Door-to-Door; Dengue Fever

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Medical Students and community members participate in dengue fever prevention efforts in Havana, Cuba (photographer, Joanna Mae Souers)

January, classes were suspended for medical students throughout Havana.  The dengue epidemic had reached its height and health officials decided it was time students joined the prevention efforts; door-to-door.  It is not the first time.  Medical students in Cuba have frequently been called upon for their volunteer services and solidarity to the community during epidemics and medical emergencies including Hurricane Katrina and the Chernobyl Disaster, political campaigns including “Bringing Home Emilio” and “Free the Cuban Five” and interests of state like harvesting potatoes and planting citrus trees.

When we first hit the streets we were armed with knowledge of disease prevention and assigned individually or in pairs to a city block.  We were oriented to visit each household daily, talk to each family about dengue prevention, teach signs and symptoms, and remit anyone in the home with fever to their local health center.  We were also given instructions to enter the homes, revise water tanks, and dispose of any items that could serve as fresh water containers where mosquitoes deposit their eggs.

On my own city block I had seen several issues solved and few to be addressed.  For example, I successfully mapped out the community and spoke face-to-face with at least one member of every household.   People were very cooperative and happy to receive us in their homes.  It was most important to see if anyone had come down with a fever or noticed any problems in the community concerning vector control and focal points where water was collecting and mosquitoes could be potentially breeding.

Most Cubans are well educated on the signs and symptoms of dengue and the methods of prevention.  Even before we speak to them, they have already heard the information from their local nurses, doctors, door-to-door inspectors, schools, community meetings, television, radio, and newspapers.  We may not have any new information to transmit to them, but we are able to bring to their awareness the severity of the epidemic and the importance of their continued cooperation in further prevention efforts by creating a presence in the streets.

The student efforts were so important because specialists were concerned that if the numbers did not return to a record low by the time the rains came in March, the epidemic would be out of control and cost many more lives.  Thanks to the students and the cooperation of the community our prevention efforts made a difference and progress was made just by going door-to-door.  The number of cases around the city steadily declined as cases were reported and prevention efforts were enforced.  The campaign lasted just a month, and in February with the epidemiologists satisfied and the community safe from dengue, we were on our way back to classes.

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