Malaria

April 25^th was World Malaria Day which made all of April: Malaria month. Fun fact: 90% of all Malaria- related deaths occur in Sub-Saharan Africa.

So while Malaria is bad and in everybody’s best interest not to get it- here are some things Burkina Faso does to help get rid of Malaria. They publish flyers in several languages talking about what malaria is and how to best protect themselves. They subsidize malaria medications throughout the country (actually I’m not sure where the money comes from- someone subsidizes it). And, they do bed net distribution campaigns throughout the country every two years or so. The bed nets come from other parts of the world though the government says to distribute them.

Mosquitos love to bite at dusk, dawn, and throughout the night. So, sleeping under a mosquito net seems like a pretty good way to protect oneself. Unfortunately, not everybody sleeps under a mosquito net- some people use it to filter water, some people go fishing with it, some people use it as decoration and, of course, some actually sleep under it. But, to really help get rid of malaria people need to engage in their own health.

The signs of malaria are pretty vague- headache, fever, joint pain, vomiting, diarrhea, that kind of stuff. And there are an infinite number of other maladies that have THE EXACT SAME SIGNS! Of course when malaria progresses and becomes, as they say in Burkina, “grave” (bad.)- it quickly singles itself out through seizures, urine the color of coke, anemia- and other less-than-awesome things.

The vagueness at the outset means that misdiagnosing comes into the equation at some point. Some nurses (not all because that would be generalizing), if they see someone with a fever will automatically say its malaria and will prescribe the necessary medication- and then, just to be on the safe side will prescribe an antibiotic also just in case they were wrong. While covering all the bases is good, it will invariably lead to resistance to the medications.

To aid in this, Rapid Diagnostic Tests have been gifted to Burkina Faso. These tests work much like a pregnancy test but rather than urine it asks for a drop of blood. Then, if the parasite is in the blood you get two lines which mean, “Congratulations, you have malaria!”

The problem with this is that some nurses don’t believe in the test and think that it’s wrong.  One time I walked into the consultation room and saw that they were prescribing malaria medication and…

Me: Oh cool, malaria case?

Nurse: Yep.

Me: So the TDR (rapid test) was positive?

Nurse: No it was negative. But it was wrong.

Me: Huh?

Now this isn’t to condemn the nursing system in Burkina Faso, far from it in fact. The Minister of Health has published a chart which all health centers are required to hang up (and follow). Its steps are: 1) Someone comes in displaying signs of malaria. 2) Do the rapid test 3) If positive then 4) Treat for malaria OR 3) If negative then 4) Look for something else.

Another problem is that the stock of rapid tests is not guaranteed. Indeed, more often than not, the rapid tests are not available in my health center so we cannot use them.

While Peace Corps volunteers typically focus on preventative measures, there are many ways to fight malaria- including more effective detection and treatment of malaria.