Procuring supplies for children
A billion mosquitoes can't be wrong... malaria kills thousands of children in The Gambia
By Kent Page, Communication Officer.
Kaiaf & Jareng Villages, Lower & Central River Divisions, The Gambia -- There are many myths surrounding malaria in The Gambia. One is that the disease that ‘causes children to have diarrhoea, fevers and fits’, is caused by a small, forest animal known in the Mandinka language as ‘subundingo’. When ‘subundingo’ attacks a child, or even when it passes by in the forest and a child later crosses its path, the fever and fits will come, and oftentimes, kill.
Another myth is that ‘subundingo’ can be scared off if children wear necklaces made from the horn of a goat stuffed with special, protective herbs and bark. Yet another myth involves the cure for children suffering from malaria: writing special verses with the ashes of a fire on a piece of wood, then washing the ashes off in the water in which the sick child is bathed. Whatever the myth and by whatever name, one thing is certain: malaria is the leading killer of children in The Gambia.
“Malaria constitutes the main public health problem in The Gambia, accounting for the probable cause of 25 per cent of deaths in children under-five,” stated Ann Therese Ndong Jatta, Minister of Education, on behalf of the First Lady of The Gambia, in her speech launching the recent UNICEF-spearheaded ‘Mosquito Bed-Net Dipping/Birth Registration’ Campaign in The Gambia. “Recent statistics issued by the National Malaria Control Programme indicate that between 1,000-2,000 children in The Gambia die each year as a result of malaria. And, a significant number of the children who do survive an episode of severe malaria have brain damage.”As colourful as the Gambian myths are, the reality about the cause, prevention and cure of malaria is clearly black and white.
Malaria is caused by infected mosquito bites. Mosquitoes thrive and breed in wet areas, along rivers, in swamps and anyplace where there is stagnant water. Raising public awareness by providing accurate knowledge on the cause, prevention and treatment of malaria, coupled with concrete preventive action, are the best ways to prove a billion mosquitoes wrong. Armed with the right information and the right protection, the battle against malaria can, and must be, fought and won: the current malaria death rate in Africa stands at one child dying every 30 seconds.
UNICEF support in the battle against malaria in The Gambia was recently augmented with the launch of a mass campaign for Mosquito Bed-Net Dipping in two of The Gambia’s poorest, rural areas: Lower River and Central River Divisions. Studies show that the populations bearing the greatest malaria burden are children under-five years of age and pregnant mothers. Furthermore, poor, rural communities like Lower and Central River Divisions tend to suffer the effects of malaria more than urban ones due to a greater lack of awareness and understanding of malaria risk and prevention, less access to preventive and curative services, and higher malaria transmission rates.
“An ounce of prevention is worth a pound of cure,” said Cheryl Gregory Faye, to the crowd gathered in Kaiaf Village, Lower River Division, for the launch of the bed-net dipping campaign on 24 May. “One effective way to prevent malaria is for mothers and children to sleep under insecticide-treated mosquito nets. UNICEF is working together with the Gambian Government, the World Health Organization and the World Food Programme to raise public awareness and take concrete action against malaria in Lower and Central River Divisions, the two regions most highly affected by malaria. Working together, we can help ensure children’s rights to health and survival.”
Lance-Corporal (Retired) Ousman’s Battle Against Malaria In Jareng Village: Beyond sleeping under insecticide-treated mosquito nets, another proven way to raise understanding about the cause and prevention of malaria is for village health workers to be properly trained, informed and active in their communities. Well-respected in their communities and understanding local languages and custom, properly informed and UNICEF-trained village health workers are effective in ensuring that words are translated into preventive action. Standing straight and tall, Lance-Corporal (Retired) El-Hadj Ousman, is a great example of such a village health worker. He’s still on duty in Jareng Village, Central River Division.
“I’ve been living here in Jareng ever since I left the Army,” says Ousman. “I was discharged on 23 February 1946 after serving for five years and 154 days with the First Gambian Regiment in the Second World War. I fought in Burma and was awarded the Burma Star. I’m 82 years old now, but I’m fit and strong and I’m still working as a village health worker. I want the people in Jareng to be fit and strong and grow old like me so I’m glad the mosquito-nets are here now and ready for dipping to protect the people of our village.”
Today, the second day of the mosquito bed-net dipping campaign, Lance-Corporal (Ret’d) Ousman stands watch outside Jareng’s small health post, where scores of buckets and white mosquito nets have formed a straight, orderly line – Ousman wouldn’t have it any other way. Although the ‘soldiers’ lined up - armed with their mosquito net weapons in the fight against malaria - are mostly women and their children, some of the men in the village are present also. Hard at work, rubber gloves covering their hands, they help some of the village women operate the Mosquito Net Insecticide-Treatment Unit set up at the health post. While a Mosquito Net Insecticide Treatment Unit may conjure up visions of computerized, high-tech, stainless steel machines, the reality is much simpler, more effective and less expensive. A few plastic buckets, a larger wash basin, some insecticide, rubber gloves and an area for the nets to dry is all it takes to impregnate the nets, thereby providing one of the best lines of defence against malaria.
But, it wasn’t always so. “I had 10 daughters and seven sons,” says Ousman proudly, but with a sad smile. “But three of my children died of malaria. They were sick with diarrhoea, had fevers, then they had violent convulsions. Then, they died. That was a long time ago and we didn’t know what the illness was back then or what to do about it. But now we know that mosquitoes cause malaria and we have to be sure that everyone has a bed-net in the village and that there’s no standing water around for the mosquitoes to breed in.”
Like every good soldier, Ousman is always ready for an inspection. “You can come and see some of the homes here, to see that we really do use the mosquito nets,” he says. We walk a short distance to a small, mud-brick hut and the mother of the family bids us welcome. Incredibly, the house is virtually spotless, despite the sandy dust that blows freely in the dry, desert-like heat typical of Jareng at this time of the year - just before the coming rainy season that brings with it the enemy mosquitoes. The mother shows us the family bedroom and her three daughters sit smiling on the edge of the mosquito net-covered bed for a photo.
“I have to be sure that every home in Jareng has a bednet like this,” says Ousman, laughing, his red, beetle nut-stained teeth flashing a grin. “Or else, I’m not doing my job.” At one point during the bed-net dipping, Ousman hands over command to an assistant and disappears to his small, mud-brick home. He comes back with a small box and shows me the three medals he was decorated with during the war, including the Burma Star. He also shows me his worn, but readable Military Conduct Card,
which reads: “Lance-Corporal Ousman: This NCO has always discharged his duties well and proved to be a reliable leader in action. 18 June 1946.”
More than 50 years later, the same words apply, but now his ‘reliable leadership in action’ is in the battle against malaria – a battle to prove a billion mosquitoes wrong and to save the lives of children and women in The Gambia.
Background Information
Malaria is endemic in The Gambia and is the leading killer of children in the country, with over 1,000 deaths per year amongst a population of only 1.4 million - more than half of whom are women and children. Pregnant women and children under-five years of age, particularly those living in poor, rural communities like Jareng and Kaiaf villages, experience the greatest malaria burden. A serious illness amongst pregnant women, malaria often causes severe anaemia, as well as leading to low birth weights of children, perhaps the most important factor in determining a child’s future survival and development.
From 24 May–3 June 2003, UNICEF led a campaign to raise awareness and take concrete action in the battle against malaria, whose transmission peaks during the June-October rainy season. During the campaign, mass media attention focused on raising public awareness of the proven, enhanced health benefit of sleeping under insecticide-treated mosquito bednets. UNICEF also supplied and distributed 32,500 bednets to families with pregnant women and children under five in vulnerable communities in Lower and Central River Divisions, as well as providing 7,300 litres of permethrin insecticide and logistic support.
In a joint effort, World Health Organization provided technical assistance; World Food Programme provided 40 metric tons of rice as food for work for bednet dipping volunteers; the Gambian Government provided nearly all vehicles and released community health workers and public health officials to work on the campaign, which was conducted jointly with a mass birth registration campaign. In 2002, UNICEF Supply Division procured almost 4 million insecticide-treated bed-nets for global distribution.
