By Silvia Ximenes and Natasha Cleary, ChildFund Timor-Leste
April 25 is World Malaria Day, a time to recognize the toll this disease takes on many people worldwide, particularly children under the age of 5.
It’s mid-morning off tropical Timor-Leste’s coast, in the mountains of Liquica district. The wet season is coming to an end, so the trees and scrub are still green, and fruit and vegetables are abundant. But the wet season also creates an abundance of mosquitos.
Elderly patriarch Jose Dias lives in one of the only houses in his village that’s made of concrete; most are made of bamboo and palm leaves. Despite its stronger foundations, the house lacks window coverings and fly screens, like all houses here, and it is full of mosquitos. They swarm as Jose speaks about protecting his growing family from malaria.
“My family received two bed nets from ChildFund, and the volunteer also gave us information about how to use them properly and why we need to use them,” he says. “Giving information with nets is important, because some people didn’t know what they were for and used them to catch fish or protect their trees from pests.”
But there are no bed nets in Jose’s garden. While his adult children are working in the fields harvesting vegetables, Jose stays at home with his infant grandson, who sleeps under a net, protected from the mosquitos.
Community health volunteers trained through ChildFund have visited his home and hold group education sessions in his community, raising awareness of disease prevention, like how and why to use nets, and advocating the use of local health clinics. Last year, ChildFund distributed 950 insecticide-treated nets in Liquica district.
Up the hill from Jose’s house is 7-year-old Jakson’s bamboo and palm leaf house. Jakson contracted malaria a few years ago, before his family started using nets. “When I had malaria, I just stayed at home sleeping. I couldn’t go to school or play with my friends,” he says. “Jakson had a fever and headache,” explains his mother, Agostinha. “I knew that I had to quickly take him to the health post to get medication and treatment. Juleta [a volunteer] had already informed my family and the community.
“If I lost a child due to sickness, life could never be the same again,” Agostinha continues.
She has four children who are 7 and younger, and they now all sleep under bed nets provided by ChildFund. Children younger than 5 are at increased risk of rapid progression of malaria, as well as more severe mutations and a higher likelihood of death, according to the World Health Organization.
But there is hope. Through interventions like distribution of bed nets and increasing community awareness, malaria has almost been eradicated in Liquica. Last year, ChildFund distributed 950 insecticide-treated bed nets in Liquica district.
“In 2006, 220 of every 1,000 people who took a blood test had malaria,” says Pedro Paulo Gomes, director of the Liquica District Health Service. “Nowadays it is less than two. The dramatic decrease has been achieved through successful interventions like training [of health staff], bed net distribution and behavior-change information provided to the community.”
Gomes adds that the Ministry of Health has a good working relationship with ChildFund. “We work in partnership to train health staff and volunteers on community health education.”
By Meg Carter, ChildFund Sponsorship Communication Specialist
Why? Because every minute, malaria takes the life of an African child. That’s an important fact to remember as we mark World Malaria Day.
How Malaria Spreads
A parasitic illness spread by female Anopheles mosquitos, malaria is the leading cause of death in children under the age of 5 in Africa. Every year, malaria kills 10,000 women and 200,000 infants worldwide. It’s especially dangerous during a woman’s first and second pregnancies. Infants become vulnerable again at 3 months, when the natural immunity they shared with their mother begins to wane.
Mosquitos bite mainly between dusk and dawn, and they carry four different parasites. The most lethal — and most common — malarial parasite is Plasmodium falciparum. Anopheles mosquitos in Africa have long lifespans and prefer to bite humans rather than animals. As a result, 90 percent of all malaria deaths occur in Africa, although India also has a significant problem. The Gambia, Guinea, Liberia, Senegal and Sierra Leone, all countries served by ChildFund, have the highest occurrence rates in the world.
Rainfall patterns, temperature and humidity affect mosquitos, so malaria infections peak during and immediately after rainy seasons. Epidemics occur when climate conditions change or when seasonal workers, immigrants or refugees lacking immunity move into malarial areas.
Approximately half of the world’s population is at risk of catching malaria. In endemic areas, adults develop partial immunity through many years of exposure and illness, so most deaths occur in young children. In regions with lower infection rates, a sudden epidemic can decimate the population.
Links to HIV and Poverty
Mozambique and Zambia have high rates of cerebral malaria — which virtually guarantees death — as well as co-infection with HIV. More than 90 percent of their populations are at ongoing risk for malaria, and more than 10 percent have AIDS.
Existing HIV infection increases the risk of malaria and also the severity and complexity of the illness; HIV infection also interferes with the medications used to treat malaria, making death more likely. Malaria also increases the risk of mother-to-child transmission of HIV.
Malaria is closely linked to poverty: The lower a country’s gross national income, the higher its malaria mortality rate. For children under 5, parasite prevalence is worst in poverty-stricken, rural communities, where lack of access to health facilities, effective diagnostics and treatment options is commonplace. Poor-quality housing offers little protection against mosquitoes, and the cost of insecticide-treated bed nets and indoor spraying with insecticides is challenging for those living on less than $1.25 a day.
To avoid malaria, families need to sleep under insecticide-treated nets nightly, and houses must be sprayed every three to six months. ChildFund is working to combat the spread of malaria in Guinea, India, Kenya, Liberia, Mozambique, Sierra Leone, The Gambia, Uganda and Zambia, and you can help by purchasing bed nets for children and families.
On World Malaria Day, let’s strike back against this threat to children.
View a video to hear a mother in Guinea describe how her children’s health has improved with treated bed nets.