The battle against the main child killer
Xai-Xai, Mozambique – Zaida Alvero tenderly strokes the forehead of her frail five-month-old baby, Julieta, who lays almost lifeless on a hospital bed in intensive care, with a tube inserted in her nose to help her breath.
“My husband does not know Julieta is in hospital,” she says. The mother, who has camped at the hospital for ten days now, explains that Julieta’s father works in South Africa.
Alvero, who left school after only completing grade four, is unemployed and dependent on her husband and his family who all live together in a small reed homestead. The doctor looking after Julieta is pessimistic, explaining that Julieta’s condition is serious. “We moved her to intensive care because she is not getting any better,” she says.
More children die of malaria in Mozambique than of any other disease. The disease accounts for 60 per cent of the child paediatric hospital admissions and 30 per cent of hospital deaths. It is also one of the main reasons why Mozambique still has one of the highest child mortality rates in the world.
Malaria is also serious for pregnant women, who run the risk of severe anaemia, which can be fatal. In addition to making the woman ill, malaria contracted during pregnancy can lead to a low birth weight of the child – one of the most important factors in determining a child’s future survivals.
There is no easy way to fight malaria, which is endemic throughout the country. The climate favours yearround transmission, with peak incidence during the rainy season.
The government, with UNICEF support, carries out free distribution of insecticide treated nets (ITN) to all pregnant women and children under five in many of the provinces. The nets are an effective and cheap method for malaria prevention; they both prevent mosquito bites and kill the mosquito.
“Not only will a pregnant woman benefit from using the net, but so will her child because most new mothers sleep with their babies for the first few years of life,” points out UNICEF Officer for malaria Timothy Freeman.
According to the World Health Organisation (WHO), ITNs can cut malaria transmission by at least 60 per cent and child deaths by a fifth if the nets are used properly.
However, ITNs must be used along with improved sanitation and hygiene practices. But even then, it is still possible to suffer from malaria. If malarial symptoms develop, prompt treatment as well as complying with the treatment, will reduce the high mortality rate.
The good news is that children slowly gain immunity against malaria, making it unlikely that they will die of malaria after five years of age except if the malaria is combined with another condition that compromises their immune system, for example HIV/AIDS.
Since 2000, some 1.7 million ITNs have been distributed through the public health systems, with about 66 per cent of these being delivered through UNICEF-supported programmes in about 86 districts in the country.
But a significant number of pregnant women are not reached, especially if they do not attend pre natal clinics. "I have never used a mosquito net because I didn’t have money to buy one,” Julieta’s mother says, looking anxiously at her daughter who still lies motionless.
Nurse Francisco Victoria, at a health centre in the poorer suburbs of Xai Xai, says she makes sure that all pregnant women receive a net. She takes her time with each pregnant woman to explain how to treat and use the net. “I tell them first and then I get them to explain to me to make sure they have understood well.”
Seventeen-year-old Nelia Machango received her net at the health centre from Nurse Victoria. “I am thankful for the net because I know how bad I felt when I was recently sick with malaria,” says Machango, who is resting at her small home in the suburbs of Xai Xai city. She fell pregnant while still at school and was doing relatively well. “I am relieved to have a net. I cannot afford to get sick with malaria,” she says.