Mr Viger is also responsible for the hygiene, water, sanitation and livelihood programme at the Mae La Refugee Camp, which is home to as many as 40,000 refugees from Burma.

The camp lies 60km north of Thai border town Mae Sot on the Thai side of the border in Tak Province.

Academic health articles say that dengue is endemic in the area and that serious outbreaks occur periodically every two to three years.

In early June this year it was reported that 216 camp residents had contracted dengue fever.

In an interview with Karen News Mr Viger explained the rigorous planning that Solidaritès International puts into its dengue prevention program.

He said: “Our planning for this year started in August 2014. In May we started a fumigation campaign that targeted all public places – this lasted five days.”

He pointed out that Solidaritès International’s dengue program is not only about fumigation, but also includes education, distribution of information,  house-to-house visits and the delivery of sand-abate (a larvicide that kills mosquito eggs).

He said: “We visit and check every household and distribute sand-abate every three months. We check water containers and encourage people to clean up garbage and discarded items where mosquitoes can breed – old tyres, toys, bottles, cans, broken bamboo poles, old buckets, flower vases and the plates under the vases – anything that can hold small amounts of water.”

Mr Viger maintains that Solidaritès International’s intensive mosquito larvae monitoring system is a good indicator and gives early warning of the risk of a dengue outbreak.

“Every month we check 50 households in each of the camp’s sections for larvae, that’s an average of 1,100 households.”

Prior to this month’s outbreak Mr Viger told Karen News: “This year we are finding in most of the sections that we test that the larvae count is up.”

Solidaritès International’s public health team leader, Naw Molly told Karen News that they have started to “warn the camp residents to start destroying the larvae, to clean their water containers and tanks, clear rubbish from around the house and to use sand-abate in their big water containers.”

Mr Viger told Karen News that, in response to a recent dengue outbreak in Mae La: “Solidaritès International conducted a full camp fumigation in partnership with the Thai District Health Office (DHO) on 9th, 10th, and 11th June 2015. We will conduct a second full camp fumigation on 17th, 18th, 19th June 2015.” He added: “An extra sand-abate campaign has been started too.”

Naw Molly pointed out to Karen News that dengue is a real health danger to all the people in the camp.

She said: “We are trying to prevent people from suffering from a very painful fever. A sick child affects the whole family as it takes a lot of time to care for them.”

Mr Viger stressed that dengue prevention only works well with the assistance of the whole community.

He said: “Our [dengue] project will only work well if we have the support and help of all in the camps – residents, various camp committees, school kids, international non-government and community-based-organisation. We depend on their collaboration and mutual cooperation.”

Planning is also critical when dealing with dengue fever

Mr Viger said: “We have in place a Rapid Response Surveillance Team at Mae La Refugee Camp led by the organization Premiere Urgence – Aide Medicale Internationale (PU-AMI) and as soon as we have a confirmed dengue case, within 24 hours we fumigate 100 metres around the patient’s home. We check water containers for larvae and seven days later we follow-up.”

Mr Viger said that this was part of Solidaritès International’s standard procedure in response to a dengue case.

He added: “If the patient is a child we do this response around the kid’s school as well. If we get more than three cases in one week we will fumigate the whole section – as many as 600 houses. This year we have already fumigated four sections.”

Mr Viger said that stopping the spread of dengue takes a lot of human and financial resources and that Solidaritès International’s project was funded by the US Government's Bureau of Population, Refugees and Migrants

Naw Molly said it is important to support the fumigation program with educational activities and materials.

She said: “We have two dramas that we take to the camp sections – we include dengue and how people can defend themselves against it. We also have educational games to promote awareness and encourage people to take preventative action.”

Edited in English by Mark Inkey for BNI