MEASURES TO FIGHT EPIDEMIC OF SCABIES IN CAMP VUČJAK, BIH

MEASURES TO FIGHT EPIDEMIC OF SCABIES IN CAMP VUČJAK, BIH


Dimitar Anakiev, MD
Global Health spec.


According to the last report (yesterday) of our chief medic in camp Vučjak by Bihać, BiH the morbidity from scabies among refugees and migrants is 2-3 times higher than expected in such conditions (10-15% should be the expected percent, instead we have 30%). Scabies is most often spread during a relatively long period of direct skin contact with an infected person (at least 10 minutes) which may occur during sex or living together but spread of infection may also occur during brief contact or by contaminated objects. It typically only occurs in those with a poor immune system (refugees and migrants are typical case). Areas with a lack of access to water also have higher rates of disease but 2-3 times higher rate shows that medical care does not exist at all. That is not acceptable for many reasons. Also, "symptomatic therapy" does not exist. Bad conditions are often taken as an excuse but the measures to fight scabies in such conditions are relatively simple if medical workers in the field are willing to firmly and systematically organize themselves in the very direction of healing so massive infection of people from scabies.

Let us see what is needed:

Causal therapy:

1. BENZYL-BENZOATE (BENZIL BENZOAT in Bosnian). Very effectively heal scabies if used properly and together with measures of hygiene. Proper use means: apply benzyl-benzoate over whole body during three days without taking shower ("luckily" there is no shower in the camp Vučjak). After three days of many times applied benzyl-benzoate in the way that whole body was covered it can be washed out.

Hygiene measures:

2. Usually bedding and clothing used in the last three days should be washed in hot water and dried in a hot dryer. As the mite does not live for more than three days away from human skin, more washing is not needed.  For the case you cannot wash clothes and bedding (your case!) take clothes and bedding into plastic bag (as such for taking trash) hermetically close the bag (tie it) for 3-7 days. Each beg with bedding and clothes taken needs to have name of the patient it belongs.

Organization:

3. Exchange of bedding and clothing is needed. So you need to have warehouse well supplied all the time. You need coordination and collaboration with different organization.

4. You also need budgeting buying benzyl-benzoate approximately 50 EUR for each 10 patients. In Bosnia is benzyl-benzoate much cheaper (2-3 times) than in Western Europe but anyway one dose-container (for 3 days) cost nearly 5 EUR (9,4 KM - see the picture bellow). So to stop epidemic you need approximately 1.500 EUR for 300 patients (30% of 1000 people). So you need to organize campaign for donation.

5. Medics and paramedics must follow patient to their beds and take bedding and clothes and also watch the situation and check nearest neighbours on scabies.

LET US ORGANIZE AND GO TO ACTION STOPPING THE SCABIES EPIDEMIC IN VUČJAK!