Want to Kick Out Malaria? Then Walk the Talk; Fight Poverty First

« KO! KO! KO! », shouted the crowd .Mind you, they weren’t participating in a boxing match, neither were they at a musical concert, they shouted KO! in response to the health officials that took turns in sensitizing the crowd of more than 5000 that gathered at the Douala Place du Gouvernement to participate in the 9KM sensitization Walk that was organized by the Cameroon’s Coalition of Businesses for the fight against HIV/AIDS, Malaria, and Tuberculosis and better known by its French acronym CCATSIDA, Cameroon’s Ministry of Public Health, and other stakeholders (local and international) in the fight against Malaria this Saturday 20^th April 2013.

Being a participant, I could not help but be marveled at how engaged fellow participants were as we criss-crossed the streets of Cameroon’s most populated town. Young and old, and from diverse horizons, one thing united this people; that Malaria be kicked Out of Cameroon.

 This passion and demonstrated in the endurance of the participants all through the alertness of their  footsteps and the smile on their faces, could not however stop me from asking myself fundamental questions around the strategy for the fight against Malaria in my country. Thus, when  one of the thousands of spectators that had  amassed  at  streets corners shouted, “Where are condoms?”, there was  an outburst of laughter from the crowd, I began asking myself  what might have prompted this spectator to ask the question he did. As I thought about this, my eyes fell on the logo of the Cameroonian Coalition of Businesses for the fight against HIV/AIDS, Malaria, and Tuberculosis and on the T-Shirt of the participant ahead of me, my answer was here. The words AIDS on this coalitions logo prompted the question from this spectator.

AIDS and its prevention methods are better known in Cameroon than Malaria and its means of protection.  This is paradoxical given that Malaria kills in Cameroon and Sub-Saharan Africa than HIV/AIDS. Mind you, I am in no way saying that resources (human and material) should be shifted from the fight against HIV/AIDS, which is causing havoc in Cameroon especially amongst youths, to the fight against Malaria. The point I am trying to make is that the fight against Malaria, HIV/AIDS, and Tuberculosis has for long been done as though they were isolated.

It is true that a person that has Malaria  or Tuberculosis is not automatically an HIV/AIDS patient, but  most often people suffering from HIV/AIDS in Cameroon are  victims of the  Malaria and tuberculosis given the milieu in which they live and  the little means they have to survive on.

I have for long being convinced that an effective fight against Malaria cannot be done in an isolated manner but must be inclusive; taking into consideration the vectors of the disease in various communities in Cameroon. A dirty environment provides good breeding grounds for Mosquitoes especially the female Anopheles mosquito, through which Malaria is spread, the fight against Malaria must start from there. If a clean environment is achieved through mechanism through efficient urban development and poverty reduction strategies, Malaria will be made history. After all, isn’t it common knowledge that prevention is better than Cure?

In Cameroon and I guess is the case elsewhere in the world, a change from a dirty and crowded environment to a cleaner environment is the main indicator that a person has emerged from poverty. This is so because people who could barely afford 3 meals a day will have little time to think about the environments in which they live talk less of women in this bracket going for prenatal consultation or even having time to take their infants to the hospital when they are sick. Thus, despite the bed-nets distribution campaigns that  have been organized all over Cameroon and despite the fact that  Malaria treatment is free for  children and pregnant women  in Cameroon, Malaria killed more than 3000 people most of whom children.

Without an efficient attack on poverty, which is fertile ground for poor living conditions, I am afraid our walk and much talk on the fight against Malaria will be in vain. For Malaria to be kicked out of this country, we must not only walk on occasions like those organized  to mark the World day for the fight against Malaria, we must truly walk the talk on the fight against Malaria daily, by  launching an immediate assault and poverty. Because Malaria is the consequence of a dirty environment which is its self a glaring consequence of poverty.

Only a Clean Environment Sustainably Kicks Out Malaria

Cause of the death of a child every second, infects 350-500 million people every year, and kills more than 1 million people in the world. These are the numbers, which according to the United Nations’ Children Funds(UNICEF), which best describe the toll of Malaria on  our world’s inhabitants- especially  those in Africa where more than 90% of  Malaria deaths occur and where Malaria accounts for more than 20 % of child deaths(UNICEF)

Women and children suffer from Malaria. When infected during pregnancy, the toll of Malaria is heavier not only on the mother but above all on the child. This is because Malaria is associated with severe anaemia and a host of illnesses affecting the pregnant woman and her unborn baby. The health of the pregnant woman thus made fragile, the risk of giving birth to a child with high exposure to sub-optimal growth and development hazards which are also leading causes of infant mortality.

Recent research has proven that a combination of Malaria and HIV is an explosive cocktail. According to scientists, Placental malaria increases the risk of mother-to-child HIV transmission. This besides the above makes Malaria the number one killer disease in Africa (http://www.thebody.com/content/art13512.html)

The above statistics and facts from the United Nations Children Fund(UNICEF) on Malaria leaves no one indifferent and is the reason why Combating Malaria has in recent times become such a priority to governments in Africa and the rest of the developing world. The fight against Malaria by the international community it should be acknowledged has transcended speeches and declarations to become effective action. Thus in a bid to eradicate this disease and its effects on the maternal and child health, many initiatives have been taken.

 LAUDABLE BUT NOT VERY EFFICIENT APPROACH TO KICK OUT MALARIA

While international donors, governments, and Non-Governmental Organizations are to be lauded for these initiatives, the efficiency of the approaches adopted by policy makers to fight against Malaria is questionable and merits to be carefully reconsidered.

‘Malaria is a very bad disease; Malaria is a very bad disease. We must drive mosquitoes away’. This is the chorus of a song we sang during our hygiene classes in primary school. This song moves on to say how we must keep our environment clean by avoiding stagnant waters around the home to drive Mosquitoes away. As illustrated by wordings from this primary school song, the environment in which one lives determines how prone one is or is not to been infected by Malaria.

THE BEST DEFENCE IS ATTACK

In a country with majority of its people in rural areas and living below the poverty line and where poor housing and horrible living conditions are the order of the day , the fight against malaria should not be limited to the distribution of Mosquito treated bed nets and making the treatment of Malaria free to children below 5 years. While these moves are laudable, their sustainability is in doubt as this could be fairly compared to problem reduction rather than problem solving.

Most people in Cameroon, daily use the saying that, the best way to defend one’s self or property is to attack all those who are considered as threats. Personally, I do not totally agree with this saying but when it comes to the fight against malaria, I think the saying makes sense. Conscious of the  fact that  warm climates, which are predominant in Africa,  are a very important factor to  the development and survival of both  the mosquito and  malaria parasite(http://www.sciencedaily.com/releases/2010/03/100303162906.htm ), it is but normal it is a reality that the fight against malaria would be more efficient if the fight is not against malaria but against Mosquitoes and I think there is no better way of attacking them than by attacking their habitat.

SUSTAIN THE ENVIRONMENT TO SUSTAIN GAINS IN THE FIGHT AGAINST MALARIA

I am intimately convinced that, if people keep their environment clean and avoid all those behaviours which are favourable conditions for the establishment and proliferation of mosquitoes, Malaria will be made history. Such behaviours will of course only be sustained by government’s action in this light. Thus, if accompanied by laws and policies which encourages individual initiatives to keep the environment clean, safe, and free of mosquitoes  while punishing not only individuals but also the business community for any acts perpetrated by them which are harmful to the environment Malaria will be out powered. Trying to make Malaria history by merely providing   insecticide-treated nets (ITNs), as it s done now, will only contribute to making this dream a nightmare.

Therefore, as governments and international funding bodies involve in the fight against malaria organize events and activities to mark this year’s World Malaria Day(celebrated under the theme: Sustain Gains, Save Lives: Invest in Malaria) on April 25th, they must keep in mind for any  fight against Malaria and its effects on infant and maternal health to bear fruits that will last, environmental protection   must be  put at the heart of Malaria eradication programs and  the living conditions of the people in Malaria prone areas , through various empowerment and poverty alleviation  programs,  must be improved upon. This is imperative if Cameroon, which is ranked 18th amongst the 20 countries in the world with the highest mortality for children under the age of 5, is to achieve the Health related Millennium Development Goals(MDGs) and make real its dreams of becoming an emerging nation by 2035.

Besides the above, environmental  policies which severely punishes  corporations, which through industrial activities, contributes to making our climate  warmer, thereby providing a fertile ground for the proliferation of mosquitoes and spread of Malaria, should put in place by governments to reduce global warming and the spread of Malaria.

Truly, to sustain gains and save Lives from the wrath of Malaria, we should invest in making our environment cleaner, safer, and more sustainable.