Dr. George Jacob

Kochi: Kerala is running high fever- of various kinds.

Of 19,000 people who reported to hospitals with fever on June 3, 2017, 680 were suspected cases of Dengue fever, of which 138 tested positive. 11 died that day, taking the Dengue toll in Kerala to 115 this year.

The capital city of Thiruvananthapuram is the worst hit. Till the middle of May this year, 68 persons died of fever in the state. According to data provided by the Directorate of Health Services, the number of fever cases reported was 9,549, of which 1,173 were from Thiruvananthapuram.

A total of 332 cases of Dengue were also reported, the capital city accounting for171. More than 10,000 people reported to hospitals daily with fever in June. Various fevers reported were Dengue (332), of which 115 died, H1N1 (487), Rat fever (474), of which 6 died, Malaria(112), of which 1 died, and Chikungunya(16),15 of which were confirmed. Of these fevers, Dengue sent shivers down the spine of Malayalees this year by sheer numbers affected and mortality associated with an otherwise self-remitting disease.

Dengue is caused by a virus that is transmitted through the bite of a species of mosquito called Aedes Aegypti that also spreads Yellow Fever, Chikungunya, Zika Fever and Mayoro. This mosquito species breeds in stagnant water in flower vases, buckets, discarded tires, clogged drains, and pools of water in accumulated waste.

The villain of the piece responsible for the latter two is plastic, a non-biodegradable material. Plastic constitutes 10 percent of discarded waste. Plastic carry bags and one-time use articles like disposable plates and cups, and diapers found in the waste remain undestroyed, forming crucibles inside which mosquitoes breed. Plastic clog drains, in which water and dirt stagnate, in which mosquitoes have a field day.

The ‘magic potion’ that can possibly achieve large-scale elimination of mosquitoes and rats, is not a Pied piper (who got rid of rats from Hamlin), but a forthright ban on plastic.

‘Waste management’ in Kerala, leaves much to be desired, despite numerous tours undertaken by politicians to foreign countries to ‘study’ waste management there. This is not to blame politicians alone. The citizens too lack civic and common sense to ensure proper disposal of waste. Their attitude to the whole problem, and an important one at that is one of indifferent ‘chalta hai’!

A typical example is the section of the National Highway 47 that passes through the outskirts Trichur in Kerala, both sides of which are strewn waste, both animal and vegetable, especially the former tied in jute bags. This is a phenomenon encountered typically on Mondays, after the brisk weekend business in the town’s markets, slaughterhouses and poultry outlets, spreading a nauseating stench, rendering driving through that section of the highway almost a nauseating ordeal on Monday mornings.

Public places, thoroughfares, tourist spots and unused plots of land too are mindlessly littered and waste collected in plastic carry bags strewn about. These attract stray dogs and rats (which spread a number of zoonotic diseases like rabies, leptospirosis, and lately, murderous attacks on humans by the otherwise docile stray dogs, and mosquitoes, spreading various fevers including malaria which was thought to have become nonexistent in Kerala), adding to the woes of citizens across the length and breadth of the state. This being the case, the only option is to ban plastic.

Though the onus is on the government, especially the local governing bodies to ensure proper waste management and to control the fever epidemic (for which citizens pay taxes), citizens simply cannot wash their hands off proper waste disposal. They must adopt a plastic-free life as far as possible and deny mosquitoes and rats breeding grounds.

Plastic has emerged the villain numero uno for rendering our lives unlivable, and for wreaking havoc on the environment on a larger scale not only in the state of Kerala and India, but the entire planet.

The damage caused by plastic depends on its type, which depend on its precursors and method for their polymerization. Recent studies have shown that plastics in the ocean decompose faster than was once thought, due to exposure to sun, rain and other environmental variables, resulting in the release of toxic chemicals such as Bisphenol A.

However, due to increased volume of plastics in the ocean, decomposition has slowed down. The marine Conservancy has predicted the decomposition rates of several plastic products. It is estimated that a foam plastic cup will take 50 years, while a plastic beverage holder takes 400 years, disposable diaper 450 years, while a fishing line takes 600 years to degrade.

Landfill areas contain different types of plastics, the degradation of which is speeded up by numerous microorganisms like Pseudomonas, Flavobacteria, etc. When biodegradable plastic is broken down, methane is released, which is a very powerful greenhouse gas that contributes significantly to global warming. Chlorinated plastic release harmful chemicals into the surrounding soil, which seeps into the groundwater or other surrounding water sources and the ecosystem too.

Among the various ecosystems, the ocean is a storehouse of plastic and poisonous byproducts of the same. Almost 90% of plastic debris that pollutes ocean water which translates to 5.6 million tons, comes from ocean-based sources. Merchant ships expel cargo, sewage, used medical equipment, and other types of waste that contain plastic into the ocean. Naval and research vessels also eject waste and military equipment deemed ‘unnecessary’.

Pleasure crafts release fishing gear, responsible up to 90% of plastic debris in some areas. A little over 10% of plastic debris in ocean water comes from land-based sources, responsible for 0.8 million tons annually. A source that has caused immense concern is landfills. Plastic material thus delivered into the ocean is toxic to marine life and humans. The toxins that are components of plastic include diethylhexyl phthalate, a toxic carcinogen, as well as lead, cadmium and mercury. Plankton, fish and ultimately humans through the food chain ingest these highly carcinogenic chemicals. Consuming fish that contain these toxins causes cancer, immune disorders and birth defects.

Plastic also adversely affects the animal kingdom other than humans. Plastic pollution poisons animals, which then adversely affects human food supplies. Plastic pollution has been described as being highly detrimental to large marine mammals, described in the book ‘introduction to marine biology’ as posing the ‘single largest threat to them’.

Marine species such as sea turtles have been found to contain large proportions of plastic in their stomach, blocking the digestive tract of these animals leading to their starvation and death. Large amount of plastics have been found inside the stomachs of beached whales. Marine species get entangled in plastic products like nets that ultimately harm and kill them. It is estimated that at least 267 different animal species have suffered from entanglement and ingestion of plastic debris. It has been estimated that over 400,000 marine mammals perish annually due to plastic pollution in oceans. Plastic equipment like nets discarded into the oceans drag along the sea beds damaging coral reefs.
It is estimated that seagulls in the North Sea had an average of thirty pieces of plastic in their stomachs. It is estimated that 1.5 million Layson Albatrosses which inhabit midway Atoll, halfway between Asia and North America all have plastics in their digestive systems. On the shore, thousands of birds’ corpses can be seen with plastic remaining where the stomach once was. The durable Plastic piles responsible for the birds’ death can still be seen in their decomposed corpses!

Similar to humans, animals, specifically sheep exposed to plasticizers experience developmental defects, when exposed to Bisphenol A (BPA). Exposure to BPA shortens the distance between the eyes of tadpoles. It can also decrease the body length of frogs.

Man is affected adversely in numerous ways by the chemical constituents of plastic.
• 95% of American adults have had detectable levels of BPA in their urine. Exposure to toxins like BPA disrupts fertility, reproduction, sexual maturation and other ill effects.
• BPA affects gene expression related to the Thyroid hormone axis, ultimately resulting in hypothyroidism(low levels of thyroid hormones, or clinical features of the same)
• BPA disrupts normal physiological levels of sex hormones, ultimately disrupting gonadal development and sperm production.
• Plastics, through prolonged, direct contact with skin causes dermatitis.
• Man also suffers from cancer, by being one among the many links of the food chain.
• Plastics lying around within the community act as ‘breeding grounds’ for mosquitoes. Food sticking within the crevices of disposable, and ‘convenient’ plastic containers attract stray animals like dogs, cats and rats, a scenario that has lately unfolded in Kerala, which is resultantly in the grip of numerous fevers that kill and add hugely to health bills that is already leaving a gaping hole in the Keralites’ wallets, thanks to the extended life expectancy of malayalees(associated with many age-related ailments), brought about by high standards of healthcare, compared to other Indian states. An inevitable medical paradox indeed!
Can measures and legislations be put in place to have plastics let go off Kerala, where the travails caused by plastic is but the tip of a huge stinking iceberg? Some of them indeed can be attempted, before wailing for the dead becomes a habitual accompaniment of monsoons and their thereabouts in the state.
• Uncompromisingly ban all types of plastics, including the so-called ‘biodegradable’ ones, as they emit significant methane, which adds to the destruction of the ozone layer, contributing to global warming. The ban ought to be stringent that plastic is rendered unavailable and a ‘phenomenon of the past’. To achieve this, only a focused, determined political will to this effect will help.
• Why not return to those days when articles bought from shops used to be wrapped in newspapers and secured with jute twines? Nobody died as a result.
• Shops using plastic bags to pack articles bought must switch over to paper bags. Let them charge the customers for this. These should be made legally compulsory, ensured through random checks. Stiff fines and even cancellation of licenses to run business in noncompliant outlets ought to be considered with all seriousness that an extremely grave current situation, which is a medical emergency merits.
• Manufacture of paper bags can well be established into a well-oiled small scale industry, and jobs generated henceforth.
• Disposable plastic items also ought to be banned, or their proper disposal and management ensured. Tonnes of these in the crevices and acute angles of which food stick to, attracting rats and stray animals are found in heaps across the state, as they are used in abundance in parties these days. These are times where even banana leaves come in plastic avatar! One of the significant sources of large amount of plastic generation is Engagement and wedding receptions and parties associated with weddings (an industry in themselves!).
• Disposable and ‘convenient’ plastic plates and glasses have almost replaced ceramic ones. In olden days, meals at receptions and wedding related gastronomic orgies used to be served on banana leaves, or in paper plates. No marriage was heard to have fallen apart on account of meals being served on banana leaves! These days, every single guest is provided with a small plastic bottle of mineral water, which is quite unnecessary. Water could well be served in individual paper cups. This will also ensure generation of employment as adequate man power is required for such an undertaking. The efficiency with which used banana leaves are removed from tables after a batch is done with eating, and fresh ones laid on cleaned tables have to be witnessed to be believed! ‘conveniences’ at wedding receptions and parties ought to be sacrificed to do away with inconveniences posed by hospitalization to treat deadly fevers, and that posed by funerals of those who succumbed!

• Government, especially local governing bodies must do away with the typical lackadaisical approach adopted to deal with waste management. Drains and canals must be unclogged and cleaned well in advance before monsoons strike. Heaps of waste beside thoroughfares must be disposed off on a regular basis, especially before monsoons. Citizens should be provided with sufficiently large animal-proof containers, preferably made of concrete and anchored deep into the earth, like a well to deposit waste, from which it would be collected meticulously and scientifically treated. Empowered Squads must be employed to nab uncaring and indifferent citizens who strew waste collected within plastic carry bags on public thoroughfare and vacant and unused plots of land.

• They must be fined heavily enough to deter them from the crime that littering is. Even imprisonment will not be out of place, considering the gravity of the situation. Littered waste including plastic is consumed by wandering animals. I was shocked recently to learn over radio that the stomach of a slaughtered cow contained 100 kg of plastic! This is something for the so-called ‘cow vigilantes’ to mull about. The overzealous Vigilantes ought to realize that lynching people suspected to have consumed beef, or seen to transport cattle, especially cows is not what vigilantism is all about. It is also about providing cows a milieu for healthy existence!
Kerala’s ears are tired of having earful of loud wailings from households that lost many people to fever of numerous kinds, brought about by an eminently preventable situation borne out of indifference, selfishness and an unhealthy tendency to stick to ‘convenience’ like food does to use-and- throw plastic luxury!