Addressing the dengue epidemic in the Philippines
by Jon Joaquin
Dengue is once again making headlines in the Philippines as the Department of Health (DOH) earlier this month declared a national dengue epidemic. This is in the wake of 146,062 cases recorded from January up to July 20 this year – 98 per cent higher than during the same period in 2018. There have already been 622 deaths, and more are feared if the disease is not addressed. Unfortunately, there is a lot of misinformation going around about dengue and this makes it difficult for communities to battle it the right way.
When my 24-year-old son contracted dengue early this year, we got the usual advice from well-meaning friends and relatives on how to treat it. Some told us to give him durian, which would have to be smuggled into the hospital since the heavenly tasting fruit also happens to smell like hell and so is prohibited in all hospitals and most buildings in Davao City. Balut, papaya leaf or tanglad (lemon grass) tea, and other concoctions were also suggested. Some even spoke of “magic balls” – apparently a kind of Chinese medicine. Most of the advice, however, focused on tawa-tawa (Euphorbia hirta), a very common grass or herb that grows practically everywhere in the Philippines. We were told of patients on the brink of death, with platelet counts down to single digits, who recovered miraculously after they were given tea made from the leaves of this plant. Tawa-tawa, we were told, really is the best medicine (if you don’t understand that joke, ask a Filipino-speaking friend what the word “tawa” means).
We took the advice in stride, knowing that dengue is a viral disease that has no cure but goes away in time. The important thing is to manage it, and to do that you have to know what it really is first. Fortunately, our long-time friend and doctor to our children is Dr. Richard Mata, a Davao City-based doctor who has blazed a trail in dengue management and is now a consultant for dengue of the World Health Organization (WHO). According to Doc Richard, the low platelet count associated with dengue itself is not the problem; what brings discomfort and ultimately kills dengue patients is dehydration. He has several videos in his website and on YouTube where he explains that dengue causes perforations to form in a patient’s blood vessels, causing fluids to seep out.
“The symptoms of a patient with diarrhea are the same with those of a dengue patient,” he says. “I always tell my patients that there are only two diseases in which the patient is still not playful even if the fever subsides: dengue and diarrhea. Why? Because both have the same weapon of destruction: dehydration.”
Doc Richard thus prescribes that doctors start intravenous hydration at the second or third day from the start of fever. “Dehydration is more dangerous than a low platelet count. Platelets will naturally increase after six days from the start of the fever as long as you are well hydrated and urinate very, very well.” In fact, he says tawa-tawa and other folk medicines appear to work only because they are normally given by desperate parents a few days after the child is diagnosed with dengue, and at which time the platelet count begins to rise.
Doc Richard also urges parents to err on the side of caution. “Always think about dengue especially if there is fever. Even if the doctor says it is another disease, still think of dengue.” What he does not want parents to do is put their faith in what amounts to quack medicine: tawa-tawa, durian, balut, etc. Even if these were effective in raising the platelet count, it’s not going to do anything about dengue itself. As Doc Richard likes to say: “The cure for dengue is proper hydration — and correct information.”
The problem, however, is that even government agencies like the Philippine Council for Health Research and Development (PCHRD) do not appear to have gotten the memo from the WHO. The PCHRD actually announced that tawa-tawa “contains active ingredients that may help dengue patients.” It cited a study made by students of the University of Sto Tomas (UST) – Faculty of Pharmacy that showed platelet counts in lab rats, which had their platelet counts artificially lowered, increasing by 47 percent when treated with the herb.
I’ve seen this announcement shared by a number of people on social media, and I’m afraid it sets back the information drive against dengue. The PCHRD, which is under the Department of Science and Technology, will do well to coordinate with the Department of Health (DOH) before it releases studies like these that move the focus from the real solution (hydration) back to folk medicines that not only do nothing to treat dengue but endanger the lives of patients.
The views and opinions expressed in this column are those of the original author, and do not necessarily represent those of the Pilipino Express publishers.
Jon Joaquin is the Editor-In- Chief of the Davao City-based Mindanao Daily Mirror. E-mail Jon at firstname.lastname@example.org.