My name is Kayla de Freitas and I am from the the Rupununi region of Guyana in South America. The main town of this region, where I live, shares a border with Brazil and, like many border regions, it faces the issue of porous borders, including issues such as the mosquito-borne diseases of dengue and malaria which are prominent in the region.
I want to share the collective experience of dengue which we face in this region, and share testimonies which are both personal and of friends from my region. The narrative below is a collection of experiences of dengue in a remote area of the world.
I want to highlight the feeling, for those who are suddenly taken ill, of isolation, fear and frustration at the lack of proper diagnosis, limited treatment and lack of options for severe cases.
Firstly, I want to share a mother’s experience of heartbreak, the feeling of helplessness as her child develops the symptoms of fever, rash, loss of appetite and crying out in pain at any light. Think of the terrifying feeling of being completely out of control, including not being sure exactly what it is because the hospital has run out of testing kits for months. And then, being left with no other option but to ride it out and juggle the administering of painkillers to a young child, which is all the trickier.
On another occasion, being blinded with fever and pain behind her eyes, a young woman explains she wants to pull her eye balls out for the pain. Paracetamol – being the only treatment option – remains a complete joke at combating the pain from the disease which is dubbed ‘break bone fever’. The itch that accompanies the disease is even worse in the humid heat of the tropical climate and it feels terrible because patients simultaneously want to be held but cannot bear the touch of someone else.
For our community, there is a constant fear of hearing stories of people we know getting severe cases of dengue and our local hospital not being able to do blood transfusions during episodes of haemorrhagic dengue, which is likely to result in death. The nearest hospital being in Brazil, the trip takes a little over an hour from our border town and this gives little comfort to our community as there is not only the distance but also cross country bureaucracy to deal with. Guyana’s biggest hospital is a two-hour flight away and the doctors are reluctant to send severe cases visa air.
So, in my community, when you begin to feel the symptoms of dengue, it is terrifying and frustrating. It's scary because you feel ill and are aware that you may have contracted dengue, but more importantly, it may be the second or third time a patient is infected: you worry because the more strains you contract, the higher the risk of developing severe dengue. This was my case. Then, you are faced with the frustration of going to local hospital, but there are no dengue diagnostic kits available there. The frustration mounts as you hear the nurse say that there is a dengue epidemic now, and so the question is: why are there no kits now, nor for the past 5 months?
People share advice on local remedies. People will tell you to drink coconut water or make tea from green papaya. As a desperate patient, you have no confirmation that this might help, but you would try anything. If you are alone with dengue you barely have the energy to get yourself a cup of water, much less go find a coconut tree to try to lash one down, cut it open with a machete before you can drink the water.
The inaccessibility of remote areas makes this disease dangerous, isolating and frustrating. There needs to be a more comprehensive effort in controlling the spread and combating the disease. We need to strengthen a holistic effort which includes maintaining and environment that would dissuade the mosquitoes being able to reproduce.
This is a priority to ensure that communities such as mine remain safe from dengue.