-health ministry targets rise in infections, disregard for treatment
‘I was almost dead 24 times’ -Regional Chairman
Faced with escalating malaria infections and a growing community of miners who are disregarding certain health rules, Mahdia has become one of the malaria ‘hot beds’ in the country. A wake-up call was sounded yesterday when the Health Ministry hosted Malaria Day 2009 in the community.
Malaria march: The Ministry of Health celebrated Malaria Day 2006 at Mahdia yesterday under the theme, ‘Counting Malaria Out towards the 2010 Targets and the UN Millennium Development Goals’. Residents held a march in the community to kick things off.
The problem in Mahdia has been compounded by poor waste disposal resulting in many clogged drains and mounting garbage piles across the community. There is also the issue of infected persons not adhering to the full treatment plan-a problem that has seen scores of residents being constantly infected with malaria. “I was almost dead 24 times, but am still here because I stuck with my treatment and saw it to the end,” Regional Chairman, Senor Bell said yesterday. Bell disclosed that he had been diagnosed with malaria two dozen times and that he has been ill for a considerable period in recent times. His somewhat frail appearance yesterday was something he openly addressed saying “even now I don’t feel well and might have it again.”
The observance at the Mahdia District Hospital drew scores of residents and children who had genuine concerns about malaria. The children appeared more informed on the issue due to ongoing educational programmes in the community geared towards raising awareness, including essay writing and jingle competitions.
But even as the residents were called upon to take a different approach to malaria, the focus was on mining activities at Mahdia. The Guyana Geology and Mines Commission (GGMC), which was part of the activity yesterday, came under fire for not being more active in its role in the mining community and for allowing miners to dig up the area and leave without covering up the ponds.
Karanchand Krishnalall, Chief Inspector at the Vector Control Unit of the Health Ministry, pointed to swelling numbers in the fight against malaria. He reiterated Health Minister Dr Leslie Ramsammy’s previous disclosure that the number of cases this year exceeded the target for keeping malaria under 10,000. He said that the figures are likely to point to some 11,000 cases by year end, adding that a more aggressive campaign is being fought to reach more people. For the year so far some 102,201 smears were taken and tested for malaria and around the same time last year the number was 98,000. As of last month 8,467 malaria cases were on file-a slight increase from last year of about 200 cases. The majority of the cases are falciparum, which is the most dangerous type of malaria, followed by vivax.
Krishnalall presented figures to paint the picture of what is happening in the various regions with malaria. He said that the problem areas are Regions One, Seven and Eight, noting that the mining and logging are posing serious problems to the health sector with respect to malaria.
In terms of cases which have been diagnosed and treated for the year so far, Region One recorded 15%; Region Seven 7%; Region Nine 8%; Region Ten 8% and Region Four 41%. Krishnalall said the majority of cases are diagnosed and treated at Georgetown Public Hospital even though Region Four is mostly malaria free. As for malaria infections to date, Region Seven has recorded 39%; Region Eight 22%; Region One 17%; Region Ten 6%; Region Nine 7%; and Region Two 2%.
Indal Rambajan, Director, Global Fund underscored the threat mining poses to communities like Mahdia and he noted that serious problems could be facing the region in the near future. He said the figures being recorded for malaria “might be exaggerated” and insisted that many of the cases are counted twice. He said the ministry usually has to cut off some cases when the cases on file are re-examined. He also noted that the Global Fund recently agreed to fund another five years of malaria programmes in the country, but according to him the funds were originally for Regions Seven and Eight and are now being stretched to include Region One. Further, he said, the project was currently out of bed nets and this is likely to pose serious challenges in the fight against malaria.
Director of Regional Health Services Dr Steve Narine briefly commented that malaria infections are preventable and he urged the community to follow the guidelines and “stay alert.” He said also that the ministry continues to face new challenges in the fight and that new strains are being picked up. “The number of cases is increasing and people are not sticking with the treatment plan, which is important,” Narine added.
Dr Luis Seoane of the Pan American Health Organisation (PAHO) called for greater malaria control activities in the country, stressing that there must be increased surveillance at the borders. He said if not tackled carefully, border malaria and multi-drug resistant malaria will frustrate the attainment of objectives that have been set. He expressed hope that the launch in Mahdia would serve as a reflection to start and lead to a better understanding of the malaria problem.
He said Guyana had made significant strides with its malaria programme, but underscored the importance of political commitment, legislative measures and the establishment of inter-sectoral linkages to prevent its transmission.
This mosquito borne disease is treatable and the government should be ashamed that in 2009 people are still being drained of their energies by this scourge. Please call “Bono” of U2 fame for assistance. As a child I remember the “mosquito larvae” man coming late at night to take specimen from brothers and sisters and spraying DDT to kill parasites. The days of flit cans. Today aerosol sprays.
The problem is more complicated than you think. The vector control workers who visited the homes during the sixties used aspirators to trap adult mosquitoes that were standing on the walls of buildings. This was essential in identifying the distribution of the (Anophles darlingi) the principal vector of the disease. They also applied DDT from a stirrup spray can to kill adult mosquitoes. As you may know, that DDT is not a safe insecticide because of its demonstrated health and ecological effects. In fact, some authorities cite it as a biocide. It contains strontium 90. Many researches have shown that Propoxur (Baygon) has resulted in more deaths to mosquitoes than Malathion but Propoxur is very expensive to apply on a large scale. Malathion applied as a mist spray is now the insecticide of choice. A mist spray is important so as to reduce drifts during application and limit exposure to aerosolize insecticide to receptors. However, it is important to understand the bionomics of the vector that you are targeting prior to instituting a vector control program. I recall the Seventh Adventist church had a program in Guyana in which medicated nets (impregnated with pyrethrum) was introduced to many hinterland settlements. I am not too sure whether an evaluation was ever conducted but I do know, that it was successful in many parts of the world in which malaria is endemic. I am still convinced that since the Anophles darlingi breeds in fresh water and in abandon mining pits, there ought to be mandatory requirements for both miners and residents to take precautions at home e.g. screening of water barrels and decommission exhausted/abandon mining pits. Residents as well as miners can also apply insect repellent that contains DEET and information is available with respect to age groups and recommended concentrations. I know both Rambajan and Krishnalall and I think that some studies can be done on the effectiveness of biological larvicide such as Bti (Bacillus thuringiensis israelensis) and Bacillus sphaericus on Anophles darlingi mosquito larvae. The effort may worth its weight in gold but who knows other than time…
Peregrine Falcon:
Your more elaborate explanation is appreciated. I was around for the early introduction of “Malathion” which became the popular choice for those with a suicidal bent.
Yes! Malathion was introduced in the rice industry to control “bush bugs” but not to control adult mosquito populations. Indeed, many citizens committed suicide by swallowing large volumes. The Oral LD50 for male rats is 1375 mg/kg and female rats is 1000 mg/kg. Homo sapiens are certainly a non target species but I do agree with you, that many souls fell victims to its lethal toxicity.
Change the culture of the porknockers,both Brazillians and guyanese and you will control malaria,not only in Mahdia but in any area where the vector is prevelant because the mosquito only transmit and humans are the only resovir for the vector,so how will malaria ever be controlled, is like looking for a needle in a haystack,education and being knowledgeable about the mode of tranmission among porknockers could work but it will also cost the taxpayers millions of dollars which could go in another direction because once they are gettting the gold nothng else matters not even their health.
the malaria march has more people than the “torture” protests. shows that guyanese are smart not to follow oppositions’ whims and fancies.
One of my friend told me that MEP (Malaria Eradication Program) means ‘Mosquito Eating People’ when I told him that I worked for MEP LOL.
However he might be right because if the patients are not educated or do not adhired to rules (taking their treatment as required) the disease can become uncontrolable – especially when it comes to miners. Malaria is going to live for a very long time in Mahdia due to ignorance of the seriousness of the disease or by ignoring rules.
All miners going into Mahadia should take anti Malaria (preventative) tablets. Also all major miners/Bossmen/women should make sure that their workers (divers/cooks etc)take preventative medication.
Anyway I wish to add the use of mosquito nets (always whether one has malaria or not
and or even screen the homes) to the lists of preventive methods mentioned by fellow blogger above.