A Rotary Foundation Global Grant project has proved highly effective in preventing the spread of dengue fever in a community in Indonesia. The one-year project, the first funded by a global grant under the Future Vision pilot, began on 1 July 2010, carried out by Rotarians in districts 3400 (Indonesia) and 7980 (Connecticut, USA).

Photo shows Ritje Rihatinah (left), past governor of District 3400, and Danarsih Santosa, a member of the Rotary Club of Solo Kartini, Indonesia, inspecting a tub as part of the global grant project to prevent the spread of dengue fever. Photo courtesy of Rotary Club of Solo KartiniThe effort helped disrupt the breeding cycle of mosquitoes that transmit the disease in Kadipiro, a community of almost 50,000 people near Surakarta, Central Java. During the project's first six months, contractors installed white ceramic tiling on the interior surfaces of cement water tubs in more than 1,400 homes, making it easier to spot and remove gray mosquito larvae spawned in the tubs.

In the second half of the project, members of the Rotary Club of Solo Kartini, Indonesia, which came up with the idea for the effort, educated residents to empty and scrub the tubs twice a week, close the lid on water containers, and bury waste that can collect water. The club also oversaw a group of monitors, who were paid a small stipend to visit participating homes weekly to check on compliance with the procedures.

Case count

As a result of the project, the incidence of dengue fever in Kadipiro fell to four cases in the first six months of this year, compared with 43 cases in all of 2010. The percentage of tubs infested with larvae averaged 1.4 percent, compared with 9.7 percent for tubs in homes not included in the project.

"This is very significant, as the community went from being highly endemic to nonendemic," says Paul Spiekermann, a physician specializing in tropical diseases and a member of the Rotary Club of Westport, Connecticut.

He also noted that chemicals, which could have proved hazardous to public health and the environment, were not used to treat tubs and other water retaining areas to interrupt the mosquitoes' breeding cycle.

Dengue affects 50 million people annually and causes about 22,000 deaths, according to the World Health Organization. "The disease is very debilitating, and drug treatment or vaccination is not available," says Spiekermann, who chairs his club's grants committee.

The project, which supports Rotary's disease prevention and treatment area of focus received a US$15,660 Foundation global grant, $7,740 in District Designated Fund allocations from the two districts, and $15,844 raised by participating clubs.

Key to the effort's success was the collaboration between the international and local Rotary clubs, Surakarta's public health department, and the Kadipiro community, say the project's sponsor Rotarians. They also point to the cooperation between the clubs and the global grant coordinator at RI World Headquarters in Evanston, Illinois, USA.

Model project

In July, the Solo Kartini club presented project data to the mayor of Surakarta, who is interested in expanding the effort to include other areas of the city. The project's effective monitoring and training components, along with its proven health benefits to the community, will help make the effort sustainable.

"There are members of the community who are less fortunate [and] live in marginal areas, far from healthy and proper social conditions," says Danarsih Santosa, a member of the Solo Kartini club. "As Rotarians, we feel obliged to help them improve their quality of life. This project is expected to become a model to reduce and possibly eradicate dengue in similar target areas around Surakarta and [elsewhere] in Indonesia where it is endemic."