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Gregory Rose (Cambodia): contracting dengue while working in Cambodian slums

Gregory Rose, now Health & WASH Technical Team Manager at the British Red Cross, had been working as a consultant for WHO in Cambodia when he was struck with dengue fever. In this patient testimonial, Gregory Rose speaks about the risk posed by mosquitoes for those in poor areas as well as the far-reaching economic consequences of being ill with dengue.

I had been working in a slum in Cambodia, now demolished and replaced with luxury accommodation. Back at the time, the local slum population was surrounded by standing water, collecting in coconuts, old tyres, water jars and the general environment. Probably the most efficient item at collecting water are South-east Asian earthen drinking water jars. Unfortunately, as they are reasonably clean and dark, the Aedes mosquitoes, which spread the dengue fever virus, like them.

In the absence of environmental approaches, the main protection against mosquitoes is insecticide. But in the rainy season, working outdoors, you are often being washed and often walk though water - even if you are vigilant about spraying insecticide, living in such conditions means that you are likely to become a target for mosquitoes which bite in the morning and late afternoon.

Eventually, I fell ill myself. The first sign I had was that of terrible body aches. I initially interpreted this as the effects of alcohol as I had consumed a small amount the day before, though I had never experienced such an immediate hangover and after so little alcohol (bad wine, perhaps, I thought)?

By morning, I wasn’t moving anywhere. There was intense pain behind my eyes, my body ached and there was a strange patchy redness on my palms which I found itched slightly. I was also exhausted. A nursing friend helped me with rehydration and the pain, and I just had to wait until I was strong enough to get back to work.

Recovery took several weeks and this is one of the main issues with dengue. Clearly there are deaths, though these may be a small fraction of all cases albeit worse where there are recurrent outbreaks. But even for those who have a milder experience, they are likely out of work for weeks.

This has significant economic consequences for families like those in the slums. Fortunately, in my personal experience, I was covered by my employer’s insurance whereas others, self-employed, relied on what they could bring in daily in order to feed themselves. In the slums of Cambodia where I worked, the local community was one which bought cooked rice, rather than grains, as they could not afford the fuel to cook it themselves, and being afflicted by an illness such as dengue fever for weeks would significantly impact any dweller's ability to afford essentials such as food. In that respect, my disease was relatively benign.

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