As a child in Madagascar, protecting ourselves against malaria was a part of our daily routine. In the mornings we would take our anti-malarial Paludrine pills at breakfast, the odious Nivaquine once a week on a Sunday.
Mosquitos fly at dusk, so my dad had an evening patrol around the house to make sure all the windows were shut. The porch doors didn’t close flush to the wall, so we would light slow-burning anti-mosquito coils in the gap to deter them with smoke. We’d spray insecticides along the door-frames and windowsills. For the mozzies that did get into the house, there was a glowing blue insect trap in the hallway that was on every night, luring them in and zapping them dead.
Depending on the season, there was also a bedtime routine of tucking ourselves into the mosquito nets and ensuring there were no gaps. In the morning, tying up the net and securing it overhead was part of making the bed.
In other words, keeping ourselves safe from malaria was a matter of daily vigilance. I can’t remember if any of us ever contracted it, but we’re all still alive and that was the primary goal.
We could afford all those forms of protection. Many others couldn’t. Even a simple mosquito net would be beyond the family budget, and deaths from malaria were all too common. Children were particularly vulnerable.
Malaria represents a serious burden to low income countries, one that we have the luxury of not having to worry about. It is a disease that compounds poverty and disadvantage. The poorest cannot protect themselves, meaning they get sick more often. Adults miss work, which costs them money. Children miss school, which costs them the education that could lift them out of poverty in the long term. When a family member dies of malaria, children may be forced to work.
There are many factors involved in global poverty, and malaria is one that is easily overlooked if you haven’t lived with it. 90% of the world’s malaria cases are in Africa. Ending the curse of malaria would be a huge boost to development across the continent.
With all of this in mind, it’s always encouraging to read about countries that have been able to declare themselves free of the disease, and this year Argentina and Algeria joined that list. The latter is particularly notable, because Algeria would be the first mainland African country to eradicate malaria.
Eradication is easier in some places than others. Rice is very important to Malagasy culture, and many communities live surrounded by their rice paddies – and you could hardly design a more perfect breeding ground for mosquitos. But you can move quickly to report, isolate and treat incidences before the infection is carried to others. As I described in an earlier post, Sri Lanka eradicated malaria by changing their focus from the mosquito to the infection. With a similar approach, Madagascar would be able to have rice – and mosquitos – without the risk of malaria.
Nevertheless, we will have to wait a long time before the WHO announce that Madagascar is free of malaria. It will be a long struggle, with drug and insecticide resistance eroding gains on one side, and new approaches and possible vaccines moving us forward on the other. But it will come, eventually.
If you would like to help speed that day along, consider a donation to the Against Malaria Foundation.