With only one public hospital and a few private clinics, medical officials in the town – which borders Ethiopia and Somalia – said the facilities were congested with dengue fever patients and they were unable to cope.
“Mandera District Hospital is congested, many patients and panicked residents are streaming into the facility, it’s the only public hospital, all wards are occupied above capacity,” Mohamed Sheikh, the provincial public health and medical officer, told IRIN. “At the moment, more than 5,000 cases have been recorded, and a large number of other cases – about half of those attending Mandera government hospital – have been treated in the few private clinics.”
The UN World Health Organization (WHO) describes dengue as “a mosquito-borne infection that causes a severe flu-like illness, and sometimes a potentially lethal complication called dengue haemorrhagic fever”. The WHO estimates some 50 million people are infected with dengue across the world every year.
A statement by the Ministry of Public Health and Sanitation on 26 September said four deaths from the disease had been confirmed but, according to Mandera residents, at least 10 people have died since early September when the outbreak started.
Sheikh said more deaths resulting from the viral infection could have occurred in homes or at private clinics.
“Symptoms of dengue fever case are easily mistaken for malaria and anti-malaria drugs were prescribed to many suspected patients for two weeks, then we got concerned when we received more cases, conducted tests last week and confirmed almost all our patients required new treatment for this viral infection,” Sheikh said.
In the absence of a specific treatment for dengue fever, Sheikh said, health facilities were providing supportive treatment to the infected: Paracetamol for those presenting with fever, fluids for those dehydrated and antibiotics for those with infections. He added that the fever often subsides after seven days.
Sheikh said the disease was believed to have spread from neighbouring Somalia where several deaths and cases have been reported this year.
He said health workers had been mobilized to help in treatment and to tackle poor sanitation, which provides an ideal breeding ground for mosquitoes, the disease’s vectors.
“Elimination of mosquitoes by chemical spraying is the surest, [most] reliable approach to eliminate the spread of dengue fever; it’s easily contracted from a single bite, mosquito nets cannot guarantee full prevention,” Sheikh said.
A community nurse at the Mandera District Hospital, who requested anonymity, said more than 100 patients were spending nights in the hospital’s compound while hundreds more were unable to access treatment as they could not pay the fees charged for diagnosis, treatment and admission.
“Many people are suffering at home, some have died; five cases known to me are from poor families, the government should consider this a disaster and waive all fees,” the nurse said.
Abridirizak Dualle, programme manager of the Rural Agency for Community Development and Assistance (RACIDA), an NGO, said the outbreak had affected almost 75 percent of the residents of Mandera, who were already struggling to cope with severe drought.
Dualle said small businesses and subsistence farming along Dawa River – which runs through the town – as well as school attendance had been affected.
“I have just recovered from dengue fever and returned to work to find that eight of my colleagues who were working on a number of drought mitigation projects are all at home sick; almost all families in Mandera central are either sick or affected,” Dualle said.
Ibrahim Maalim, a local leader, urged the government to quickly establish mobile clinics at Buruburu, Township, Tawakal and Kamor, the worst-hit areas of Mandera.
Abdi Mohamud, the Mandera central zone education officer, said a crisis meeting was convened on 26 September following reports that parents were withdrawing their children from school for fear they would contract the fever.
“Five teachers from this zone have contracted dengue fever; they are unable to work. I have yet to find out how many children are affected,” Mohamud told IRIN.
A teacher at Mandera Township Primary School said only three out of 22 teachers had reported to work while more than half the school population of 1,900 pupils had not turned up.
“The matter is very serious, fewer than 900 pupils attended classes today. In one class 20 out of 84 pupils were present; not all are sick, some are assisting sick relatives,” said the teacher, himself just recovered from the disease.