 Hello and welcome to the press launch of Vector Awareness Week, which is celebrated from May 23rd to May 27th. I am your host, Fenel Neptune. Today, we have a first panel who is going to discuss Vector Awareness Week and also vector-borne illnesses. On the panel, we have the Medical Officer of Health, Dr. Glensford Joseph, the National Epidemiologist, Dr. Michelle Versua, also the Deputy Chief Environmental Health Officer, Cheryl Zendromaine, and also the Environmental Health Officer for Vector Control, Charlotte Charles Leia. Welcome everyone to this program today as we speak on Vector Awareness Week. To start off, we will call on Charlotte Charles Leia to speak on Vector Awareness Week. As we launch our annual Vector Awareness Week, this national initiative from its inception in 2013 has brought together a network of partners and collaborators which have made Vector Awareness the success that it has been for the past nine years. This annual week of observance is aimed at increasing awareness of vectors and vector-borne diseases on Island and also to encourage clean and healthy environments to decrease the incidence of vector-borne diseases amongst our population. Though our many advancements in technology and medicine, the COVID-19 pandemic and many other public health emergencies have continued to humble us as a society as we lament on our susceptibility to many infectious disease threats. Thus, community cooperation and collaboration is essential to detect and alert response to outbreaks and manage the risk of emerging diseases such as dengue, Zika, and leptospirosis, just to name a few. I am convinced that if communities are provided with adequate information backed with the legislative tools aimed at reducing and controlling mosquito-borne diseases and, of course, improving general sanitation, we can significantly reduce the risk of vector-borne diseases. This highlights three key aspects of controlling the spread of diseases within any population. That is collaboration, trust, and community engagement. Collaboration not only with other system ministries and agencies but also community groups. Collaboration is required across many disciplines and at all levels of government and society. Thus, in public health circles, it is well known that outbreaks start and end in communities. Bearing this in mind, we announce the theme for this year's Vector Wellness Week, and some anuditri vermin pupli bon santé. This week of observance should not merely be seen as one of activity during a year of 365 days but rather the start of an exciting journey as we come together as St. Lucians to keep our communities safe and free from vectors and vector-borne diseases. Thank you very much, Mrs. Charles Leon. As we go ahead and we realize you mentioned about vector-borne diseases, I now call Dr. Nishita Swar to provide data trends as we listen to Vector Wellness Week. Thank you, Ms. Neptune, and a pleasant good morning to all viewers and listeners. It really gives me great pleasure to be here this morning in recognition of Vector Wellness Week as vector-borne diseases are considered quite a significant public health burden. According to the World Health Organization, these diseases account for 17% of all infectious diseases and result in approximately 700,000 deaths annually. Dengue is probably the most prevalent of vector-borne diseases, and over the last two decades, the reported cases have increased significantly, from just over 500,000 in 2000 to 2.4 million in 2010 and 5.2 million in 2019, that here being the highest number of cases to ever be reported globally. Unfortunately, the burden of these diseases is highest in tropical and subtropical areas such as ours. And over the last two decades, the world has seen an increase in emerging and re-emerging vector-borne diseases such as dengue, chickenganya, zika, and West Nile virus. Dengue is endemic to St. Lucia and is probably the most prevalent above viral disease locally. Although cases are detected throughout the year, the incident tends to peak during the rainy season. Over the years, the Ministry of Health and Wellness, together with our stakeholders, have managed several outbreaks of dengue, the most recent and largest being in 2020, where approximately 1,321 cases were diagnosed with an incidence of 729 per 100,000. Four deaths were recorded during this outbreak. By our estimation, this is a significant under-reporting of cases. This number was unprecedented. As previous outbreaks were calculated with an incidence of 448 and 165 per 100,000 in 2011 and in 2013, respectively. In 2014, St. Lucia witnessed the introduction of the new and emerging chickenganya virus to the island. That year, the island recorded 238 confirmed cases. Since then, cases have been confirmed sporadically throughout the years. The Zika virus, also new and emerging at the time, was first diagnosed in St. Lucia in 2016, where a total of 65 cases were confirmed in St. Lucia. Since then, we have not recorded additional cases, although testing is ongoing. Although not endemic to St. Lucia, malaria is another above viral disease, which we have recorded in St. Lucia, sorry, on an annual basis. Fortunately, these cases have been imported, meaning that these are cases who are infected elsewhere and come into St. Lucia, and due to the efficiency of our surveillance system and our vector control program, there have been no local transmission. Leptospirosis, also considered a zoonotic disease, is a bacterial infection transmitted by animals. Rodents such as rats, in addition to dogs, serve as important vectors in both urban and agricultural settings. The transmission of Leptospirosis occurs most often to contact with contaminated water by urine from infected sources. The Pan-American Health Organization estimates that approximately 500,000 cases of Leptospirosis are diagnosed annually, and that numbers tend to soar post-clubs and hurricanes. Persons exposed to infected waters for recreational as well as occupational purposes are also at risk of infection. In St. Lucia, Leptospirosis is endemic, and the Ministry of Health and Wellness has recorded approximately 170 confirmed cases over the past 10 years. Both climatic and non-climatic factors have been associated with the emergence and re-emergence of vector-borne diseases. Long-term changes in weather condition and patterns may affect the habitat, the reproductive cycle of the pathogens, while we have unplanned urbanization as well as excessive antimicrobial drug use result in poor water and waste management and drug resistance, respectively. In both these instances, this can lead to an increase in vector population. Fortunately, most vector-borne diseases cannot be transmitted directly among humans and can be prevented and controlled through protective measures and community mobilization. An important element in reducing the burden of vector-borne diseases is behavioural change. In the case of mosquito-borne disease, the following can be done. Elimination of breeding sites in and around the homes. This can be done by discarding of all open containers and stagnant water in and surrounding your home on a regular basis. The use of insect repellent, which may be applied directly to the skin, to the clothing, or to mosquito nets. The wearing of long-sleeve shirts and pants, especially during the peak hours of mosquito activity. Leptospirosis can be prevented by the use of protective footwear and clothing when exposed to floodwaters, stagnant water, and animal farm water runoff. With these measures, we can reduce the burden of vector-borne diseases. Thank you. Thank you very much, Dr. Faswa. And of course, you did give and put into perspective how persons can actually get rid of, in terms of vector-borne illnesses and what are the different measures they can take to prevent this. I now turn to Dr. Glensford-Joseph, who will speak as it relates to give a clinical overview of vector-borne illnesses. Good morning, Ms. Nespichoon. Good morning to the listening public, and good morning to my fellow panelists. We do look forward to this engagement whereby we can sensitize the general population as it relates to vector-borne diseases. And this Vector Awareness Week offers us the perfect opportunity to do so. And one of the things that you're going to learn moving forward is while we have Vector Awareness Week, vector control should be our everyday concern, which you will learn more from our environmental health team. Thank you, Dr. Faswa, for providing us with an overview as to the impact of vector-borne diseases in terms of the burden on Saint Lucia. And you have rightfully noted conditions like dengue, chikungunya, zika, and leptospirosis, along with malaria, as some of the vector-borne diseases impacted Saint Lucia. But also coming out of your intervention is that dengue plays a significant role in terms of the impact on the individual, the community, and the country as a whole when it comes to the amount we have to spend in terms of caring for patients and also the poor outcome that we may have as it relates to vector-borne diseases. And with this, I would kind of take some focus on dengue while we look at some of the other illnesses. Dengue is really caused by four types of dengue viruses, dengue virus one, two, three, and four, and each of these can be present at any time you have an outbreak or you can have a combination of these viruses in circulation at any time and a particular individual may very well have more than one of these viruses in circulation. You will learn and many of us know that dengue virus is transmitted by the 80s species of mosquitoes. We have the 80s Egypti as well as the 80s avipictus that can transmit this virus. Approximately 80% of the persons who become infected with the virus may have no symptom at all or they may have mild symptoms, indicating that persons may be infected and not being aware that they have dengue. And as Dr. Faswa reported is that these are some of the reasons why we can have under-reporting of the cases of dengue. 20% of these cases would likely develop the more severe form of the disease and we can have up to 1% of them than because of severe complications. For persons who become exposed, you've been bitten by an infected female, 80s species of the mosquito, you find that within 4 to 10 days persons who are going to develop symptoms are likely to develop symptoms and these symptoms may last for about 2 to 7 days. It is important that we understand some of the symptoms so that we can present ourselves to healthcare facilities for care. And some persons may develop high fever and they may have other symptoms such as nausea, vomiting, they may have a severe headache. Some persons may have pain behind the eyes and joints and bone pains among others. And of course I want to note that some persons may very well develop swollen glands and a rash. Now when you present to your healthcare provider, they are going to go through your signs and symptoms and try to classify you as to whether you have dengue or whether you are a candidate of severe dengue so that they can determine whether you can be managed at home or whether you need referral into the healthcare facility into a hospital for admission or you need urgent care. So while you understand or appreciate the signs and symptoms of dengue also if you're having any severe abdominal pain you're having a persistent vomiting, you find that your breathing becomes difficult or you're bleeding from the gums or you're having blood in your vomit or in the stool, these are reasons for you to really present yourself very urgently to the healthcare facility for management because it is single signalling the potential that you're having a severe dengue. Of course at this point there is no specific treatment however we do have supportive care to ensure that you rest adequately you're adequately hydrated and you have medication that can control your fever as well as your pain. While at home it is important that you avoid using things like ibuprofen or aspirin to manage your fever and pain because these can worsen the bleeding that arises from dengue fever. Things like paracetamol or acetaminophen can be used. We do not have a vaccine to prevent dengue in Sintlutia and while there are limited use of vaccines in some territories there are specific conditions under which those are being used. Just to note that leptospirosis also caused by a vector here, an animal and we do have the rodents that can be responsible and as Dr. Fraswa would have highlighted there are certain risk factors that can predispose one to such an infection such as working outdoors in the farms, persons who work with animals recreational activity especially swimming, exposed to flooded waters or even drinking or eating contaminated food all can increase your risk of developing leptospirosis once the bacteria that causes the illness is present. These persons may also present with fever headaches they may very well have muscle pain, abdominal pain and you may have yellowing of the eyes called jaundice and develop a rash. So you recognize that with dengue and leptospirosis there are some similarities and only your healthcare professional will be able to make that diagnosis and to treat you appropriately. As a result, it is important that we implement the very measures that will reduce our risk of exposure to the organisms that cause whether we are looking at dengue, checkengonia, zika or leptospirosis and the environmental management is very critical and as such at this point I'm going to hand you over to Ms. Neptune to guide us with the intervention for our environmental management and prevention of these vector-borne diseases. Over to you. Thank you very much Dr. Joseph and of course speaking on the different signs and symptoms that persons should look out for when it comes to dengue, leptospirosis and other vector-borne diseases. As the Ministry of Health continues to sensitize persons on vector-borne diseases and also vector control it is important that as we celebrate the week that we look at some of the activities that can be launched to actually sensitize the public. With that I'm going to call on Mrs. Saint-Romein to speak on vector awareness week and the activities that are planned. Good morning to all. Thank you for now and listening and viewing audience out there. Over the years St. Lucia, just like other parts of the region have undergone frequent and intense storms, floods, droughts and other climatic conditions like troughs and what we're experiencing now, Saharan dust incursions. These have had detrimental impacts on the country's development on its people health and well-being. The social and economic costs of these climate-sensitive health outcomes poses a disproportionately large burden to the economy as we are limited in our capacity to sufficiently respond to repeated disasters. In addition, epidemiological trends have noted increase in infectious disease outbreaks like dengue fever and leptospiruses during or after the rainy season with a recent outbreak seen of dengue fever seen last year, 2021. The Ministry of Health, Wellness and Elderly Affairs through the Environmental Health Division observes vector awareness week annually prior to the commencement of the Atlantic hurricane season typically in April or May. This activity is geared at raising awareness of the presence of vector-borne diseases within our communities. This is done in an attempt to encourage our people to take preventative measures to avoid possible outbreaks of vector-borne diseases. Climate is one of the factors influencing the distribution of vector-borne diseases. Changes in climate affect the geographic and seasonal distribution of vector populations and the diseases they can carry in addition to human behavior and practices. Such changes result in vectors adapting to change or expanding in the geographic ranges in order to thrive. Mosquitoes require as little as a bottle cap filled with water to breathe and sometimes breathing containers with little or no water in anticipation of rain filling up containers for the eggs to hatch. The hotter it is, the shorter the life cycle of the mosquitoes are. Rats, on the other hand, come home for food and stick around making their nest in and around your homes. During heavy rainfall, the nest gets flooded and they move into yours, contaminating everything in their way. Reducing contact and transmission of vector-borne diseases is a personal responsibility. Securing water-holding containers and disposing of unnecessary vessels with the capacity to hold water is paramount in reducing mosquito population. While rat-proofing homes and reducing garbage and clutter in your yards deters rats' presence. In simple terms, improved sanitation reduces vector presence in and around your home, thus reducing the risk of disease transmission, keeping you and your family safe. This year's observance is from May 23rd to May 22nd. Under the theme of some are known as the three women who play born healthy, translated together, let us destroy vectors for better health. For this year's vector awareness activity, the Environmental Health Division, through the Ministry of Health, Wellness and Elderly Affairs, encourages you to be part of and take note of our planned activities. And our activities include a Northern and Southern motorcade. The Northern motorcade is going to be held on the 28th, that's Saturday the 28th of May. From Grosjele to end in Anslerie. Let me hasten to say, however, the motorcade is going to be confined to only 10 vehicles. So we, the members of the Environmental Health, the Ministry of Health will be transitioning through the different communities in an effort to bring our, to further our outreach, to get people to create, to sensitize and create an awareness, a greater awareness so persons can identify with what is going to be happening in the coming months as a result of the rainy season. Additionally, we have partnered with the Ministry of Education and we're going to be having a school exhibition to happen in the, at the Independence Square in Viewford and that is slated for June 9th, 2022. What the anticipation of that, what we anticipate the outcome to be, is for the kids to create through art their perspective of what they think vector control or intervention of vector control is. And you know how kids can be. So we are hoping to have that kind of artistic materials on that day. Additionally, we'll be airing, there will be airing a public service announcement on local television radio stations in addition, in an attempt rather to create, continue creating that awareness. We'll be also having loudspeaker announcements from various communities. There will be media appearances by members of the Ministry of Health, Wellness and Elderly Affairs to have discussions with the members of the public to continue in that raising or sensitization process that we're starting. The Ministry of Health, Wellness and Elderly Affairs urge you to be mindful of your surroundings, not only during that period whilst we are creating that heightened atmosphere but to continue to be mindful of your surroundings especially during the rainy season and dispose of any unused containers at least once weekly or after the rain to reduce the increase in mosquito population and to leave your yard clear of debris or clutter to deeterats and mice presence in your yard. I want to say and I continue saying that it is a personal responsibility. However, we cannot do it alone but together we can fight vectors and diseases that they spread for better health in St. Lucia and some are no detui vermin who play Bonsanti. Thank you. We will now turn to vector awareness and also vector control. One of the areas, the focus we realize for this year's schools and also the communities when it comes to getting rid of vector and sensitizing us to reduce to vector control. Why is it so important for us to target the young ones in terms of sensitizing them as it relates to vector control? Anybody can go ahead and answer. I think all of us can attest that when we're very young we learn certain habits and by the time we move into adulthood sometimes those habits are a bit more difficult for us to get out of. The reason that we target in our younger audience especially this year at the schools is that we want them to learn how to do things the right way quite early. So in terms of drumwater collection we're not asking members of the public to not collect water but we want them to practice safe skills in terms of how you collect water at your home. We do condone collecting water in drums and containers but learning the habits of always ensuring that your drum is covered after you've collected your water if you're going to use smaller containers like buckets and bottles that these things are secure and they're kept free from access from mosquitoes. So we want to instill that type of knowledge and that type of habit from early on so that when our young people grow into adults they're used to doing that it should be covered the effects of poor sanitation on health and so forth. So we want to instill that type of habit quite early on within our young people. Also additionally over the years we have used the schools we have collaborated to say use but we have collaborated with the schools and it has always amazed me with what these kids come up with whether it be theater or otherwise their perspective, the way they see things what they see as possible interventions and I think it's fitting now that we return to them go back to them so we can it's more or less to create that kind of on-hands as the word I say is on-hands so people can see what these kids are thinking of what they see because these are the very kids that are in the communities and if they can't come up with such ideas they too can bring these ideas back into their communities. I have always loved working with the schools and I am waiting with better breath to see what they come up with at that exhibition. Thank you and of course it's a discussion so feel free as somebody presents as somebody speaks on a topic that is asked that other persons can also go ahead and piggyback on it because it's a discussion. Okay so one of the things in the activities is the communities will be doing the motor kids in the communities. If you can speak as to when you go out in the communities what is it that is going to be happening and also why is the community such a critical why is it critical for the community to play their part as it relates to reducing the risk of vector-borne diseases. Okay so like I mentioned in my welcome address outbreaks start and end in communities it doesn't start and end at the environmental department or at any other government agency but it starts with communities so what we need to do is to reach out to the community members because at the end of the day the mosquito breeding the poor sanitation doesn't happen in an office it happens within a community so we want to give the community the type of information that they require to make the right choices we want to give them sound scientific and technical technical knowledge in terms of how it is that they can best control the spread of vector-borne diseases because it's not something very difficult that they have to do at the community level it's just a matter of of taking a little bit of effort and making some very basic changes so also we've also observed that sometimes our members of the public call our department and they were asking for assistance in terms of how do I control mosquitoes I have lots of mosquitoes they're saying that they've covered their drums they have no containers but they're still seeing lots of mosquitoes in many instances they are not aware that the roof guttering that is clogged may be contributing to mosquitoes within their homes sometimes it's a defective septic tank we see it happening a lot where people start the construction of a septic tank maybe they run out of funding and therefore it's not properly constructed or it's not it's incomplete so instead of having a concrete slab where it's sealed completely they made us throw some pieces of galvanized over it it's collecting water it's being used and then that contributes to mosquito breeding even sometimes the peat toilets that we have can collect water and they may contribute to mosquito breeding and sometimes flower pots with water inside of it other small containers and because they're not aware that this is making this is contributing to what the mosquito issues are they they tend to just think of drums and containers only so you want to go out in the community we want to give them that type of technical knowledge because sometimes when our team goes out and we show them where they're like I never knew that so whether mosquitoes were breeding they would have never thought of it so we want to give them that type of information so that they can make the sound decisions and they can practice proper water among collection and storage as well as improving sanitation in and around their homes and also within their communities so we really want to take it back so before that outbreak actually starts within the community we have placed in a stopgap for that let me just add that as I indicated in my statement earlier that behavior change is really the key to this it's very difficult we know this we have been struggling with behavior change not just for dengue or vector bond diseases but also for NCDs we see it and it really is the key to everything and in a lot of the communities through the years that we have been to and we realize that sometimes the individuals it is beyond their control for example you live in communities where you don't have running water at times or you go through periods where you don't see water for several days and they are forced to store water the importance of going down to the communities to as Mrs. Charles Layaw said is to work with them, help them identify creative ways of dealing with a problem out of their control but identifying these creative ways to controlling vector breeding to controlling the mosquito breeding and waste disposal etc so that their intent can see the benefits of what they are doing and as she said sometimes they are not even aware sometimes they don't know that the simple things in their household can be used or can prevent mosquito breeding so it's very important that one on one with the community to understand where they themselves are coming from and we meet them halfway and together we sort of talk it out and see ways and means of dealing with the problem at hand If I may add to the discussion I can see us really zooming in on that community approach and one of the things I know that the environmental health team is going to tell you that we are trying to have an integrated approach in terms of vector control and vector management and to have this integrated approach it's much more than what we are doing at the Ministry of Health or from the perspective of the Environmental Health Department and key to this integrated approach is our community based participation because at the end of the day it's the persons who live in the community have a better understanding of their community and they can determine with the knowledge or information provided to them as to where they likely have the challenges in terms of rectifying the problem and can contribute to the solution so it's much as yes we are going to share information we are going to give them through those community engagement and opportunity to really come up with solutions to the problem and as such it's going to have greater buying greater participation and at the end of the day each and every individual would contribute and we are going to have a collective integrated approach and better control of vectors I must say that we have made a success over the years and we are looking forward to building on it I know Mrs. Charles did indicate the collaboration through the Ministry of Education to really change so that when they become adults they are going to better contribute that is very good but also we would like at this stage when the children learn more about vector control and the impact of the vector-borne diseases on their overall health you find that these children can go home and share that information among their peers at home in the community but also with their parents and their adults so that they can become integrally involved even in their 10 years towards the immediate environment of the breeding grounds for these vectors once you teach them about how to handle the ways or any water collection object that has been disposed in the immediate surrounding knowing that the 80s love to live in and around our home so that they can control that environment and to reduce the breeding grounds and once we can attack the breeding ground then they will not be in need for so much of the top-down approach in terms of the de-fogging and all the intervention that you would need from the environmental health or the Ministry of Health because you would be able to reduce the population to reduce the breeding grounds at that level so that integrated approach is good and the community participation is excellent because it gives you an opportunity to be integrally involved in the process and so you can take ownership of the success Thanks In speaking, you mentioned we have seen successes in the past what are some of the successes the Ministry of Health has seen when it comes to the community play in their part in getting rid of those vector-borne illnesses and managing Great, and while I start the dialogue I know I'm going to be supported by the environmental health team who is on the ground we have seen over the years in particular where we have had from Dr. Faswa instances of the increase in vector-borne diseases especially post-sorten disasters, we have seen 2020 with the COVID-19 where we have had a challenge in initially as we try to learn more about the management of COVID and how we interact with the community and so we would have had that significant number if that may be our largest outbreak of dengue for example but as we go into the community and we learn more about COVID-19 we see how we can interact with the community in a safe way as we use our physical distancing as we continue to use the mask and we are going to continue encouraging persons to be vaccinated but also when it comes to the vector control we know that environmental health has been on the ground working with the communities removing working with Solid Waste Management Agency to remove objects in the community that can breed these organisms and so we have been able to make such a stride and I know the community was instrumental in contributing but we want to build on those and at this point I can yield to environmental health Ms. Charles In terms of some of the gains that we have seen at environmental health one of the things that we try to stress on is personal responsibility and community is not waiting for the Ministry of Health to take an initiative when they see an issue within the community but you know take that initiative yourself as a group come together as a community and do something to reduce the number of mosquitoes or rats or improve sanitation within your community and we've seen that happen quite a bit throughout the years we've been approached by a number of community groups so if you just come to us and say hey we want to do a cleanup we want to have some sort of workshop to teach our community members what it is that they have to do we've done a walkthroughs with our various community groups persons within our communities to help them identify some of these mosquito breeding sites to help them to identify some of the basic issues of sanitation put them in touch with various agencies like Solid Waste Bureau of Health Education other system ministries who can assist in terms of the issues that they're seeing within their communities and I think that's the fact that we've been approached we don't have to do the initiative take the initiative but we're approached and the community members themselves are taking the initiative I think that speaks volumes in terms of the success that we're having that means that persons are seeing the importance of personal responsibility and they're willing to take up that responsibility because they're seeing how it affects their communities also I would say the fact that our outbreaks have not been continuous from before 2020 I don't think we've had some really bad outbreak like that previous so I think and since 2020 we have not had and I think that type of outbreak that it speaks volumes to persons recognizing that there is an issue within the communities of issues around their homes and taking some proactive measures okay so one of the areas I wanted to touch on very quickly is has to do with persons realizing because we know we are approaching the hurricane season and you might have persons who might be affected by the A.D.S. Egypti mosquito and they might have symptoms can you speak on the importance of persons actually going to get medical care seeking medical care if they develop those symptoms great I'll take that as pointed out earlier some of the symptoms that may be interesting that you have for instance dengue one of the major issue we have found in our setting although we would have had in the past zika, chicken gonia and we do know that leptospirosis is one of the vector-borne illnesses actually a zoonotic disease that can impact us once you have any of the symptoms presented it is important that you seek medical care the reason being especially let's start with dengue once you seek medical care early your healthcare provider will be able to determine whether it is dengue you're having and to guide you appropriately they're going to try out your symptoms and to put you let's say in dengue as an example as to dengue without warning signs or you have dengue with warning signs that can lead to severe dengue and we know that once you get to that severe stage the outcome can be fatality that is you can die so if they identify you early and let's say you have dengue without warning signs and you're a person that can be managed at home and with follow-up care of course then that will be done and of course if they identify you as a person who developing warning signs like severe abdominal pain persistent vomiting bleeding gums they may find that you have an enlarged liver then this is somebody that you really want to get into the healthcare system to be hospitalized so that they can be monitored and managed closely to prevent or reduce the risk of you becoming so severely ill and dying of the illness likewise when you think about leptospirosis it is important that you present early so that you can be managed appropriately their medication that can be used to treat the organism that cause the illness and once they can do that early it reduces many of these complications such as liver disease brain illness damage you have things like kidney failure and all these things you'll be able to prevent because by the time you get to that stage the cost of care is going to be significantly increased but also not only the cost of care that is from the individual perspective or within the healthcare system the resources that it would have to use to manage you but at the end your overall well-being will be much better the quality of life will be much better if you are being picked up early in the early stages of the disease you can manage effectively as compared to when you wait so it is very important that once you develop signs and symptoms especially your fever pain, eye pain that is pain behind the eyes or anything suggested for any of these illnesses that you present to your healthcare provider you have the wellness centers in the community you make use of that or you have the hospitals or persons have their private care physicians such help so that they can be diagnosed early and manage effectively to reduce those complications that will impact your quality of life and your overall productivity let me add to as well although I'm not a clinician but what has happened is that the majority if not all of these diseases or conditions may make each other the symptoms so you have the dengue, you have the leptosepirosis you have even covid you have the fever, the joint pain the runny nose and so on so as Dr. Joseph is saying it's important especially persons with underlying conditions that if they experience in any of these symptoms that they seek medical attention with a level of urgency in addition to that just to move away from the importance of seeking medical care just because you require medical care the Ministry of Health as well as the Department of Environmental Health would also use this type of information in terms of the number of cases that we've seen the location of the cases to target our interventions if take for instance in community X we have 20 persons who have come down with dengue to see the doctor the system is not alerted that there is a situation in this particular community and therefore we will not be able to respond so when persons feel ill they go see the doctor they are tested they test positive for dengue or any other vector-borne diseases it alerts the system that hey we're having an issue in community X informed by the Department of Epidemiology Unit our team at environmental and environmental health can go to that particular community do our interventions do our treatment for if necessary or whatever other intervention necessary we can go ahead and do that within the community but if the system is not alerted we're unable to respond if I may sorry if I may build on that you're right trying to gather the information for intervention in the community is key but also for instance if you find someone with dengue in the early stages the four speakers so the virus is more or less circulating in the blood and as such you would want to from the epi perspective where they would want to do the research and environmental health also working so that those persons can be managed not only from the medical aspect of it but also when it comes to protecting them from being bitten by auto mosquitoes that can transfer or transmit the virus from that individual to other persons and which is key go ahead let me just add that in 2020 when we saw this outbreak ever it was a time when we were also going through our pandemic and it became very important for us to try to differentiate when an individual began with fever and usually in the case of COVID you start with a low grade fever and it progresses but in the early stages when you just have fever it is absolutely important for us to determine whether that individual was born illness or whether we are dealing with COVID-19 or whether we are dealing with something totally new and different and it is important because we've said this a million times and the public knows this we need to be able to identify persons with COVID-19 at an early stage so that we break that chain of transmission so for us it is key it is paramount in addition to avoiding that individual progressing to severe dengue or to a more critical stage of the illness but for us to differentiate and know what is happening on the ground to be able to address it and particularly with the new variants coming out and we're hearing new and emerging diseases that are not related to vector born it is crucial that we know what is happening on the ground at all times and we don't just dismiss it as oh we're going through COVID and everything is COVID we are entering our hurricane season and so as I indicated earlier the numbers tend to rise during that period because we have a lot of waste by the sides that collect water and then we have breeding so it is very important particularly now when we know that our numbers tend to increase that persons know what is happening with them and we are able to get reports of these at an early stage and another contributing factor as well is what we call we have areas where we call hotspots and these areas like Dr. Gomet as I indicated earlier most of these situations are beyond people's potential beyond the area that they can do anything about it beyond their control, thank you beyond their control in some of these hotspots where you do not have easy access to water so you find a lot of people storing water some of these other conditions where we have close proximity to water bodies they have no control over so these are the areas that we have that we need to look at or we continue to look at or pay very much attention to before the rainy season or on the whole but these are one of the indicators as to what situation we are dealing with coming into the hurricane season or even before an outbreak perhaps you can reiterate what can persons do to prevent the breeding of vectors especially since we are in the brink of the hurricane season I can stop by saying it's a person and that's what I'm going to start of by saying it's a personal responsibility last year during our commemoration of vector awareness week we made it about the home persons taking time to inspect their homes do not wait until the officer or the inspector comes about to inspect your home every two to three days because of the climatic conditions now the mosquito breeds faster, shorter period and it hatches faster the eggs and evolve so we encourage persons and to do inspections conduct inspections around their homes identify containers identify containers or things within their homes one that persons don't realize is your toilet bowl and we encourage persons to always keep the lead on because that mosquito because there's a constant water level in the toilet the mosquito because it's looking for water to lay its eggs to breed it will lay its eggs when you flush that life cycle the aquatic cycle continues in that septic tank and most persons there's this waste pipe that we do not protect because we encourage persons to put in a mesh to prevent the mosquito if it is not covered the adult mosquito would after when it evolves into the adult it would fly out of that vent your toothbrush holder you know any bit of water that the mosquito can the film a mosquito can get to lay its eggs it will it can lay its eggs there go through that aquatic stage in there and it can evolve your dish washing sink your sink your wash dish wash holder dish drainer okay refrigerators now do not really have a drainer at the bottom I hardly see that happening these days but that's another area to look at so there are little things that you're not even aware of that that mosquito which has become very smart and very domesticated which is it is in your home it lives with you and they look for any area that they can find all they need is a drop of water and some of them they are so smart they would lay the eggs there in a dry container anticipating that rain to fall and the moment it falls it evolves and of course for the the week and for the month basically will be celebrating vector awareness one of the areas for the the PSA's would be on home inspection and also on asking persons to take personal responsibility but another area would be the media appearances going on the different radio and talk shows and I know this year we're having a different focus can you highlight or speak a little bit on the focus that will be taken this year as it relates to the media appearances on the talk shows okay so for for previous years we focused a lot about the vector one disease is like dengue chicken gun, Zika meleptospirosis and we've spoke a lot about how do you control it and how do you protect your family but this year what we want to do is to look at how other aspects of health other aspects of life and environmental health can actually contribute to issues with vector one diseases so take for instance safe water safety in terms of your portable water that is your drinking water again we we tend to encourage persons to store water especially during the rainy season where sometimes after heavy rains there is no water in the community for a couple of days and especially if you don't you don't have access to a proper municipal supply of water you want persons to store water because of course persons to drink, wash their hands and so forth but you want them to store water in the right way so you want to focus on giving persons these type of tips in terms of your food safety your food security people tend not to think too much about other pests like flies rotis flies rotis in terms of your kitchen we want you to look at health holistically so these pests can actually contribute to diseases diseases when they come in contact with your food so we tend to see flies on feces and so forth so after that fly actually goes on feces it goes on your food you eat your food you get gastroenteritis and you have other medical issues other diseases and these pests actually contribute significantly to it so we want to just bring people's attention to this as well in terms of how other aspects of environmental health other aspects of life actually are affected by vectors and pests and as we get to the close of this discussion the motorcade which will be happening to be happening in the north and the south and we know persons would be anticipating and be excited for this motorcade can you tell us speak just briefly on some of the areas that will be highlighted in the north and the south so that persons can look out because we know as time goes by more information will be provided as it relates to the dates but if you can just put into perspective some of the areas that will be highlighted okay so some of the areas that we are going to look at for our motorcade in the north we are looking at making stops like in Moshi, Corinth Babuno Roso and the In the south we are looking at communities that we know have certain issues as well I mean in all of these communities but we are looking at places like the Denri Valley Denri Village Labri and also the Shoso and Sufri villages so these are the communities that we are looking at I mean once our community members to look out for us please feel free to ask the staff questions we are there to raise some level of awareness answer questions and to give some level of support to the community members thank you very much and as we are about to close any final words well for me I am always excited about vector awareness week once we go out there and especially now with everything going on the latest as is what's the monkey box so persons are consumed with every other thing but an vector and so I am happy that we are able at this time to create or heighten that level of awareness for our people and it's I want to encourage and continue to encourage that personal responsibility that person must take whilst we cannot do it alone we are here to offer the support give the information in whatever way that we can whatever medium that we can but persons every individual bigger small has a responsibility and we hope that whatever information we are taking into you we are creating that greater outreach whatever information that we bring to you that you can take it and make that difference that can help contribute that difference for you at your homes in the community and for the nation thank you very much also I would like to thank the panel for being here and providing us with such valuable information as it relates to vector control and also vector awareness week thank you with that we've come to the end of the launch of vector awareness week on behalf of the entire production team I am Fynnell Neptune thanks for watching until next time