Is malaria-free life in Kiboga just around the corner?
Oct 04, 2007
THREE-year-old Najib Kuteesa got malaria but she was lucky. In another place, another time, her mother, a peasant farmer, would have been forced to walk for hours with a high fever to the nearest health post. There a nurse would, hopefully, have enough time to treat her before things got worse. Kute
Is malaria-free life in Kiboga just around the corner?
By Fred Ouma
THREE-year-old Najib Kuteesa got malaria but she was lucky. In another place, another time, her mother, a peasant farmer, would have been forced to walk for hours with a high fever to the nearest health post. There a nurse would, hopefully, have enough time to treat her before things got worse. Kuteesa’s mother, however, needed only enough strength to reach the health hut in her village, Kakola in Wattuba sub-county in Kiboga district, where a qualified volunteer community health worker diagnosed and treated her using the latest and most effective drugs.
Coartem, an arteminsinin-based combination therapy (ACT) is currently being piloted at the village level in Kiboga and Gulu districts for home-based management of fevers. ACT, which is made from an ancient Chinese medicinal plant, Artemisia annua, has proven effective in fighting drug-resistant malaria.
“After the consultation, the community health worker gave me medicine and explained to me how to use it,†says Aisha, a 28-year-old mother of three. “She asked me to give my child the first drugs in her presence to see if I understood the explanation, and I did.â€
Then the nurse talked to Aisha about malaria prevention and advised her to always sleep under an insecticide-treated mosquito net.
Like Kuteesa, without life-saving anti-malarial drugs, Joshua Mukoza would not be alive today. Through Malaria Consortium training and assistance, the two-year-old received prompt treatment. Mukoza was sick for three days before his aunt and caretaker brought him to Butema Health Centre III in Hoima district, three miles from the family’s home. Although the family lives closer to a private health clinic, the cost of getting treatment there was more than they could afford.
“I thought about going to a traditional healer, but I thought the medicine that would be given to him wouldn’t suit the illness,†his aunt said.
“I’m happy I brought Mukoza here for treatment,†she says, adding: “If I had stayed at home, I would have thought the illness was being caused by spirits, but now I know it’s malaria.â€
The aunt says the anti-malarial drugs worked quickly and Mukoza started eating and playing again soon after.
Mukoza, his head covered in a knitted peach and white stripped bonnet, leans his head on his aunt’s shoulder, with dark chocolate sleepy eyes. They had returned to the clinic for reviews after a three-day treatment course of life-saving anti-malarial drugs. This time the results were negative, meaning that the treatment had wiped out all the malaria parasites.
But Kuteesa and Mukoza are just two of many lives that have been saved. Malaria is the leading cause of death among pregnant women and young children in Uganda, but its prevention and care is just one service of a comprehensive package of clinical services and community interventions the Malaria Consortium provides.
In Hoima, for instance, the Malaria Consortium has provided Hoima Regional Hospital with an oxygen cylinder with multiple delivery tubes, where more than four children can receive oxygen even in the absence of power.
It has also provided children’s wards in Kiboga and Hoima districts with haemoglobin colour scale estimators, rapid malaria testing kits, glucometres for measuring sugar levels and insecticide-treated nets.
Besides distribution of free long-lasting insecticide-treated nets, the consortium has also trained health workers from 17 pilot districts from north, north-eastern and north-western Uganda in health data management, store management, as well as management of severe malaria and new malaria policy.
It is clear that the training has yielded dramatic results. According to the district health officer of Kiboga, Dr Allan Muruta, the reporting, completeness and timeliness of health management information system has improved from 70% to 90% as availability of essential drugs and treated bed nets.
Milly Nalubega, an enrolled nurse at Kikolimbo Health Centre II, concurs that the training, especially in logistics and supply management, has helped her to determine the minimum and maximum stock she requires in a certain period.
“Before training, we used to run out of essential drugs and sometimes some drugs would expire,†says Nalubega.
“Now there are no more stock outs. I know how and when to make orders. Incase I have drugs I won’t be using but nearing expiry, I send them to the main hospital were the demand is higher.â€
However, after watching members of their community fall ill and many die from malaria, many residents, particularly women of Kiboga, felt they needed to do something about the situation. Women suffer greatest losing children, nursing sick family members, spending scarce finances and missing out on work because of the disease.
Teddy Nassali, a mother of eight, is a volunteer community health worker known as Community-based Medicine Distributors (CMD) in Kakola village.
“We were always getting malaria,†Nassali says. “Our children were dying before they reached the hospital. We had no drugs in the village, no knowledge of the treatments. But since the Malaria Consortium came, we have new hope. We have gained knowledge and we now have home treatment kits that have all the necessary drugs to keep us out of danger. We have learned to use insecticide-treated nets. Our children still get sick, but they are not dying.â€
CMDs are key players in the campaign against malaria across Uganda. They are trained in recognition and treatment of malaria among young children within 24 hours. They are usually well-known and respected members of the community, with a record of reliability and a relatively high levels of literacy. There are two in every village and are regularly visited by health educators who support and update them with the latest information on malaria.
“Before CMDs, malaria often claimed the lives of children and even adults,†says Sulaiman Nsubuga, 42, from Kyayimba village. “Women faced many difficulties trying to get to the health post, where sometimes there would be stock outs.†But such complications are becoming fewer, as many health services are now available where people live.
According to Emmanuel Batiibwe, Kiboga Hospital medical superintendent and Tom Ediamu, a paediatrician at Hoima Regional Hospital, the health of the children and mothers in their districts has greatly improved, courtesy of the Malaria Consortium.
They say cases of severe malaria have drastically fallen since the coming of the Malaria Consortium and so are ‘preventable deaths’ due to malaria. “We would have almost 20 deaths in a day due to severe malaria,†says Batiibwe. “Now we admit about 80 children and spend more than three days without a single death.â€
Ediamu agrees that they are currently admitting between 300-400 patients per month as compared to 500-900 admissions two years ago, with severe malaria accounting for 50-60% of total admissions.
“Now, more children are being handled at peri-referral health units and at the village level by CMDs. This has, of course, reduced our workload as we are mainly dealing with anaemic malaria.
“CMDs are encouraging pregnant mothers to get preventive malaria therapy from antenatal care services and prompt treatment when sick, referring patients with signs of severe malaria to health centres and using insecticide treated nets,†Ediamu says.
By Fred Ouma
THREE-year-old Najib Kuteesa got malaria but she was lucky. In another place, another time, her mother, a peasant farmer, would have been forced to walk for hours with a high fever to the nearest health post. There a nurse would, hopefully, have enough time to treat her before things got worse. Kuteesa’s mother, however, needed only enough strength to reach the health hut in her village, Kakola in Wattuba sub-county in Kiboga district, where a qualified volunteer community health worker diagnosed and treated her using the latest and most effective drugs.
Coartem, an arteminsinin-based combination therapy (ACT) is currently being piloted at the village level in Kiboga and Gulu districts for home-based management of fevers. ACT, which is made from an ancient Chinese medicinal plant, Artemisia annua, has proven effective in fighting drug-resistant malaria.
“After the consultation, the community health worker gave me medicine and explained to me how to use it,†says Aisha, a 28-year-old mother of three. “She asked me to give my child the first drugs in her presence to see if I understood the explanation, and I did.â€
Then the nurse talked to Aisha about malaria prevention and advised her to always sleep under an insecticide-treated mosquito net.
Like Kuteesa, without life-saving anti-malarial drugs, Joshua Mukoza would not be alive today. Through Malaria Consortium training and assistance, the two-year-old received prompt treatment. Mukoza was sick for three days before his aunt and caretaker brought him to Butema Health Centre III in Hoima district, three miles from the family’s home. Although the family lives closer to a private health clinic, the cost of getting treatment there was more than they could afford.
“I thought about going to a traditional healer, but I thought the medicine that would be given to him wouldn’t suit the illness,†his aunt said.
“I’m happy I brought Mukoza here for treatment,†she says, adding: “If I had stayed at home, I would have thought the illness was being caused by spirits, but now I know it’s malaria.â€
The aunt says the anti-malarial drugs worked quickly and Mukoza started eating and playing again soon after.
Mukoza, his head covered in a knitted peach and white stripped bonnet, leans his head on his aunt’s shoulder, with dark chocolate sleepy eyes. They had returned to the clinic for reviews after a three-day treatment course of life-saving anti-malarial drugs. This time the results were negative, meaning that the treatment had wiped out all the malaria parasites.
But Kuteesa and Mukoza are just two of many lives that have been saved. Malaria is the leading cause of death among pregnant women and young children in Uganda, but its prevention and care is just one service of a comprehensive package of clinical services and community interventions the Malaria Consortium provides.
In Hoima, for instance, the Malaria Consortium has provided Hoima Regional Hospital with an oxygen cylinder with multiple delivery tubes, where more than four children can receive oxygen even in the absence of power.
It has also provided children’s wards in Kiboga and Hoima districts with haemoglobin colour scale estimators, rapid malaria testing kits, glucometres for measuring sugar levels and insecticide-treated nets.
Besides distribution of free long-lasting insecticide-treated nets, the consortium has also trained health workers from 17 pilot districts from north, north-eastern and north-western Uganda in health data management, store management, as well as management of severe malaria and new malaria policy.
It is clear that the training has yielded dramatic results. According to the district health officer of Kiboga, Dr Allan Muruta, the reporting, completeness and timeliness of health management information system has improved from 70% to 90% as availability of essential drugs and treated bed nets.
Milly Nalubega, an enrolled nurse at Kikolimbo Health Centre II, concurs that the training, especially in logistics and supply management, has helped her to determine the minimum and maximum stock she requires in a certain period.
“Before training, we used to run out of essential drugs and sometimes some drugs would expire,†says Nalubega.
“Now there are no more stock outs. I know how and when to make orders. Incase I have drugs I won’t be using but nearing expiry, I send them to the main hospital were the demand is higher.â€
However, after watching members of their community fall ill and many die from malaria, many residents, particularly women of Kiboga, felt they needed to do something about the situation. Women suffer greatest losing children, nursing sick family members, spending scarce finances and missing out on work because of the disease.
Teddy Nassali, a mother of eight, is a volunteer community health worker known as Community-based Medicine Distributors (CMD) in Kakola village.
“We were always getting malaria,†Nassali says. “Our children were dying before they reached the hospital. We had no drugs in the village, no knowledge of the treatments. But since the Malaria Consortium came, we have new hope. We have gained knowledge and we now have home treatment kits that have all the necessary drugs to keep us out of danger. We have learned to use insecticide-treated nets. Our children still get sick, but they are not dying.â€
CMDs are key players in the campaign against malaria across Uganda. They are trained in recognition and treatment of malaria among young children within 24 hours. They are usually well-known and respected members of the community, with a record of reliability and a relatively high levels of literacy. There are two in every village and are regularly visited by health educators who support and update them with the latest information on malaria.
“Before CMDs, malaria often claimed the lives of children and even adults,†says Sulaiman Nsubuga, 42, from Kyayimba village. “Women faced many difficulties trying to get to the health post, where sometimes there would be stock outs.†But such complications are becoming fewer, as many health services are now available where people live.
According to Emmanuel Batiibwe, Kiboga Hospital medical superintendent and Tom Ediamu, a paediatrician at Hoima Regional Hospital, the health of the children and mothers in their districts has greatly improved, courtesy of the Malaria Consortium.
They say cases of severe malaria have drastically fallen since the coming of the Malaria Consortium and so are ‘preventable deaths’ due to malaria. “We would have almost 20 deaths in a day due to severe malaria,†says Batiibwe. “Now we admit about 80 children and spend more than three days without a single death.â€
Ediamu agrees that they are currently admitting between 300-400 patients per month as compared to 500-900 admissions two years ago, with severe malaria accounting for 50-60% of total admissions.
“Now, more children are being handled at peri-referral health units and at the village level by CMDs. This has, of course, reduced our workload as we are mainly dealing with anaemic malaria.
“CMDs are encouraging pregnant mothers to get preventive malaria therapy from antenatal care services and prompt treatment when sick, referring patients with signs of severe malaria to health centres and using insecticide treated nets,†Ediamu says.