April is World Malaria Month!
Worldwide, there are…
- 214 million cases of malaria reported annually.
- 438,000 malaria-related deaths every year, 90% of these in Africa.
- there were 6.9 million cases of malaria in 2015.
- 40% of hospitalizations in children under 5 are malaria-related.
- 30% of all outpatient visits are for malaria.
- 57% of households have at least one ITN (Insecticide-Treated Net).
- 34% of those families slept under an ITN the night before the survey.*
At my health center, there were…
- 8,655 confirmed cases of malaria in the last year.
- 312 confirmed cases of malaria last month.
- 4 consecutive months of malaria test kit stock-outs in the last year.
- 4.5 months of malaria treatment stock-outs in the last year.
But those are just the numbers. What do they really mean? How are families affected by malaria? What happens when there is no malaria medication available? It is difficult to get a clear picture of the problem when you focus on the numbers alone. Everyone’s story is vital to gain a better understanding of the situation. These are the faces of malaria…
Women, men, girls, boys, babies, grandparents, sisters, brothers, mothers, fathers… malaria does not discriminate. Its wrath rips through entire families with no mercy.
My counterparts and I have completed numerous door-to-door malaria surveys in our catchment area. I have learned more about how malaria has affected Malawi through these conversations, than by reviewing any amount of statistical data.
The numbers don’t tell you about the 4-year-old girl who has been unable to walk since she was diagnosed with cerebral malaria in January.
Or the man who cannot tend to his fields because he does not have the energy to move.
Or about the mother who traveled 2 hours to the health center daily for a week, praying for malaria medication to be re-stocked.
Every household has a story to share. These narratives make up essential pieces of the malaria puzzle. In my community, malaria is accepted as inevitable. Everyone gets it; it is just something that happens, like a common cold. People were shocked to hear that we do not need to use bed nets or worry about malaria in the United States.
Foster (my counterpart) and I are collecting photos of families who sleep under their bed nets. We will post them at the health center as a “Wall of Fame” to encourage others to use their bed nets correctly. To my surprise, every house we have visited so far has had at least one bed net hung.
Now that doesn’t mean they aren’t misusing some of the bed nets. There were many households with a bed net properly hung next to one being used for maize storage. This was an opportunity to discuss other solutions to these issues so people will no longer need to use the bed nets for anything but sleeping. The more we talked, the more we learned. Several families acknowledged that they only sleep under the nets during the rainy season, when mosquitoes are ubiquitous.
Overall, community members know a lot about malaria, how to prevent it, the symptoms, the importance of seeking treatment, etc. Nevertheless, when malaria meds are out-of-stock, most families have no choice but to wait it out. One mother talked about preparing for the stock-outs by not completing malaria treatment when it is available. She felt that it is better for both kids to get some treatment, than for one to get none at all. My counterpart and I can go to great lengths to explain all the problems with not completing treatment, but will the advice be heeded in desperate situations?
I have been doing malaria work at site for almost a year and there is so much more I need to learn and understand to complete this puzzle. I have the numbers. They create the essential outline of the puzzle, but the narratives fill in the rest. It’s these faces of malaria that have helped me find new, better ways to assist my community.
We can talk and teach until we are blue in the face, trying to close the gaps we have discovered. Yet, there may be more than meets the eye. My counterparts and I will continue to facilitate bed net care and repair sessions… sharing new skills and ideas, but even more important will be our door-to-door follow-ups with the families. It is during those conversations that we find out the malaria story of each individual and where their needs still lie.
*(The statistics for this post were gathered from the Stomp Out Malaria in Malawi Manual, the 2015-2016 Malawi Demographic and Health Survey, and my health center’s monthly reports.)