Malaria, a protozoal disease, is defined as a communicable, notifiable, debilitating disease characterised by fever, rigors and prostration.
As a young person in Namibia, I am very worried by the alarming reports of malaria cases and deaths reported in Namibia recently, particularly in the Zambezi, Ohangwena and Oshikoto regions.
It cannot be right that after 34 years of our independence, we are still struggling to eliminate a preventable disease, malaria.
This letter attempts to provide some possible solutions on how effectively we can eliminate malaria in our country.
Malaria can be spread through the bite of an infected female Anopheles mosquito. The female Anopheles are infected when they take their blood meals from infected humans.
They then transmit the parasite when they bite an uninfected person. Once in the human body, the parasite multiplies in the liver, and then infects red blood cells. The fundamental question is why the cases remain high, despite interventions such as conducting active case searches, malaria surveillance, case management, vector control, net distributions, and bionomic and behavioural changes.
It is very simple; we are not doing well with our intervention strategies. It is high time that we all apply the correct formula, and that is by letting the community lead. How do we expect to eliminate malaria if we are not distributing nets to everyone in the endemic areas, and if our hospitals and clinics are full of papers on their walls written, “No mosquito nets available”?
It is worse in Zambezi because that is the region which is topping in malaria cases and deaths in Namibia. The same region is topping in HIV/AIDS incidences and prevalence countrywide. I cannot celebrate this.
I remember in 2003 when I was diagnosed with malaria at the Engela State Hospital. Everyone in our household was given a net. Why are the nets not distributed like before? It cannot be right for our country to spend more money on anti-malaria drugs, yet we don’t want to spend money on prevention measures. What happened to the statement “Prevention is better than cure”?
As a qualified nurse from a government training centre and someone who has been managing malaria cases for three years, let me prescribe the following:
The current social behaviour communication change programmes need to be strengthened more.
The public should be educated more about malaria, and take their health more seriously.
The removal of all papers written (no mosquito nets available) from our healthcare facilities should start with immediate effect.
Nets should be procured and given to people who need them, just like condoms. People from the most-affected areas should be made part of the response programmes, and be part of the solution. People from Okongo, Eenhana, Omundaungilo, Engela, Onandjokwe, Choi, Sibinda, Shachoma, Mashokotwani, Chinchimane, Kanono, Eengodi and Omuthiya should be trained, educated and be recruited so that they become the drivers of progress in the malaria response. Letting communities lead builds healthier societies.
This should be strengthened mor,e as it reduces the mosquito populations and is one of the important tools in malaria control programmes. The young people who are interested in the fight against malaria should be deliberately sent to higher institutions to study entomology and various other important courses. It cannot be right that Namibia, after 34 years of independence, has only one female trained entomologist: Rosalia Shitaleni Joseph. She was second to be trained after Dr Richard Kamwi. We need more scientists like Joseph in Namibia, as these are the people who bring new ideas and develop innovations and strategies which contribute significantly to vector control methods.
We also need to collaborate with neigbouring countries, and ensure effective coordinated strategies in malaria prevention. It should be noted that no country will be able to eliminate malaria on its own, as mosquitoes cross borders any time they wish, and they do not carry passports.
Lastly, making Namibia a malaria-free country is possible. It will not be done in a few months, but it can be done. If the nation is educated on malaria preventions, it would minimise the burden of cases, leading to elimination and allowing resources to be spent on other health priority areas or programmes, as this is a limited resource now.
*Alfeus Lungameni Hamundja is a qualified nurse, and previously served as a TB focal healthcare worker at the Outapi District Hospital. He was also an Immunisation Support Officer at the Okongo District Hospital. The opinions expressed herein are his.