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On expiry of 48-hour ultimatum to Chua Jui Meng tomorrow, DAP will convene an all party/NGOs/mass media meeting to launch a high-impact multi-prong campaign to create nation-wide alert of the worst dengue epidemic in the nation's history among Malaysians particularly urban Malays who suffer the highest incidence of dengue cases and deaths


Media Conference Statement
by Lim Kit Siang

(Penang, Friday): Yesterday, DAP issued a 48-hour ultimatum to the Health Minister Datuk Chua Jui Meng to declare a dengue epidemic and launch a high-impact anti-dengue counter strategy or DAP will initiate a multi-prong campaign to create nation-wide dengue alert among Malaysians particularly among urban Malays who suffer the highest incidence of dengue cases and deaths.

On the expiry of the 48-hour ultimatum to Chua tomorrow, DAP will convene an all party/NGOs/mass media meeting to launch a high-impact multi-prong campaign to create nation-wide alert of the worst dengue epidemic in the nation's history among Malaysians particularly urban Malays.

The severity of the worst dengue epidemic in the nation's history was again highlighted today when the New Straits Times reported that two Malay children, a boy and a girl, died of dengue at the Ipoh Hospital in the new year.

Perak State Health director, Dr. Abdul Razak Kechik said Nurul Shazlyn Ab. Fairul Hisman of Kampung Ahmad Said Tambahan died last Friday (3.1.2003) while Adam Danial Zarisham of Kampung Manjoi, Ipoh died on Tuesday (7.1.2003).

These are two dengue deaths in the Ipoh Hospital alone in the first seven days of the new year. What about dengue deaths in other hospitals in Perak and in the other states in the whole country in the new year?

Nurul Shazlyn's mother, 24-year-old Missda Zulkaarnain, told the NST that the Ipoh Hospital had treated the girl for normal fever, and only confirmed three days later that it was dengue - by which time it was too late, as her condition had become critical.

Missda's complaint has become too frequent and heart-rending in Malaysia in the past six months of doctors who did not immediately suspect that patients suffering from fever could be dengue cases only to discover too late to be able to save lives - demonstrating that the Health Ministry's failure to launch a high-impact media compaign to create nation-wide alert and awareness about the worst dengue epidemic in the nation's history has not only lulled the general public but also medical practitioners into complacency about the lethal threat of the dengue epidemic.

I have said publicly that from the various official accounts and media reports, there were over 30,000 dengue cases and over 66 dengue deaths last year, making it the worst dengue epidemic in the nation's history - as the worst fatalities from dengue in previous years were 58 in 1998 and 50 in 1997.

It is most significant that neither Chua nor any Health Ministry official had made any attempt to challenge or question these estimates, which is the strongest proof of their veracity.

Chua broke his long silence on the dengue outbreak yesterday, not to belatedly create the nation-wide alert about the worst dengue epidemic in the country but to claim that fingers should not be pointed just at his Ministry as the Housing and Local Government is also responsible in fighting dengue.

What I find totally unacceptable, inexcusable and unforgivable is not merely his attempt to exonerate himself from the unchecked rise in the number of dengue cases and deaths, but his most irresponsible attempt to play down the severity of the worst dengue epidemic in the nation's history, as it could only lead to more avoidable deaths and as if Malaysians have no reason to be upset that the country recorded over 30,000 dengue cases and over 60 dengue deaths last year and should be instead be grateful and thankful to Chua!

I feel so outraged that I have decided to call this media conference when I had intended to take a day's rest as I cannot bear the thought of more avoidable deaths in the current dengue epidemic because of the continued irresponsibility of the Health Ministry and other government departments. Why should more lives be lost in the dengue epidemic because of the irresponsible attitude of the Health Minister?

I agree with Chua that fingers should not be just pointed at the Health Ministry for the unprecedented toll of deaths in the dengue epidemic, as under the principle of collective responsibility, all Ministers - including UMNO Ministers - are also responsible, especially as before the Cabinet meeting this week on Wednesday, I had proposed the establishment of a Cabinet Committee to deal with the dengue epidemic.

Chua's attempt to say that the dengue situation in Malaysia is endemic and not epidemic is the height of Ministerial irresponsibility, and this ground alone, he should be removed from the Cabinet.

Dengue is endemic in Malaysia and this is the reason for the high number of annual dengue cases and deaths, as for instance, the following dengue statistics for the country from 1991 - 1996:

Year            No. of cases               Deaths

1991            6,628                            39
1992            5,473                            24
1993            5,615                            23
1994            3,133                            13
1995            6,543                            28
1996          14,255                            30


However, in 1997 and 1998, dengue is no more endemic but reached epidemic proportion when it recorded the following figures:


Year           No. of cases                Deaths

1997              19,544                          50
1998              27,379                          58


How can Chua claim that the dengue outbreak last year is only endemic and not epidemic when there were over 30,000 cases and over 66 deaths?

What I also find most shocking is the deliberate misinformation by Chua yesterday about dengue fatalities, saying that Malaysia has been able to keep dengue haemorrhagic fever (DHF) case fatality rates to 10 per cent (Berita Harian) while claiming that in other developing countries, the DHF case fatality rate is as high as 50% with some countries reaching 70%. (Sin Chew Daily)

Why is Chua comparing Malaysia with the worst countries in the world instead of with the best - or just with Malaysia's own past public health record?

Chua seems to be proud that Malaysia's DHF case fatality rate for the worst dengue epidemic last year was 10 per cent, when the World Health Organisation (WHO) had declared that "With appropriate intensive supportive therapy, mortality may be reduced to less than 1%". (http://www.who.int/inf-fs/en/fact117.html)

Chua should refer to the same WHO website about information on DHF case fatality rates, viz:

"Some other statistics (world):

  • During epidemics of dengue, attack rates among susceptibles are often 40 - 50%, but may reach 80 - 90%.

  • An estimated 500 000 cases of DHF require hospitalisation each year, of whom a very large proportion are children. At least 2.5% of cases die, although case fatality could be twice as high.

  • Without proper treatment, DHF case fatality rates can exceed 20%. With modern intensive supportive therapy, such rates can be reduced to less than 1%. "

Chua should explain why Malaysia's DHF case fatality rates is 10 per cent and he is very proud of it when WHO said that "With modern intensive supportive therapy, such rates can be reduced to less than 1%"!

(10/1/2003)


* Lim Kit Siang, DAP National Chairman