Africa, Development & Aid, Headlines, Poverty & SDGs

SIERRA LEONE: (Misused) Key to Malaria Prevention

Mohamed Fofanah

FREETOWN, Nov 30 2010 (IPS) - Lucky for Osman Conteh that one of his aunts disagreed with the family consensus that he had been stricken by an evil spirit. She insisted the twitching, incoherently babbling child be taken to the hospital rather than a witch doctor.

And so he was rushed to the Bonthe government hospital, where Dr Manso Dumbuya diagnosed him with cerebral malaria. A day of treatment and he was stabilised; three days later, he was discharged from hospital.

“I am happy to have saved the boy from the clutches of malaria,” said Dumbuya.

That was in October, and the doctor noted out that Conteh was the 93rd case of malaria recorded in the Bonthe hospital’s district in just the month of October.

Malaria is responsible for a quarter of all deaths in Sierra Leone, according to the Ministry of Health. The ministry says that malaria accounts for 40 percent of public health expenditures, 30-50 percent of inpatient admissions, and up to 50 percent of outpatient visits.

To reduce this heavy burden on the health system – and improve public health – the government and its numerous partners have been issuing bed-nets to communities all over the country as a way to prevent the disease.

The Red Cross gave out 875,000 bed-nets to children under five years of age in 2006. In 2008 and 2009 the government in collaboration with UNICEF gave insecticide-treated bed nets to every pregnant woman and parent with children under five.

The Red Cross expected that its campaign would save the lives of 5,300 children in its first year alone; the government believed the later campaign would reduce malaria by half.

“Disappointingly, we are still unable to combat malaria”, said Dr Alhaji S. Turay, the only doctor in Koinadugu District Hospital. His hospital registered 115 cases of malaria in October – and 28 deaths.

“We have realised that the beneficiaries of these treated bed-nets are not using it for its intended purposes,” he said.

“These beneficiaries have discovered very peculiar alternative uses for the bed-nets in my district,” Turay explains.

“Koinadugu district is an agricultural district. We discovered that many parents we supplied with insecticide-treated nets have been using them to cover their [plant] nursery beds. Instead of protecting their children and themselves, they were now protecting their crops from insects.”

From the fishing island of Bonthe, Dr Dumbuya, said his staff had observed that the bulk of the people who received bed-nets are using them to fish.

Bonthe island resident Moisia Ngobu is unapologetic. “We had to choose between putting food on the table or fighting mosquitoes,” he says.

“It has never been an easy choice for us, but we have to survive, even the children have to eat and to even see a fishing net to buy is difficult. When you see one to buy it is very expensive, so we have to use the free nets we have and feed our families.”

Marian Kargbo, a nursing sister at Princess Christian Maternity Hospital in Freetown, says, “In the Western Area and other parts of the country, the beneficiaries of these bed nets sell them to other people. Some people we found using the insecticide bed nets to kill bed bugs: they will wrap their mattress with the nets which kills the bugs, but exposes them to the mosquitoes. Some others could not find anything to do with the bed-net, and they just keep it, and they say they simply could not sleep inside the bed-nets because it is too hot,”

Yet another campaign to distribute treated nets is under way now. The British Minister for International Development, Stephen O’Brien, who came to Sierra Leone in July 2010, donated one million bed nets to support the Government of Sierra Leone’s aim of providing every household in the country with bed nets by December 2010.

The campaign, which runs from the Nov. 25 November until Dec. 2, aims to put at least three nets in every Sierra Leonean household.

Abass Kamara, Public Relations Officer of the Ministry of Health, said that the government is well aware that many people have not been using the bed-nets for the intended purpose. To mitigate this, they have convened all local chiefs, paramount chiefs, and head administrators from all the regions of the country to get them to discuss the issue, develop by-laws against misuse of bed-nets and also discuss strategies to enforce those laws.

“We are also doing massive sensitizations all across the country to encourage every one to understand that the use of bed-nets will prevent malaria,” said Kamara.

Used properly, bed nets are a basic intervention that Kamara, says his ministry expects to cut malaria deaths for all ages by a third. Besides saving lives, “nets could radically reduce the burden on health services, because fewer patients will need hospital treatment for malaria.”  

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