Numbers Aren't Everything
We need to get a few things clear when it comes to jellyfish in Thailand and the region which includes Malaysia, Cambodia, Vietnam, Philippines, Brunei and Indonesia - effectively the entire Indo-Pacific region including northern Australia and beyond which could include China, Japan, India, Sri Lanka, New Guinea .. we need to get the numbers straight .. don't we?
The seas around here are teeming with jellyfish - but who's counting. Many species sting and hurt. Several species have the capacity to kill. All of the countries mentioned above have been associated with fatalities from jellyfish stings - all!
Dr Peter Fenner, a medical doctor and jellyfish expert with long international experience in public health, recently addressed the 9th Asia Pacific Travel Health Conference in Singapore on the subject of fatalities and serious stings from jellyfish in the region.
What is obvious to Dr Fenner is that the region does not have satisfactory surveillance systems to report jellyfish stings. In fact, they are virtually non-existent. Stings are usually reported by word of mouth and through the media including social media or by a victim if they are motivated to do so or if they can find somewhere to report the incident.
Hospitals' systems in the region are not prepared for reporting, or as the situations in Malaysia and some other countries attest, they are negatively influenced by external and internal forces and refrain from public reporting with-holding any if not all data. The bottom line is deaths and serious stings from jellyfish are not good for business.
Dr Fenner does have his own website sting reporting system at http://www.marine-medic.com.au/ (follow links to 'report case') but it's an effort to find it if you don't know it's there or do not speak English. I know of those who have used this and are very grateful for the advice, care and follow up.
The sting numbers that are reported are believed by those who work in this area including the Divers Alert Network (or DAN, http://www.danasiapacific.org/main/research/jellyfish/jellyfish.html), Sting Advisory Services, Thailand's Bureau of Epidemiology, Dr Fenner and numerous other experts, to be just the tip of the iceberg. There are regular reports of stings via various means though no-one is sure of just how many occur every day, every week, month etc - there is no effective global reporting system or central data base.
A good example is Indonesia. There is really no reporting from Indonesia. No information at all comes from the government. Indonesia is a massive, sprawling archipelago of hundreds of millions of people and untold number of jellyfish - there must be something going on but how on earth is anyone to know?!
Yet, we received a snapshot a few years ago when we fortuitously unearthed several local newspaper items all in Bahasa Indonesia of course that told of 3 deaths in differing locations around Java in a 6 month period. There is no mistaking the cause of these deaths - box jellyfish, or more specifically Chironex box jellyfish. No mistaking!
We do not have the resources to trawl local newspapers across the region (this is not my job, just my blog!). Fishing villagers across the region do not have the wherewithal or technology to report stings. Local media report facts but do not understand the issues and rely on local medical expertise - an example of this is one young victim in Indonesia had a crab and chilli paste rubbed on his stings, he was soon dead.
Thailand is attempting to lead the way in the region but still has such a long way to go. There is very little money to address this issue properly. Authorities talk to hospitals and clinics about effective surveillance but putting this into practice has proved problematic.
We know that people get stung, we know it happens, we do get reports; however, we do not get the whole story. We cannot give you accurate numbers. Are numbers in this instance relevant anyway? Do the facts not speak for themselves: jellyfish can be dangerous, they sting and some do kill, there are many places in the region where these jellyfish exist, where they have killed - does this suddenly stop?
We are trying as hard as we can to find out more, to build a clearer picture, to create awareness, to hopefully save someone from excruciating pain or even death. In 2008 in Thailand there was no belief that box jellyfish even existed there, and it was only with irrefutable evidence that the government officially acknowledged their presence later that year.
We rely on victims to come forward or others who have seen or heard of a sting to let us know. Even then getting all the right details, the full story, is not so easy.
For example, in March 2012 we received a report from a diver who was stung off Koh Phi Phi. We received a fairly detailed report and photos of the lesions. Few people if any actually see what sort of animal struck them. This diver received a nasty sting from what appeared to be a single-tentacle box jellyfish (carybdea such as Morbakka or Irukandji).
Then, mid-April we received a report of a swimmer at Khao Lak who describes a sting in some detail. From all accounts it is a multi-tentacle box jellyfish (chirodropid such as Chironex or Chiropsoides buitenijki). Though we are unable to follow up thoroughly without proper contact details. Local arm-chair experts say Khao Lak does not have box jellyfish, we beg to differ based on this report but cannot confirm. Who do you believe? What do you do?
Many such as ourselves would err on the side of caution, while others would not. Perhaps there is no right or wrong, each to their own. If your number is up, it's up - right? But are you prepared to take the risk? At least what we are attempting is to give you some facts, some stats, some balance, ensure you can make an informed choice. We have no vested interests. We are concerned only about safety. We know what these animals can do and we know how they can effect victim's families' lives forever.
So, while we cannot provide you with daily detailed updates on stings like a progressive score in a football match, we can advise you that the tropical and sub-tropical waters of the Indo-Pacific DO contain dangerous jellyfish that CAN seriously injure and kill. The rest is up to you. And if you do happen to get stung or hear of a sting, please let us know so we can continue to monitor the situation and get the right information to the right people. This is an issue that is not going away, it is only going to become more of a problem. The numbers are meaningless when a tragedy is a tragedy.