Nets help to fight malaria
By Denise Shepherd-Johnson
Jamame, Central/Southern Somalia, 23 March, 2007 - Somali people have known malaria for centuries, especially in the central and southern part of the country. In fact the Somali town of Buale is so named because many people from that area used to have a ‘big belly’: a condition associated with chronic malaria caused by ‘splenomegaly’ (an enlarged spleen).
Since the malaria component of the Global Fund programme was introduced to the country in 2004, widespread distribution of long-lasting insecticide-treated nets (LLINs) has made a big difference to riverine communities and those in flood- prone areas.
Dr Abdinor Mohamed is a UNICEF staff member and the coordinator for the Global Fund programme responsible for malaria prevention and control in the Central/Southern Somalia. In February 2007, in partnership with the international NGO, Muslim Aid, he visited Bangeni village, south west of Jamame to distribute over 600 mosquito nets. There, he met grandma Ruqia who told him, ‘Ever since that these nets were brought to our village, our children no longer know malaria’.
Says Dr. Abdinor, “I felt thrilled that an elderly lady from a far end of Somalia understood the concept of preventing malaria through vector-control in simple words. As she expressed her gratitude to UNICEF, I was so excited and told my colleague: ‘I wish I had a video recorder for this occasion!”.
Dr Abdinor’s work involves training health workers on the new malaria treatment, the Artemisinin-based Combination Therapy (ACT). The treatment is made up of two drugs: Artesunate and Sulfadoxine- Pyramethamine. Since January 2006, UNICEF has been training health workers in the country on malaria treatment using ACT to replace drugs to which there is high resistance. Dr Abdinor trains the health workers on preventive therapy for pregnant women along with the promotion and distribution of mosquito nets especially for children and pregnant women.
Though mosquito-nets have always been commercially available, at $4 each, few could afford them. Under the Global Fund Malaria programme mosquito nets are now distributed for free to the most vulnerable groups, children below five years and pregnant women.
Dr Abdinor is enthusiastic about his work and describes working with UNICEF as extremely satisfying, “I don’t want to go back to private practice. I’m part of a great organization, helping my people. [People] rely on what we can do for them. My actions [now] help so many more people than I ever reached during my 14 years as a private physician in and outside Somalia”.
However, working in riverine villages, many of them off-the-beaten-track, does come with some risk. Dr Abdinor once cautioned a colleague to look out for lions that sometimes came for a drink at the water pipe outside the UN field accommodation. Instead, his colleague was surprised to see a four foot red cobra!
Dr Abdinor describes every day as a learning process; he says he gains knowledge from his colleagues and the communities they serve. And he’s motivated by results: “I see how many people benefit as a result of what I do. In distributing 20,000 nets I’m helping to prevent 20,000 people or more from getting malaria. To me, that makes good and perfect sense. I don’t think that I would have achieved that, even in 50 years of private work”.
“I am proud to be useful to the community where our actions are visible and [especially] in country where all public health services [have been absent] for more than 17 years.”
Malaria control efforts in Somalia are funded through the Global Fund to fight AIDS, Tuberculosis and Malaria. In 2004, the Global Fund gave Somalia a $12.8 m grant to help in malaria prevention and control. One of the main components of the grant was the provision of effective malaria treatment drugs and the strengthening of diagnostic capacity. Other activities planned included the development of a national malaria control strategy, procurement and distribution of insecticide treated nets (ITNs) to the most vulnerable, and increasing public awareness about the disease. About 4.6 million people among them, 966,000 children under five years of age and 230,000 pregnant women are expected to benefit through this Global Fund initiative.