epidemic

Health

Vanuatu’s malaria epidemic

Vanuatu’s Rotary Club malaria con trol campaign started in 1991 upon request of the state’s Ministry of Health, after other methods formerly used on the island state, including fogging, had

proved unsuccessful. Chloroquine also

progressively became less effective

through the 1980 s and chloroquine-resis

tant malaria is now found in many coun tries of the region, including Vanuatu.

Between 1987 and 1990, malaria in Vanuatu meant the following: The most common reason for admission to hospital, the cause of ten per cent of all out patients’ visits in clinics and hospitals, the major cause of death in children under five and pregnant women, and the third most common cause of death for people of all ages, Vanuatu Rotary says in a sub mission report to Rotary International last

April.

“One in every 100 people in Vanuatu was admitted to hospital each year with malaria; it is the third most common dis ease in outpatients with over 10 percent of all outpatients being treated, the third most common cause of death (all ages), accounting for over seven per cent of all deaths, and a major cause of deaths in children, causing 15 per cent of all deaths in the 0-4 age group,” the report says.

The disease is a serious one here: With the Solomon Islands, Vanuatu is the most affected country in the South-West Pacific.

Since 1991 over SUSSO,OOO have been injected into the project by World Health Since 1991, over SUSSOO,OOO has been injected into the project by World Health Organisation, UNICEF, and the Australian and Japanese governments, mainly to import the bed nets and provide insecticide.

The Vanuatu campaign consists of a free distribution of mosquito bed nets

throughout the Y-shaped archipelago’s 80

islands at a village level, and, more recently, in boarding schools. There, teams from the health department also teach villages how to maintain their bed

nets’ efficiency by regularly re-impreg

nating them with permethin, a much more efficient insecticide than DDT.

This year, Vanuatu’s Rotary Club wants to convince Rotary International to adopt the idea on an international scale.

“We want them to run this programme on an international scale, just they did

with the Polio Plus campaign. That is our hope,” says John Smith, a rotarian who was involved in the project from the start five years ago.

In the documentary produced to pro mote the idea, narrator Malcolm Ferguson says in the 20 minute presentation, that 10,500 people worldwide had contracted malaria and 73 people had died from the disease.

Malaria parasites are estimated to cur rently affect some 270 million people annually, with up to two million of those dying from the disease. It is ranked in the top five causes of death by disease in the world, a Rotary report explains.

The germ (there are five species; plas modium, falcuiparum, vivax, oval and malaria) is transmitted to humans by mos quitoes biting mostly between sunset and sunrise.

The only mosquito than can transmit malaria is the anopheles. Only the female mosquito bites: She requires blood protein before she can lay her eggs, mostly at

night. The anopheles mosquito makes no

noise: It doesn’t hum or hover as do most mosquitoes. After choosing her human target, the female anopheles mosquito pierces the skin. Then two blades, bearing very fine teeth, will lacerate the skin like a microscopic saw. When a small vein is found, it is pierced and a flexible tube is inserted. During the process, the mosqui to introduces saliva to the wound. This saliva acts as an anaesthetic, so the bite is not felt.

It is through this saliva that the plas modium parasite enters the human body.

After the germ is injected into the human bloodstream (by a mosquito bite), the par asite develops in the red blood cells, until they burst. Without enough blood cells to carry oxygen through the body, the victim becomes anaemic and can die from rental failure or convulsions.

It usually first takes the form of aches, fever and vomiting, later anaemia and in the most severe cases, cerebral malaria. A child infected with a virulent strain can die within hours of the first symptoms as ravaged blood cells clog capillaries and deprive the brain of oxygen. Milder cases are characterised by drenching sweats and shaking chills followed by months or even years of anaemia and periodic fevers.

Pregnant women and children under five are the main victims. ■