Malaria is a tenacious enemy, especially for the very small and very young. Half of the fatalities from malaria in Uganda – a country where the disease is both widespread and endemic occur in those less than five years of age, and there are thousands of cases of malaria each year. The way people cope with malaria shows just how varied and telling the narrative of the disease is. The service of the mutant insects, for the Eradication of Light-Fingered Mosquitoes ( otherwise known as the Fellm) came to an end poisoned by local mosquitoes in alleys and in mud-floor huts. The convenience warriors from Oxitec in Arizona, however, will not give up so easily. They’ve announced plans to fund the same sort of operation in the Dominican Republic.
The Burden of Malaria in Uganda
Uganda is in East Africa, where temperature and humidity – needed for the Anopheles mosquitoes that breed the disease – are warm. Indeed, malaria accounts for more than 30 percent of outpatient visits and is one of the main reasons for hospital admissions in children, and it is the second leading cause of death of children in Uganda, according to the Uganda Ministry of Health.
After all, a disease as old as the hills and prominent in the news is so much more than a statistic: it is a daily fight for the families afflicted with it. And behind every statistic of mortality lies the untold.
Stories from the Frontlines: Children Battling Malaria
1. Amina’s Struggle: Battling Malaria in Rural Uganda
Amina, only seven and from a remote village in northern Uganda, demonstrates not only the lasting impact of living in a malaria‑endemic environment but also the effects of this ‘neglected’ disease on many rural families.
Amina’s first symptoms were high fever and chills. Her mother, Mariam, soon discounted these as just another case of malaria that everybody suffered from now and then. When Amina’s condition didn’t improve, with persistent vomiting and weakness, Mariam took her to the health center. There, they diagnosed her with malaria again, and the staff admitted her for treatment.
‘I was afraid, I was lost,’ Mariam recalls. ‘My daughter was very ill; it was difficult. To get to the health center it takes many hours to get transport up the mountain, and it costs us a lot of money.’
Yet, after timely treatment and the support of a local malaria outreach program, Amina recovered and is once more a regular at story takes a promising turn. But the parents struggle to seek the right care promptly which remains the disappointing underbelly of many encounters with disease.
2. Joshua’s Journey: From Malaria to Recovery
Amina was five years old and living in a small town in southwestern Uganda when she first fell victim to malaria. But unlike babies like Peter, Joshua, and Kofi, no one would bother to keep it that way. Joshua was just nine years old, but his town was part of a successful health campaign that regularly educates families about malaria symptoms and early care. His mother, Grace, also received a visit from a community health worker who had cautioned her about the illness.
When Joshua’s symptoms began, Grace quickly sent him to the local health post where he was treated without delay. His case was advanced, but early treatment helped him recover faster. ‘Early detection and treatment can make a big difference,’ Grace noted. ‘I think learning about malaria through the community education [or outreach] and our health workers is vital to managing [cases].
‘If it hadn’t been for the contact tracers, for their efforts and the education we received in the community, it would have been so much worse,’ Grace explains. ‘That early diagnosis and treatment saved Joshua from death.
This shows the need to expand and strengthen both education and community health programs in the fight against malaria so that the sick are diagnosed and treated early before the disease takes its toll.
3. Fatima’s Tale: Overcoming the Odds
Fatima, a five-year-old girl in rural eastern Uganda, had a less diverse and rich microbiome, with fewer bacterial species and less diversity within each species. Her family lived in a region with limited health services and mosquito control infrastructure, and her quickly worsening symptoms did not earn her access to much better care. Fatima’s parents, Ahmed and Aisha, were struggling.
Over several days, Fatima got sicker and sicker, until she was finally taken to a distant hospital. They could give her life-saving treatment. She survived. She recovered, and she’s being followed.
Ahmed and Aisha’s story illustrates the barriers encountered by families living far from towns. When families are sick it is hard to seek medical care and malaria prevention materials are often inaccessible.
The Role of Malaria Programs and Interventions
There are no simple answers. The lives of Amina, Joshua, and Fatima tell the stories of three children battling malaria in Uganda. They also highlight the need for targeted malaria control programs and interventions.
1. Community Health Workers
Not only does a CHW educate about malaria and distribute mosquito nets, but they’ll also give first aid, as a basic treatment on the ground can minimize the impact of the disease and stop it from spiraling into something more serious. While researchers and doctors might view the lab and the hospital as the frontline of the fight against disease, a CHW in an outlying village also represents the frontline, quietly connecting families with vital medical care.
2. Malaria Prevention Programs
Prevention – in the form of insecticide-treated nets (ITNs) and indoor residual spraying (IRS) of houses, to kill mosquitoes on contact or repel them – plays a big part in reducing transmission in the first instance. Programs that expand coverage of these and other prevention measures must be a top priority to better protect children, especially those living in risk areas.
3. Health Education and Awareness
Teaching the community about the symptoms of malaria, what can be done to prevent it, and suggesting places they can go to if they suspect they have malaria might be of great help. Through awareness programs and education, families can know what signs of malaria are so they can act accordingly.
Moving Forward: Addressing the Challenges
Despite this success, important challenges remain to combat malaria. To ensure better outcomes for children such as Amina, Joshua, and Fatima, further efforts need to be made in the four areas below.
1. Expanding Access to Healthcare
The efficient functioning of healthcare facilities and services can improve, especially in remote areas or under-served communities. The government should increase investments in healthcare infrastructure and transportation to improve the accessibility to the remote areas where people live.
2. Strengthening Malaria Control Programs
Such programs, which include the distribution of mosquito nets and IRS, must be supported year after year so that malaria transmission is reduced. In this process, organizations producing nets and conducting indoor residual spraying must monitor and provide feedback on what is working and what is not.
3. Enhancing Community Engagement
Participation of the community in malaria control can improve intervention efforts by creating a sense of ownership over disease management and also ensures better collaboration between local health workers, the national government, and global organizations.
For every statistic we cite on malaria in Uganda, there is a human being struggling to cope with the burden of the disease. A family grapples with anguish, their child’s shattered limbs left paralyzed by disease. Amina, Joshua, and Fatima embody their struggle. Yet, a history of a region transformed by sustained malaria control efforts emerges. Prevention, early diagnosis, and treatment work together in synergy, combining forces to crush malaria.
With the government of Uganda stepping up the fight against malaria, these children’s experiences speak to the human face of malaria disease and the need for continued commitment and investment in cutting-edge malaria control interventions and innovations so that the next child is no child.
