Health Protection Agency issues alert on spread of dengue and viral fever

The Health Protection Agency (HPA) has issued an alert warning of the spread of dengue and viral fever in Malé and the atolls.

The HPA said its statistics show an increase in the incidence of mosquito-borne dengue fever and advised precautionary measures to control mosquito breeding during the rainy season.

The agency also advised ensuring cleanliness and seeking medical assistance if a fever persists for more than three days.

Last year, the health ministry said dengue fever has become endemic in the Maldives since 2004 with annual outbreaks.


Hand, foot and mouth disease spreading, warns health agency

The Health Protection Agency (HPA) has issued a health alert warning of the spread of hand, foot and mouth disease across the Maldives.

The HPA said reported cases mostly involved children between the ages of one and four.

The disease is passed through a patient’s pus, saliva, discharge, snot and vomit. Common symptoms include fever, change in appetite, tiredness, throat infections and body aches.

The agency advised parents against sending infected children to school and to take precautionary cleanliness measures to contain the infection.


Nolhivaranfaru ground water contaminated as flooding causes septic tank overflow

Severe flooding on Haa Dhaal Atoll Nolhivaranfaru Island has caused a sewage overflow resulting in contamination of the island’s ground water.

According to Nolhivaranfaru Councilor Adham Jaufar, torrential rains on December 18 and 19 caused damage to septic tanks on the island resulting in sewage overflowing in bathrooms and onto the streets.

The Health Protection Agency (HPA) has issued an alert expressing concern over health risks due to contaminated water, and urged Nolhivaranfaru’s residents to pay attention to cleanliness to avoid the spread of water-borne diseases.

“We appeal to the public to use chlorinated well water in all areas of the island, to only use boiled water or rainwater that has been stored safely for cooking and drinking and to pay particular attention to general cleanliness. We note it is important to wash hands with soap after using the bathroom or before cooking,” a statement by HPA said.

The National Disaster Management Center (NDMC) has said it has distributed chlorine to disinfect wells and puddles on the streets, and the HPA conducted an awareness campaign on health risks.

Although the 1,030 strong population have access to potable drinking water, the sewage overflow has left 47 households without any water for bathing or washing, Jaufar said.

Over 50 residents staged daily protests this week over the lack of safe water, but suspended activities today after an environment ministry team arrived on the island to inspect damage.

Protestors have warned they would resume demonstrations within three days depending on the outcome of the visit.

The Maldives National Defense Force (MNDF) has drained water from the streets and is now in the process of cleaning and draining overflowing septic tanks.

Jaufar said Nolhivaranfaru requires a sewerage system to prevent sewage overflow in the future.

The worst affected areas are at a lower elevation than the rest of the island, and residents of the 47 houses have to periodically drain septic tanks to avoid overflows, Jaufar said. Maldivian islands are on average only one meter above sea level.

Meanwhile, the NDMC has allocated 100 tonnes of water for Nolhivaranfaru, but the water has not yet been transported to the northern island as there are no mechanisms to store water there.

Head of the Environmental Protection Agency Ibrahim Naeem said the agency is waiting on a report from the ministry team on the extent of the damage.

In addition to a sewerage system, the island would also needs an artificial drainage system, Naeem said.

According to Jaufar, the government had promised a sewerage system in 2012, allocating funds for the project in 2012, 2013, and 2014. But there has been no progress yet.

In early December, a fire at Malé’s desalination plant left the capital’s 130,000 residents without running water. The government declared a crisis, set up water distribution centers throughout the city, and requested foreign governments for assistance.

India, China, and Bangladesh airlifted bottled water, and India sent in ships equipped with desalination plants to produce water for the capital.

Normal operations resumed at the Malé water plant on December 13.

In June, residents of Laamu Atoll Gan also staged protests over a sewage spill on the island following severe damage to the island’s sewerage system.

Related to this story

Malé water supply cut after fire at MWSC

Water distribution to stop as Malé water crisis nears end

Gan Council fears “health disaster” after severe sewage spill


Nigerian quarantined in Hulhumalé has no symptoms of Ebola, assures health ministry

No additional reporting by missing journalist Ahmed Rilwan

A Nigerian tourist quarantined today as a precautionary measure has no symptoms of the Ebola virus, the Ministry of Health has said.

The health ministry and Health Protection Agency (HPA) briefed the press this afternoon following media reports of a Nigerian man taken from the foreign ministry in Malé to a quarantine facility in Hulhumalé by Maldives National Defence Force (MNDF) officers in protective suits.

HPA Epidemiologist Dr Aishath Aroona Abdulla explained that the foreign ministry informed the health authorities because the Nigerian was “sick looking”.

“After inspection, the doctor at the Hulhumalé hospital said he did not have fever. He is not taking medication for anything at the moment,” she said, noting that the most important symptom of Ebola was high fever along with fatigue, headaches, and aching joints.

Dr Aroona said she questioned the patient and took his history at the Hulhumalé hospital.

“He told me that he did not have a fever or any symptoms, but said ‘I am sick because I have nothing to eat,'” she said.

As the Nigerian did not have a fever, Dr Aroona said there was no risk of people he came into contact with catching the Ebola virus.

“However, he will be observed for the next 24 hours to see if he gets a fever,” she said, adding that both the MNDF officers who transported the suspected patient and the doctor were wearing personal protective equipment.

As the Nigerian could not be considered an Ebola patient, Dr Aroona said samples would be sent to a laboratory in Pune, India for testing only if he exhibits symptoms of a fever in the next 24 hours.

Under protocols put in place in accordance with World Health Organisation (WHO) guidelines, she said if he develops a fever the patient would be treated as a suspected case until the test results return negative.

The authorities had the resources needed to treat a suspected Ebola case, she said, adding that the patient would be released with surveillance if he did not develop a fever.

Precautions taken

The Nigerian was screened upon arrival in the Maldives and entered into the HPA database, revealed Dr Aroona, explaining that visitors from countries facing an Ebola outbreak were placed under surveillance if they had been in the country for 21 days, which is the incubation period for the virus.

While 109 individuals from countries where the virus has been detected have visited the Maldives so far, Dr Aroona said 78 were placed under surveillance, of which 27 were presently in the country.

The resort or guesthouse where the tourist is staying are told to inform the authorities if a guest exhibits symptoms of Ebola, she explained.

She noted that Nigeria and Senegal were “low-transmission” and “low risk” nations with no new cases reported in the past 21 days.

“It’s very unlikely for someone who has traveled to Nigeria to contract Ebola,” she said, adding that visitors from the country were placed under surveillance as a precautionary measure.

While the countries where Ebola was rapidly spreading were Guinea, Liberia and Sierra Leone, Dr Aroona said there have been no visitors from any of these countries.

While passport holders from the three African nations have visited the Maldives, she noted that none had traveled to these countries for 21 days prior to arriving in the Maldives.

State Minister for Health Hussain Rasheed said the Maldives was following international best practices in accordance with WHO recommendations and efforts were underway to improve surveillance capabilities.

He appealed to the media to correct initial reports and provide information responsibly, noting that the Maldivian economy was dependent on tourism and could be adversely affected by alarmist news headlines.

Director General of Health Services Dr Sheeza Ali revealed that the Nigerian was in the Maldives on a tourist visa but had attempted to find work in the country.

“So we will be consulting with the immigration [department] and the tourism ministry,” she said.

The Nigerian arrived in the Maldives on September 13, she added.

Dr Aroona meanwhile said the incident would be reviewed to improve the process of isolating and testing.

The Nigerian had gone to the foreign ministry for “personal purposes,” Dr Aroona said, declining to reveal details.

According to the WHO, more than 3,000 people have died from the Ebola outbreak in West Africa while a total of 6,574 cases have been reported so far.


Ebola health alert issued, minimal risk for Maldives

The Ministry of Health has issued a health alert regarding the Ebola outbreak in West Africa, although the Health Protection Agency (HPA) has said the risk is minimal for the Maldives.

“We have discussed this with the WHO as well, the risk is minimal for Maldives,” said Dr Aishath Aroona, an epidemiologist at the HPA.

” It is very unlikely as there are very few people going or coming from these three countries to Maldives, and infection control in the Maldives is very effective,” she said.

The health ministry has warned against travelling to the three countries in which the disease have been found – Guinea, Liberia, and Sierra Leone.

The ministry requested anyone who has travelled to these countries to look for symptoms of the disease for 21 days and to seek medical assistance should any be recognised.

Meanwhile, the Health Protection Agency (HPA) is working with the Department of Immigration and Emigration to identify people arriving in the Maldives from these countries.

These people will be checked at the airport’s health counter and released if the virus is not found. The HPA will keep track of those released, advising them to report immediately if any symptoms are found. In this event, the agency recommends people visit the major tertiary hospitals rather that health centers and clinics.

Additionally, the agency has sent infection control guidelines to to all health service providers around the country – including those at tourist resorts – to ensure the safety of patients and staff. Doctors are asked to take great care and proper measures to avoid infection, including the use of gloves and waterproof clothing.

Dr Aroona said that WHO is working in these countries to ensure no infected person travels abroad in order to minimise the risk of a global outbreak.

The disease

The health ministry alert referred to WHO warnings regarding the virus noting that, while it is currently known to be transmitted only through direct contact and bodily fluids of an infected person, the possibility of the virus being transmitted through other means is still under investigation.

The WHO has reported total of 1,603 cases and 887 deaths since March in the three afflicted West African countries. While Nigeria has reported three probable cases there is no outbreak in the country, with further information revealing that one of the three had come to the country from Liberia.

The incubation period between infection and the onset of symptoms can last from two to 21 days.

After this period the first symptoms of the disease which become visible include fever, intense weakness, muscle pain, headache, and a sore throat. This is followed by diarrhoea and vomitting.

The disease can impair the functioning of organs such as the kidneys and liver and can results in internal and external bleeding. Currently there is no vaccine or cure for Ebola and past outbreaks have had fatality rates of up to 90 percent.

More information on the Ebola virus disease have been provided by the WHO here.


Health Protection Agency plan youth services to bridge gap in sexual health education

A sexual health education pilot aimed at young people will be launched in Hulhumalé before the end of this year, the Health Protection Agency (HPA) has told Minivan News.

“There is no comprehensive sexual education in the schools,” said the source. “We have to keep talking about these issues, about how to keep young people safe.”

The pilot will provide a comprehensive sexual health and general health service to all young people aged 10-24 years old.

According to the agency’s Reproductive Health Unit (RHU), the the project will attempt to bridge gaps in sexual and reproductive health services for young people.

A member of an established health service provider, who wished to remain anonymous, highlighted age-appropriate guidelines as key barriers to sexual health education.

The comments come after the body of a new-born baby was discovered in a house in Maafanu earlier this week. Local media reported that the 18-year-old mother, currently in police custody, committed infanticide after having hidden her pregnancy.

National Guidelines

The national guidelines issued by the Ministry of Health and Gender prohibit some elements of sexual health education – including condoms and safe sex – until students are 18-years-old.

“There is a standard which is maintained by the health sector. There are a lot of cultural and religious barriers in providing this information,” the source told Minivan News.

“Unless those issues are not tackled, the stigma in accessing [health education] will not happen.”

Reticence in the health sector is mirrored in the family sphere, argued the source, who stated that family members are reluctant to speak candidly with their children about sexual health.

“There are some views of parents that if you talk about sexual health, they might go and do it.”

With no accurate information from schools or parents, the student will often turn to peers or the internet for support on sexual health, noted the source, which results in the rapid spread of mis-information.

Religious barriers

Under the 2008 constitution the Maldives is a 100 percent Muslim country, with national guidelines surrounding sexual and reproductive health being strongly influenced by religion.

A report conducted by the Department of National Planning in 2013 concluded that religious beliefs had been the reason behind an increase in trends such as a preference for home schooling, refusal of vaccination and other medical services for women.

Expressing a similar view, the health sector source noted that religion had contributed to some of the barriers in delivering sexual and reproductive health education.

“That’s a huge barrier actually on sexual health education, because there’s certain beliefs on providing information, or on family planning, on safe abortion,” stated the source.

“They [religious scholars] have a lot of myths related to sexual reproductive health.”

The source suggestion that there is support for the assimilation of religion into sexual health education delivery, but that disagreements between religious scholars had meant that progress was slow.

Next steps

The RHU project is underpinned by the imminent release of their new guidelines, National Standards for Adolescent and Youth Friendly Health Services for Young People.

These guidelines outlines the key standards for health education for all young people aged 10 – 24 years, ensuring that they will “enter the productive age in the fullest possible wellbeing.”

Noting the closure of previous similar projects, such as the Youth Health Café, the RHU noted that there are a number of difficulties in launching a new healthcare service.

The RHU source also wished to remain anonymous, reflecting the strong emotions provoked by discussion of sex education.

“Convincing people to initiate something in health facility is not easy,” they stated.

“It will be difficult. At present it is very difficult, unless the person is coming seeking the services it is difficult.”

When asked if they felt that young people are getting the right information at the right age, RHU representatives responded with a firm “no”.

“Not all. They are not getting that information. As far as access, there is no access.”

Issues regarding a lack of support services for sexual and reproductive health in the Maldives have been well-documented in the past.

A report entitled ‘Maldives Operational Review for the ICPD Beyond 2014‘, carried out by the Department of National Planning (DNP), claimed that incidents of infanticide and unsafe abortions are symptoms of a lack of sexual education in young Maldivians.

The report identified, “clear indicators of the imperative need to provide access to information on sexual reproductive health and reproductive health services to the sexually active adolescents


119 cases of Hand, foot, and mouth disease reported since January

A total 119 cases of hand, foot, and mouth disease has been reported across the country since January this year, the Health Protection Agency has said today.

According to the HPA, cases have been reported in the Malé area as well as Gaafu Dhaalu, Gaafu Alif, Baa, Haa Alif, and Haa Dhaalu atolls

An official from the HPA said that the disease has been seen more frequently in the Malé area lately in comparison with January, at which time it was concentrated more in the atolls.

The official also said exact figures on cases reported in Malé were unavailable due to some difficulties in acquiring the information from Indhira Gandhi Memorial Hospital (IGMH).

In a statement alerting the public to the situation, which requested greater caution, the agency said children between 1 – 5 years are most vulnerable to this disease, warning that is is likely to spread among students in preschool and primary grades 1- 2.

Hand, foot, and mouth disease – while not always serious – is contagious. According to the HPA, it can easily spread through close contact by means of saliva, nasal mucus, feces, and blister fluid.

Early signs of the disease include fever, reduced appetite, feeling tired, body aches, and sores in the mouth.

The HPA has requested all members of the public to take the following precautionary matters to control the disease:

  • Do not send children infected children to school
  • Keep infected children separate from others and do not taking them to public gatherings
  • Thoroughly clean objects such as plates, towels, and toys used by children with the disease before allowing other children to use them
  • Pay extra attention to hygiene of children and their surroundings, particularly toilets
  • Wash hands with soap before eating and after changing diapers, cleaning or going to toilet
  • If the disease is discovered at a school, suspend all activities involving the use of sand

Health Protection Agency warns of cold and conjunctivitis outbreak

The Health Protection Agency has warned of a potential cold and conjunctivitis epidemic in the country, local media has reported.

Vnews reported that agency as urging anyone displaying flu-like symptoms to contact a doctor as well as staying away from public areas.

The capital city Malé is one of the world’s most densely populated islands at around 18,000 people per square kilometer.

The agency warned those with symptoms not to touch their eyes, as this causes the infection to spread more easily.


Free cervical cancer screening service at DhamanaVeshi

Health Protection Agency has begun cervical cancer screening at “Dhamana Veshi” (formerly Male’ Health Center), Vnews has reported.

According to the Ministry of Health the service will be provided one day every week, and 25 appointment for screening will be issued.

According to the Ministry, the first phase of this project – funded by UNFPA – will be implemented with assistance from Indhira Gandhi Memorial Hospital (IGMH).

The service will be provided as a public health service without any charge. The Health Ministry recommends women of 30 – 50 years to take this test at least once every five years. The service was part of the Health Ministry’s ‘first hundred days plan‘.