World Malaria Day

A child dies of malaria every 60 seconds, which adds up to 1,400 children a day, and yet it only costs $1 to treat a child for malaria.

This seems, on the surface, like a simple, cheap, and easy problem to solve-- only an additional $1,400 a day to the global aid budget-- and yet people have been dying of malaria since King Tut died at the tender age of 10 from a mosquito bite and the disease still infects over 200 million people every year.  This is a disease we have been fighting for centuries, from quinine to coartem, from mefloquine to malarone, with mosquito nets and bug spray and chemical wall sprays and daily and weekly prophylaxis, and yet still 6 children die every hour.

One of the main roadblocks, perhaps-- and this is a roadblock to many aid projects all ovr the world-- is that a project involving human lives is never as simple as numbers and cash.  There is implementation-- who will deliver the mosquito nets?  Where and when will they distribute them?  Which clinics need how much coartem how often?-- and distribution-- what if the truck delivering coartem breaks down?  Which roads will cause the least delays?  How often must deliveries be made?  How much does each clinic or community need?  Should people be charged and how much should nets and medicine cost?-- and availabilty-- What happens if the clinic runs out of coartem or nets?  Where and how soon can they get more?  What if a sick patient walks 10km to a clinic for medicine and the clinic doesn't have any, can they survive another long walk to the next clinic?-- and education-- how can we be sure those mosquito nets we handed out won't be used for fishing or a wedding veil?-- and diagnosis-- does the clinic have malaria tests?  Are they expired? How does a patient know if they need to go to the clinic or not?-- and treatment-- what if the woman with malaria is pregnant?-- and the list goes on and on.

Diagnosis can be particularly difficult because malaria symptoms can resemble a very bad flu-- chills, vomiting, feever, muscle aches, etc.-- and if the clinic is 10km away and you are sick in bed with the flu, what are the chances you are going to walk to the clinic just to make sure the flu isn't actually malaria?  This is especially a problem in rural areas where people don't always understand how serious malaria is-- I've known counterparts to say I have malaria if I sneeze or have food poisoning, and my host grandmother once got malaria and asked me to run to the nearest tuck shop to buy her painkiller.  Even if someone knows for sure they have malaria (because when you really have it, you feel the pain of it deep in your bones) and that it is something too serious for advil to handle, there is no guarantee the clinic will be well-stocked when they get there.  Malaria is spread by a certain type of mosquito that is most active at night, so it is crucial that people sleep under a mosquito net, and yet many people do not do so, either because a net is not available or because they do not know to ask for one or they are given one but are not told or do not understand what to do with it and why.  While a child is cured by $1 medicine, a disease is cured by education and prevention.

So the moral of the story, I suppose, is that it might cost $1 to treat a child, but it actually takes a lot more work than that.  It takes education and awareness and committment to preventing and curing the disease.  It takes supplies and skilled doctors and organized governments and aid groups prepared to provide those supplies efficiently.  It takes well-stocked and well-staffed clinics and accessible community health workers-- Zambia is required to have a functioning and well-stocked health post every 10km, but this is not always the case in practice-- and roads that sick patients can easily navigate.  And yes, it takes medicine for when you are sick, and prophylaxis and mosquito nets and bugsprays for when you are well.  Stopping malaria is a constant struggle, and it is not something we can just throw a dollar at and walk away.  It is something that takes committment from everyone from world leaders to doctors to clinic workers to the patients themselves to you and me.

April 25th was World Malaria Day, and this month Peace Corps worldwide is spreading the word about the importance of STOMPing out malaria.  To learn more about the malaria prevention and treatment effort, visit stompoutmalaria.org.