Posted by: kristinej | August 25, 2009

August 25th

Malaria did exist in the United States and in Western Europe, but it was eradicated in the middle of the 20th century. At the time, the World Health Organization had launched a campaign to eradicate malaria in the whole world, but when they realized how hard that was going to be in Asia and Africa, the campaign was abandoned. In recent years, though, with better technology people have again begun to push for malaria eradication. The Global Fund was created to collect and distribute aid for HIV/AIDS, malaria, and TB, and the 6th Millennium Development Goal focuses on fighting malaria.

Malaria is so prevalent in Sub-Saharan Africa because of its tropical climate. While it is impossible to ever totally remove mosquitoes, there are ways to keep them under control and to limit exposure as much as possible. Removing standing trash and preventing standing bodies of water around homes can reduce areas in which mosquitoes can breed. Indoor residual spraying, in which the entire inside of a house is sprayed with insecticide, can also reduce the number of mosquitoes in a home. And, of course, everyone should sleep under a bed net, though bed nets alone cannot end malaria, since people still get bitten by mosquitoes. What is most important is to be able to recognize the danger signs of malaria and seek treatment within 48 hours of the onset of symptoms.

One thing that I learned about malaria recently is that the reason that young children are so vulnerable is because they have not yet built up an immunity to malaria. Children under five will suffer an average of 2 cases of malaria a year, and so over time, assuming they survive those bouts, they build up a semi-immunity. They still risk getting severe malaria, but more often they will just get mild malaria or may not even notice the symptoms. This is why visitors to malaria endemic countries, like myself, are just as vulnerable as young children to malaria – because we haven’t ever suffered malaria and therefore have no resistance built up. In fact, one of our doctors here suggested that we might be even more vulnerable since babies get a little bit of immunity from their mother before they are born. I am lucky enough to be able to take a prophylaxis that makes it much much less likely that I will get malaria, but you can imagine how someone who moves to Bamako from the north of Mali, where malaria is much less prevalent, would be very much at risk.

During our malaria discussions last week we heard several very touching stories from our community health workers and our Malian staff, and I thought I would share a couple of those here. The first goes like this: One of our community health workers (CHW) was doing her morning rounds in her zone when she noticed a family living in a shack that she had not visited before. She came up and greeted the family, and ask if there was anyone in the family that was sick. The parents said that yes, in fact, there was, and brought her into the little house where an 8 year old boy was lying on a mat, convulsing a bit and barely conscious. He was at severe stage of malaria, called neurological malaria, where the disease starts to affect the brain and can cause permanent damage. Our CHW recognized that this was an emergency, and so she had the boy evacuated to the hospital, where he received treatment. The next morning she went back, and the boy was awake and asking where he was. A couple of weeks later she came back to check on the family, and the boy was just returning home from school with his backpack on, energetic and completely healthy.

Another story that one of our Malian staff members told was of an old man who came to him saying that he had not been able to urinate in over 2 days and he was bleeding as well. Chaka said that he almost cried when he saw this man, because he could not imagine what kind of pain he must be in. Chaka took him to the clinic, where they ran tests and he underwent surgery. The surgery cost about $100, which doesn’t seem that much by American standards but which was about a third of his annual income. 3 weeks later Chaka came back to visit him, and his was totally better and couldn’t stop smiling and thanking him for his help.

View of my neighborhood from the roof of my house

View of my neighborhood from the roof of my house

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