Right now, in the dry air of ‘Satan’s breath”, the thought of any relief from the heat is hard to imagine. Eight months in, I feel as if I have acclimated some, but the seasons are now changing quickly as we move right along into rainy season. Unfortunately, with the rain comes the mosquitos. With the mosquitos comes the increased cases of malaria.
The good news is that this month of May is International Malaria Month. A month to raise awareness and do positive work within our communities! Of course, the work goes beyond this month, but it is a positive jump start!
The big picture is, of course, a malaria free world. There have been big changes and developments over the span of years and years. Malaria was eradicated in Europe and the United States by using heavy amounts of IRS, Indoor Residual Spray, but by the 1950s, IRS failed to eradicate the disease elsewhere. The drug Chloroquine was used to treat malaria until the 1990’s. Malaria became resistant to this medication. It was not until the 2000’s that the development of ACTs, Artemisinin Combination Therapies came into motion. This combination therapy is currently the frontline treatment.
The malaria parasite is not a one blanket parasite. In fact, there are five different kinds of the genus Plasmodium: P. falciparum, P. malariae, P. ovale, P. vivax and P. knowlesi. Plasmodium falciparum is the most dangerous and common of all. Can you guess the major genus here in The Gambia? You got it. P. falciparum.
Did you know that not all mosquitos cause malaria?
Below is the Anopheles mosquito. This mosquito feeds on blood, and the female Anopheles is actually the one that carries malaria. They need to feed on blood to feed their babies, unfortunately, ingesting and spreading malaria from bite to bite. These babies are hatched in water, so it is very important to keep a clean compound, eliminating as much standing water as you can.
This little clear guy is the Culex mosquito. It enjoys feeding on dirty water and is less of a threat than Anopheles.
This last mosquito is the Aedes, commonly known as the Yellow Fever mosquito. This bugger may not spread malaria like the Anopheles, but can spread a whole host of other diseases. Often, Aedes feed mostly on trash…yummm.
Have you ever wondered why some people are ‘more desirable’ to mosquitos than others? Well, there are some ideas on how much CO2 is released from a person. This causes long-distance detection of hosts. Once the mosquito is close, heat and humidity emanated from the body also attracts the mosquito. This is an issue especially when a person is sick and runs a fever. Then there is the highest biting time. Those individuals sitting out around 12-2 am are most vulnerable. From around 10pm-4am, there is a slow increase and then decrease of mosquito concentration. Hence why a bed ned is so important and effective if used consistently and correctly.
With Anopheles buzzing around heavily in the Central River Region and the Upper River Region (my home), Peace Corps is working hard on prevention work. How can we stop these buggers from getting our loved ones sick? How can we stop the spread before it goes from family member to family member?
Well, we are helping promote vector control including LLIN, Long Lasting Insecticide Nets. These nets are designed to block mosquitoes physically, but also has been treated with safe, residual insecticide for the purpose of killing and repelling mosquitoes. IRS, Insect Residual Spray is sprayed on the walls of homes. This spray kills mosquitos upon contact with the wall and can last up to nine months.
Along with vector control, case management is a growing aspect of what we are currently working on. We prompt for diagnostic tests and treat with effective antimalarials early to prevent further spread. Chemo-prevention such as (IPTp) intermittent preventive treatment of malaria in pregnancy, (IPT) intermittent preventive treatment for infants and children, and (SMC) seasonal malaria chemo-prevention targets the most vulnerable population. Those with a lower immunity and who are more susceptible.
As the Upper River Region Representative for The PCTG Malaria Taskforce, I have been working along side of some amazing people. Above is a picture of our Mini Stomp Out Malaria Boot Camp that we just wrapped up. What a great training and productive time to brainstorm, chair ideas, and plan! This month, we have been putting work in with school health talks, bed net distributions, community sensitizations, trainings, surveillances, and so much more. Health, agriculture, and education sectors have been doing fantastic prevention work!
In my own village, we have started heavily promoting bed nets. It is a huge issue! In my baseline survey, my Community Health Nurse, HM, and I discovered that 0% of our sample group was currently using a bed net. So, starting from ground zero, we have first reached out to the children at the Kulari Basic Cycle School. The picture at the beginning of this entry was taken after a health talk and PE game of “Malaria Tag”. Two kids got to be mosquitos, I was the doctor, and there was a bed net for a 10 second break in its safety. If the mosquito caught one of the kids, they had to run to me, the doctor, and act out the symptoms of malaria. This would allow them to receive their ‘medicine’ and continue playing!
We also just had Catholic Relief Services in Kulari handing out bed nets. Each family receives two to a bed net and pregnant women get individual bed nets. I was lucky enough to spend the day helping distribute to my family and friends.
Next on the agenda is to begin capacity building. My Village Support Group, Village Development Group, and teachers are very active in the community. In about a week, my nurse, village health worker, and I will be hosting a training on bed net promotion with hopes that these wonderful neighbors will help reach all corners of my beautiful city-village.
There are big things happening in Kulari and in so many of the other villages in The Gambia that my wonderful Peace Corps family currently live in. I could go on and on about the work being done, but here it is in a nutshell! Spread the word as this month wraps up that malaria work is still top priority here and underway! This group of volunteers along with some amazing counterparts and villages are a force to be reckoned with.