in the Alalak Utara area of Banjarmasin.

After he recovered, Arliansyah noticed that a similar virus struck a few other people in his neighborhood. He said that it happened because of one reason: The people did not care much about the cleanliness of their area. 

In 2009, two people contracted the dengue hemorrhagic fever, a more severe case of dengue fever. "And then there were three people in 2010. Every year, people regularly get dengue fever," he told Tempo.

By 2012, Arlinsyah felt like he had had enough. The neighborhood chief was troubled by the worrying trend so he consulted with the former head of the Alalak Tengah community health center (puskesmas), Dwi Atmi Susilastuti. 

He complained about the widespread dengue fever cases in his area despite the occasional mosquito fogging. Atmi responded by offering him training as a 'juru pemantau jentik' (larvae monitoring specialist), or 'jumantik'. As a jumantik, Arliansyah is required to monitor for larvae and their breeding ground in his home to stop them from developing into Aedes aegypti mosquitos. 

Atmi asked him to invite people to volunteer as a jumantik and form the health rapid response team. Arliansyah quickly agreed and gathered the people in his neighborhood to commit to cleaning their surroundings together. 

Atmi gave them workshops on the benefit of having a clean environment. The doctor shared information on how to detect mosquito larvae and stop the spread of dengue virus early. They started an independent jumantik program in the same year.

With Arliansyah's encouragement and Atmi's knowledge of healthcare, 70 homeowners at Alalak Utara became interested in volunteering as jumantik. "Some were really enthusiastic about their new task as jumantik," said Arliansyah.

According to Atmi, volunteers have to know what larvae look like and the kind of places that might become perfect breeding ground for mosquitos, as well as how to stop their spread with larvicide. Meanwhile, the neighborhood also formed a rapid response team to give first aid to babies and pregnant women who get the virus. "There are five people in the rapid response team," she said.

To ensure that the program runs smoothly, Arliansyah often gives short briefings at gatherings, such as during religious lectures or other social meetings. He would ask people to remind each other of the cleanliness of their environment.

Atmi stuck on a sticker checklist in each house for things they need to do to monitor the mosquito larvae. "It is easier for people to monitor if they have a reminder of what they should do," she said.

However, because the independent jumantik program of RT 19 is a pilot project for the local puskesmas, they do not have the funding to print 150 stickers. Atmi related how she had to pay the printers out of her own pocket.

Once a month, a puskesmas staffer comes to the area and goes door-to-door checking on people and answering any questions they might have. Atmi explained that she would send someone over any time they found mosquito larvae in a place that requires immediate fogging. 

Moreover, Atmi added that the Alalak Utara residents had become more concerned with the cleanliness of their environment. "And because they do their own monitoring, they realize how important it is to prevent their family members from getting dengue," she said. Arliansyah also holds routine events where the locals clean the area together.

Arliansyah said that he could not be prouder of the independent jumantik program of RT 19. He has not found cases of dengue fever or dengue hemorrhagic fever since 2015. 

Meanwhile, Atmi explained that the neighborhood of Alalak Utara managed to evade the dengue epidemic that ravaged Banjarmasin. "There has been an increase of dengue fever cases in the city," she said. 

According to data at the local health office, dengue fever and dengue hemorrhagic fever cases in Banjarmasin totalled 653 and 75 respectively in 2015. Five people died because of the dengue virus. This was a significant increase from the year before. In 2014, 99 people contracted dengue fever, and only 11 got the more severe strain. 

Arliansyah now encourages other neighborhoods to adopt the program. "I kept receiving good responses from them, but they have yet to start the jumantik program," he said. 

Despite the success, Atmi had to move to the Sungai Jinga Puskesmas in 2014. The program at Alalak Utara is not as active as when Atmi was still in charge. "If the doctor doesn't go out to the people, the program will be useless. Doctors have more influence than a neighborhood chief," Arliansyah said. (*)

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