Although malaria is directly caused by tiny parasites transmitted into a person’s bloodstream via mosquitos, you have to look beyond the bugs to find the real root cause. Can you name any developed countries where children die every day from a single mosquito bite? Where every fever needs to be tested just in case it’s malaria? Where it’s usually a correct assumption that you don’t just have the flu, but actually malaria? I can’t. Take a look at the CDC’s Malaria Map. Play around a little. If you look at the details about developing countries all around the world, you’ll see that, in most of them, the major cities and highly touristic areas are not affected by malaria. Malaria kills nearly one million people every year. A disproportionate number of those people live in rural, impoverished areas.
A recent post on the Aid Watch blog discusses Helen Epstein’s essay on the politics of malaria from the March issue of Harper’s Magazine. Epstein describes how malaria control efforts over the last century have been largely ineffective when they target the disease alone. The only effective efforts to truly eliminate malaria from an entire region have been those that directly address the social, political, and economic conditions that allow malaria to thrive. As early as the 1920’s, the League of Nations Health Organization recommended a program of “rural uplift” to fight malaria. Epstein cites successes in Italy, Borneo, and the Tennessee Valley when economic development, education, better housing, drainage of swamps, and improved healthcare, including effective malaria treatment were simultaneously addressed.
Reading Epstein’s article, I couldn’t help but think that this sounds awfully familiar. As Epstein says, “Malaria hovers over impoverished, distressed societies, and fighting the disease without improving basic living conditions is like trying to fight a fire by waving away the smoke.” While Nuru’s community health workers are hard at work encouraging the community to sleep under properly hung and tucked-in insecticide-treated mosquito nets to prevent malaria, Nuru’s holistic model also fights malaria indirectly. The combination of Nuru’s Agriculture, Education, Community Economic Development, Water and Sanitation, and Healthcare programs provides a more effective approach to ridding Kuria, Kenya of malaria for good than mosquito nets alone.
This is not a popular school of thought. The WHO World Malaria Report 2010 focuses on control and prevention strategies including distribution of insecticide-treated mosquito nets, indoor residual spraying, diagnostic testing, and appropriate medical treatment of confirmed malaria cases. The same basic strategies are being used by the Global Fund, the Gates Foundation, and numerous other NGOs around the world. These strategies are quite effective in preventing individual malaria deaths, but these strategies alone will never completely rid the world of malaria.
Nuru’s community health workers will continue to go house to house teaching the community what they can do to prevent malaria. They will continue to sell long-lasting insecticide-treated mosquito nets (over 140 sold in the past month alone!). They will continue to conduct community trainings about malaria prevention. According the 2008-2009 Kenya Demographic and Health Survey (DHS) only 43.6% of children under 5 years old in rural Kenya are sleeping under insecticide-treated mosquito nets. Nuru’s community health workers will continue to work hard to improve this.
But even if Nuru were able to convince every single person in Kuria, Kenya to sleep under a mosquito net every night, malaria will prevail as long as poverty prevails. That’s why it’s important that the five components of Nuru’s holistic model work together to lift the community out of poverty. When the Agriculture program increases maize yields, it also contributes to malaria eradication. When the Community Economic Development program teaches farmers about financial planning and helps them start saving money, it also contributes to malaria eradication. When the Education program improves children’s literacy, it also contributes to malaria eradication. When the Water and Sanitation program increases the community’s access to safe water, it also contributes to malaria eradication. The Healthcare program alone is not enough.
Today is World Malaria Day. Take a moment to think about the vast variety of NGOs, programs, and interventions working to control and eliminate malaria, both directly and indirectly. Think about malaria control and prevention within the broad context of global poverty. Think about how malaria and poverty are intertwined in developing countries around the world. Think about how malaria was controlled in your developed country, most likely long before you were born. Think about what you, personally, can do to eradicate malaria. Talk to your friends about malaria, comment on this post to join the conversation, take whatever action you can. Do your part and get into the fight with Nuru International to put an end to extreme poverty and an end to malaria.