Segment 1

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In Africa, malaria takes the lives of 2,000 children every day.

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Many are quietly buried, mourned only by their families.

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Without a Net

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Tanzania: Dar es Salaam, Nambunju

VOICEOVER

In Nambunju, a small village in Eastern Tanzania, six out of ten people carry the malaria virus. Most are women and children. Sofia, a young mother, is worried about her baby daughter, Fadida. She has a high fever.

ALLI A. NIHUKA [clinician, district health information manager]

I went to Sofia's house. I assessed the baby. The problem I see today is Sofia is not using a mosquito bed net. And the child always falls sick. I advise the mother to send the child to the dispensary. Tomorrow take her to the dispensary. The big killer of the children in Nambunju is malaria. We raise awareness of the community by educating them to know, to recognize the early signs and symptoms of malaria.

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Malaria is caused by the anopheles mosquito, which spreads the virus by sucking the blood of an infected human and passing it to its next victim. That is why a physical barrier such as a bed net is crucial in preventing the disease.

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Bagamoyo Hospital

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This year, nearly 250 million people around the world will be infected by malaria. More than 800,000 people will die.

DR. ALEX MWITA [program manager, National Malaria Control, Tanzania]

There are 80,000 malaria deaths in the country. But malaria is a treatable disease. The challenge is, we want to reduce those deaths by half.

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The only way to diagnose the illness is from a blood test. But testing is difficult and expensive, and many villages are not equipped for the work. Government clinics, like this one, carry out tens of thousands of blood tests each year.

DR. NAHYA SALIM

My name is Nahya Salim. I'm working with Ifakara Health Institute, Bagamoyo Branch as a pediatrician. More than half of the beds are occupied with malaria cases. And we see anemia and convulsions as common complications associated with malaria. When I arrived here in the ward, we had two serious patients. One of them, he was admitted with a fever and history of convulsions. So we had to start treatment as a case of severe malaria. Sometimes when the child starts to have convulsions, they usually go to the traditional healers, receives some local treatments, and that complicates the whole situation. We have a huge task to do: to change the perception of the community.

ALLI

I went to Sofia's house to make a follow-up. I'd like to know if the child is doing better or not. The child was sick, with a high fever. During my assessment I found the child with a bracelet and this indicates that they go to the traditional healers. They believe that when you put on that bracelet, this helps prevent them or their children from becoming sick, especially heavy convulsions. And we are trying to educate that the convulsion itself is due to fever and nothing else.

VOICEOVER

Alli decides to reach out to the traditional healer, Mr. Mohamadi Mohammed.

ALLI

Before dispensary the parents used to go to the traditional healers. Now we educate our traditional healers to work together with the dispensary health center. Because we need them to help us to educate people. We train them to assess the children, and if the problem is malaria, they normally ask them to go to the dispensary or hospital. Me as a medical personnel and the community try to solve the problem together.

VOICEOVER

The Ifakara Health Institute is well known for carrying out research on the effectiveness of bed nets, developing new drugs, and carrying out clinical trials on a malaria vaccine. The IHI is part of the worldwide effort by governments and non-government organizations to tackle the disease.

DR. SALIM ABDULLA [director, Ifakara Health Institute]

For the last 10 years I've been involved in doing malaria research work. The last piece of work that we have done is on testing new vaccines and so far we have tested the RTS,S which is the most advanced malaria vaccine to date. We have to really focus on prevention because the time between someone getting an illness and succumbing to the illness may be very short and with everything that we have today, we cannot prevent that death.

HEALTH INSTRUCTOR

What are the symptoms?

VOICEOVER

No amount of medicine will help the village if people do not know the basic facts about malaria.

HEALTH INSTRUCTOR

Diarrhea, vomiting, and high fever. Give me another effect.

ALLI

We have a community health plan in Rufiji to fight against malaria. We educate our community to keep their environment clean and also to use treated bed nets.

VOICEOVER

In these remote areas, there is no radio or television and getting the message out can be a challenge. A local drummer group is hired to help the community recognize the symptoms of the disease, and convince them to bring their sick to the medical clinic rather than to traditional healers. Even the men, often the household decision makers, turn up to watch the show.

DR. ALEX MWITA [program manager, National Malaria Control, Tanzania]

We should empower people. Empower people to understand what malaria is and what they can do. I have seen a lot of reductions in malaria, because of the interventions that we have been doing. However it is tricky to eradicate malaria. It is tricky because malaria knows no borders. We have to work together. We have to be persistent until we see the last case of malaria gone.

ALLI

Sofia's baby was diagnosed with Malaria, and got antimalaria medicine from the dispensary.

DOCTOR

If the child doesn't improve, you bring her back.

ALLI

I showed Sofia how to put on bed net. And then herself, did the same. The net must be tucked in. Now Sofia is using bed net. And I expect the baby, if continue to sleep in the bed net, this will be one method of preventing malaria.

DR. NAHYA SALIM

It's very difficult. Unfortunately the child developed convulsions this morning, having continuous convulsions with fever. So, we had to start treatment for cerebral malaria, as the disease continue to progress. And we see that the child is not responding well. We are really struggling to improve, and we're not going to stop. Hopefully it will work.

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