Although the number of reported cases of dengue began to increase sharply in October, it was not until 9 February that health emergencies were declared in the San Martín, Loreto and Madre de Dios regions. 7,857 cases have been reported in the first two months of the year alone. The largest number of cases (2,224) is in the Tambopata province of Madre de Dios, where tourism and illegal gold mining are important activities.
Researchers argue that neglected tropical diseases like dengue mostly affect the poor and contribute to inequality. In the case of such mosquito-transmitted diseases, deforestation associated with gold mining is an important contributory factor.
The number of cases of the dengue virus increases during the rainy season in the Amazon, but the trend has been for the numbers to increase year-on-year. This year they are especially high, averaging 919 cases weekly. Six persons have died from the virus so far in the Madre de Dios region, five of them in Tambopata.
According to Dr. Eduardo Gotuzzo of the Cayetano Heredia University in an interview with Ojo Público, “when the rains increase there are more places where the mosquitos can reproduce and when the temperature rises the mosquitos mature faster so that, instead of biting during three days, they do so for six to seven days”.
Dr Veerle Vanterberghe and Dr Kristien Verdoncke from the Institute of Tropical Medicine in Antwerp, Belgium, point out that “the burden of dengue is high among poor people because they often live in communities where mosquito vectors are abundant, because they use less vector-human barrier methods, and because interventions tend to be less effective in disadvantaged populations”.
They go on to explain that this is because the poor live in conditions where the water storage infrastructure and garbage disposal facilities are inadequate, favoring mosquito reproduction. In addition, the poor usually cannot afford effective protection measures such as repellants, mosquito screens and air conditioning.
Furthermore, they argue that measures taken by the health authorities are less effective amongst disadvantaged populations. As a dengue epidemic spreads, it tends to increase poverty and inequality because of the loss of income associated with the inability to work and the costs of even basic healthcare.
Renzo Anselmo argues in an article for Servindi that the high incidence of dengue in Madre de Dios region and, more specifically, in the Tambopata province may be due to the high rate of deforestation. Between 2013 and 2016, 30,500 hectares were deforested in the region. Furthermore, Madre de Dios is the 24th out of the total of 26 regions when it comes to unsatisfied basic needs according to the social progress index published by CENTRUM.
In recent years the principal driver of deforestation in Tambopata has been illegal mining. In 2012, the national medical association published a study which concluded that “mining areas are propitious for favouring the proliferation of diseases associated with the consumption of contaminated water”.
The health authorities’ response to the epidemic has been late in coming. The budget for combating such diseases in Madre de Dios was reduced from S/.5.4 million in 2019 to S/3.3 million this year. A vaccine was authorized for sale in 2015 but requires certain conditions for its use.
For the moment the epidemic appears to have peaked in the Amazon as the rainy season draws to a close, with the number of weekly cases falling from 500 to 100 in Madre de Dios. The Health Ministry claims that this has been due to the coordinated efforts of the ministry and regional and local authorities, as well as strategies to involve local people. Nevertheless, researchers emphasise that, until efforts are made to address “the causes behind the causes” and interventions are much better targeted, dengue may be expected to return together with the next rainy season in the Amazon.