Update from the field October 2009 to January 2010
By Chukwumuanya Igboekwu MD, MPH
Consolidating on our new strategy of targeted house to house malaria prevention campaign, our malaria project continues to make positive impact in the life of people in poor communities in rural Mashegu. The new strategy is much more effective as it provides us the opportunity to offer customized recommendations to individual families on simple environmental engineering and behaviour modifications that will eliminate malaria vector breeding sites.
Within this reporting period, we conducted outreaches in four villages, namely Bokwai, Kaboji, Sabon-rijia and Mulo. The project reached 1300 vulnerable households with targeted malaria prevention education, prophylaxis, treatment and insecticide treated nets. The house to house visits provided a unique opportunity for the malaria team to educate families about malaria prevention through environmental sanitation. In particular, elimination of mosquito breeding sites was emphasized as we approach the onset of rainy season when malaria transmission is highest.
We continued to emphasize and educate families especially mothers on how to recognize early symptoms and signs of malaria and on the need for sick children to receive prompt medical attention. This is particularly important because most of the deaths due to malaria among under five children is due to delays in instituting treatment for such children. Thousands of young children who suffer acute attacks of malaria frequently develop complications such as anaemia and convulsions, because they do not receive prompt treatment, and such complications are usually the cause of their death.
Our malaria team also continued to focus on school-based malaria education sessions for 450 children in the four community primary schools in these villages. Children who participate in these educational sessions now serve as messengers, taking what they have learnt to their various homes. There is the case of Abdullahi, an 8 year old primary 3 pupil, who after participating in our malaria education session went home and convinced his father to embark on environmental sanitation; to clear the vegetations in their house and remove all stagnant water in their surroundings in order to eliminate mosquito (malaria vector) breeding grounds.
We are very grateful to all our donors who support the work we do. We are very grateful to you. Thank you for supporting the work we do. Your unrelentless support to our work has been our biggest strength. On behalf of the communities we serve, we say thank you for all your support.
Our malaria project continues to make positive impact in the life of children and their families in rural Mashegu; thanks to the generous donations from our donors. During the past two months, we adopted a new strategy of targeted house to house malaria prevention campaign to educate families on how to eliminate vector (mosquito) breeding sites in their environment. This is particularly important as July and August marks the period of peak rainy season which provides favorable breeding conditions for malaria. This also translates to peak period of malaria attacks and deaths for children under-five.
Within this reporting period, the project team conducted outreaches in three villages, namely Adogon, Nassarawa and Sahon-rami. The project reached 2350 vulnerable households with targeted malaria prevention education, prophylaxis and insecticide treated nets. The house to house visits provided a unique opportunity for the malaria team to educate families about malaria prevention through environmental sanitation. In particular, elimination of mosquito breeding sites was emphasized, as this is the period of peak rainy season when malaria transmission is highest. Families were also educated about early symptoms and signs of malaria and on the need for sick children to receive prompt medical attention. Insecticide treated nets were distributed to pregnant women among the families visited.
The project team also conducted three school-based malaria education sessions for children in the three community primary schools in these villages. During the school outreaches, sick children also received medical attention from the malaria team physician. Of note was the case of six year old Hadiza who was treated by the malaria team during the visit by the malaria team to her school at Adogon. She had developed fever about 2 days prior to the malaria team visit. But due to lack of financial resources, her parents could not afford to take her to the health facility, so her condition had continued to deteriorate.
Luckily for Hadiza, the mobile team visited her school two days after the onset of her illness. She was diagnosed of acute malaria by the mobile team doctor; and received antimalaria treatment free of charge. One week later, we received a short note from Hadiza expressing her gratitude to the malaria team for curing her. Here is what she wrote: “Good morning sir, I want to thank you for treating me when you visited our school last week. Before you gave me medicines, I feel feverish and too weak to play with my friends. I could not do draw my favourite pictures. But now I am well again. I can play with my friends again. Thank you doctor and nurse for treating me. My mother is very happy that I am well again”.
In rural mashegu, thousands of young children who suffer acute attacks of malaria frequently develop complications such as anemia and convulsions, because they do not receive prompt treatment, and such complications are usually the cause of their death.
Although the house to house campaign strategy that we have recently adopted was very tedious and time consuming, it proved very rewarding as it provided the malaria team the opportunity to see firsthand the environmental conditions under which families live, and to offer tailor made advice on how they (families) can improve environmental hygiene and eliminate mosquito breeding sites around their homes.
We are very grateful to all our benefactors who donated to this project; most of whom have donated to this project over and over again. We thank you for your unrelenting generosity. We thank you for the lifeline you have given to thousands of children in rural Mashegu though your donations. With your donations, many children like Hadiza will have the opportunity to receive life-saving treatment.
Thank you and May God bless you.
During this first quarter, PSJ’s malaria team visited Mullo village, a rural community with a population of about 7500 people. Most people in the village are peasant farmers. Many live on less than $2 a day.
On arrival, the malaria team paid a courtesy visit to the village chief to inform him of our arrival. He had earlier been briefed about the details of malaria team’s visit and what the malaria project is all about, so he had opportunity to mobilize the whole village to take full advantage of our visit. On the eve of the malaria outreach, the village town crier went round to remind villagers of our visit. So the entire people of the village including women and children were already assembled at the village square in anticipation of malaria team’s arrival.
The day’s activities commenced with health education on environmental hygiene and sanitation. Topics covered include the role of mosquito in malaria transmission, common mosquito breeding sites at homes, early signs and symptoms of malaria, and ways of preventing malaria.
This was followed by a community demonstration session on the use of Insecticide treated nets (ITNs). In excitement the chief of the village volunteered to sleep under the net during the demonstration session. Thereafter, ITNs were distributed to pregnant women and nursing mothers. A total of 100 ITNs were distributed. The women who were lucky to get an ITN beamed with smiles, and were full of appreciation to PSJ donors who made contributions through the GlobalGiving Foundation. Most families are poor and could not have afforded the ITNs by themselves.
Because of the limited number of nets available, we had to restrict the age limit of beneficiaries to mothers with infants (children less than one year of age) only. This still leaves hundreds of other children vulnerable to malaria attack especially during the peak malaria transmission season starting from late May.
The third activity of the day was antimalaria treatment of all children and pregnant mothers who presented with clinical features of malaria. The clinical team was led by a community physician. Targeted malaria chemoprophylaxis was also administered to pregnant women and children under-five. 125 children received malaria treatment, while 37 pregnant women received targeted malaria chemoprophylaxis. The malaria treatment is targeted at children under-five and pregnant women because they are the most vulnerable group to malaria morbidity and mortality.
At the end of activities, the malaria team held a dialogue with the village elders on the common health problems facing the community, and how Physicians for Social Justice (PSJ) can assist the community achieve their highest attainable level of health. The village elders thanked the team for the free services rendered to them. They also expressed their gratitude to all those who donated money for purchase of ITNs given to their women.
Usually, the period between June and September marks the peak of rainy season in rural mashegu. This year was certainly not an exception. The rainy season characteristically witnesses malaria vector (mosquito) multiplication and increase in breeding sites that inevitably leads to more malaria attacks especially for children.
For this quarter (June – September 2008), the PSJ malaria control team concentrated our malaria control outreach activities in three rural communities that lack any form of modern health facilities. These communities represented areas where children were most vulnerable during the peak malaria attack season. They include Tunga-Magajia, Maiasara, and Nassarawa-mullo.
As is typical of peak rainy season, the biggest challenge we faced was that of logistics to reach remote villages like Tunga-Magajia due to the dilapidated un-motor able state of the roads leading to the villages. It was difficult to get through even with motorcycles. What remained of the existing road was so marshy and waterlogged that it very difficult for one to put his feet down on the ground. Meandering through the bush paths to get the desperately needed services to children in those villages was even more difficult.
Despite these challenges, our malaria control team treated a total of 556 children who had acute attacks of malaria. 112 infants received anti-malaria prophylaxis. Due to dwindling resources, we were able to distribute only 123 insecticide treated nets during this quarter.
On behalf of the villagers and the children we serve, we wish to express our sincere gratitude to all the 38 donors who made financial contributions to this project so far. We know some of you have donated more the once to this project. Some have even made up to 4donations. Thank you so much! Through your donations, many children’s lives have been saved and many more children were able to stay in school to get more out of their education.
Also recently, just last month, we conducted an intensive three-day training program for 40 teachers in 15 rural primary schools on ‘the prevention, early detection and first-Aid treatment of simple malaria’ for pupils in their school. Each of the 15 participating schools also got a fully stocked first-Aid box with anti-malaria medicines (for prophylaxis and treatment). The training was made possible through a grant that PSJ received from American Jewish World Service (AJWS) and the Global Fund for Children (GFC).
For those children who live in villages without any modern basic health facility, this new innovative arrangement has become life-saving as their schools now serve dual purposes as centers for learning as well as centers for health promotion. For these children, the school represents the center of their community life.
During the period from Early April to Mid May, PSJ’s malaria project team comprising a primary care physician, a community health nurse and two community health extension workers conducted malaria control outreach activities in five rural communities namely Sabon-rijia, Bokwai, inner-Mashegu, Manigi and Sahon-rami in Mashegu. The team distributed 556 insecticide treated nets to 509 children under-five and 47 pregnant women. At Sahon-rami which serve as both the project base and field office of Physicians for Social Justice, there was a massive turnout of villagers mostly women and children to witness the demonstration sessions on how to use the insecticide treated nets.
The mobile team also treated 321 cases of malaria in children and administered antimalarials chemo-prophylaxis to 71 pregnant women.
Communities elders in all the five villages were very grateful for the nets given to their women and children and expressed their gratitude to all those who donated the insecticide treated nets that their communities are benefiting from. Also during this past month, a total of about 3600 individuals in rural Mashegu have received health education and behaviour change communication messages about malaria vector (mosquito) eradication and personal protection from mosquito bites. The health education aspect of this ‘Preventing Childhood Malaria Death Project’ is particularly important as we approach the peak of rainy season in this region when the transmission and attack rates of malaria are highest due to increase in vector breeding sites brought about by increased vegetation around dwelling environments.
The project team is very grateful for all those who made donations to this Malaria project since inception. Your donations through the Global Giving Foundation has no doubt saved hundreds of children from repeated deadly episodes of malaria attacks.
At Manigi village, the project team encountered a mother who trekked about 10 kilometers on foot from a neuighbouring village to present her nine months old baby for treatment. She heard the news about the visit of our malaria team who will be offering free malaria treatment to children from one of her friends. The mobile team treated her sick child and equally provided her with an insecticide treated net. She was full of gratitude to our sponsors and all those who provided the resources that made it possible for her baby to get both free malaria treatment and a treated bed net.
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