In Sierra Leone, malaria is rife. It is the biggest killer of children under five and causes a massive burden on families and the country’s barely functioning health system. Malaria is preventable, detectable and treatable. Rapid Diagnostic Tests make diagnosis simple and effective, even in hard to reach rural settings. Artemisinin-based Combination Therapy (ACT), a treatment that works in just three days, is supposedly available for free to under five year olds and pregnant women from the Ministry of Health. So why are so many people still dying from malaria in Sierra Leone? “People are very poor and even if the ACT treatment is given free to pregnant women and under five year olds in the Ministry of Health clinics, people still cannot afford the registration fees, the doctor’s consultation, the cost of other drugs that they might need, etc.” says Willemieke van den Broek, Head of Mission for MSF in Sierra Leone. “Another problem is that transport and roads are very bad and people often have to walk several miles to reach a rural health post or clinic. Some villages are completely cut off during the rainy season”. MSF is tackling this with a new community malaria programme, currently being piloted in Bo and Pujehun districts. Two people from each community are chosen to be Community Health Volunteers. They are trained by MSF in how to diagnose and treat uncomplicated cases of malaria, using Rapid Diagnostic Tests and ACT treatment. With the training and a community health kit, the volunteers are able to diagnose and treat uncomplicated malaria cases in children under five and pregnant women, the two groups most at risk.

2008 Sierra Leone — World Malaria Day

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"2008 World Malaria Day in Sierra Leone — MP4 Video - 11.3MB
Malaria is the biggest killer of children under five in Sierra Leone. This is despite the fact that treatment and early diagnostic tools are available. MSF Belgium’s project in Bo is tackling the biggest obstacles facing local communities access to treatment.

Interviews with Community Health Volunteers

Joseph Tucker

Joseph Tucker
Photo: Olivia Blanchard, MSF. “My name is Joseph Tucker. I am 38 years old and I am a farmer. I have four children and we live in Bandajuma Village. I was appointed by my community to be a Community Health Volunteer because I was well known by everyone and I met the criteria of being able to read and write and being reliable and honest. I received three days of training from MSF where I learnt about malaria and how to diagnose it and treat it. Then, three weeks ago, our community was given a health kit, containing the diagnosis tools and ACTs so I could start my role of volunteer. Normally I see patients between 7am — 10am every day and then I go to work in my field. If there are very serious patients that need to be seen during the day, then I come back from my field and treat them. In my village there are 145 children under the age of five and four pregnant women. 43 of the children and pregnant women I tested in the last 3 weeks were malaria positive. Before this time, they would have had to walk 3 miles to reach the nearest clinic to get treated. Now, we even have people coming to our village from other villages because they know we have the tools to treat malaria. Malaria is a very dangerous problem in our community and I am very happy to be a community health volunteer because I am saving lives."

Jabaty M. Juana

Jabaty M. Juana
Photo : Olivia Blanchard, MSF. “I am Jabaty M. Juana. I live in Mandu village with my wife and six children. I am 31 years old and I am a farmer. Malaria is a very big problem in Mandu. When people come to me with fever, I test them, and if they are positive, I treat them with ACTs. I feel very happy to be a volunteer because I am saving lives, especially the lives of children. My village has benefited very much because our people no longer have to walk for miles to the nearest clinic, now they get the treatment at a faster rate and for free in our own community. We have had the health kit for almost one month, and people are even coming to me from other villages nearby because they know that we can treat malaria in Mandu. I have treated people every day, and we have had 44 malaria cases in the last three weeks. They are all very happy because they got treatment quickly and they are all well.”

More Information:

24 April 2008 — Opinion Piece for World Malaria Day 2008 by Dr. Prudence Hamade, Head of MSF's Malaria Working Group

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