Senegal

Senegal: Simple but powerful ways to beat malaria

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THIES, 17 December 2009 (IRIN) - In 1999, just before the new school year was to begin, El Hadj Diop lost his 12-year-old daughter to malaria. Now, he and other parents have had enough of losing family members to this preventable illness, and have taken simple but effective steps to fight it.

"I wanted to stop this scourge that is taking away our women and children," Diop told IRIN. Their efforts are having an impact in the rural community of Tiénaba - about 180km from the capital, Dakar, in the Thiès region - where 15 cases of malaria were reported among 4,000 residents in 2009, compared to 1,140 in 2004.

With help from the Global Fund to Fight AIDS, Tuberculosis and Malaria, people in the region are being tested for malaria, dispensing medicines, and learning to prevent, detect and treat the illness.

Diop is the president of an association launched in 2000, which comprises 65 public health committees headed by village women who run education and awareness campaigns, and impose penalties when people do not follow hygiene rules.

The women do monthly home visits to check. Any bed found without a mosquito net costs the family a fine of 250 CFA francs (55 US cents) - a considerable amount, especially in rural areas, where many people cannot afford the entry fee of 200 CFA francs (44 cents) at some health centres.

If families cannot afford enough bednets, the association chips in via a "solidarity fund".

"Thanks to mosquito nets I can go out and work," said Fatou Thiongane, 52, a mother of seven, whose family lives mainly off her sales of cashew nuts. "Before I had to stay home [much of the time] and take care of family members ill with malaria."

Besides the bednet patrols, people in Tiénaba have grown accustomed to cleanliness and hygiene checks. Every Monday young and old clean up rubbish and get rid of stagnant water - breeding grounds for mosquitoes.

Prevention measures go a long way in reducing malaria, but so does improvement in diagnostic methods and treatment, according to villagers as well as health officials.

Fatou Nian, 25, was selected by her fellow villagers in Nekhe Nian, also in the Thiès region, to be their home health worker and she was trained by doctors in Thiès to detect malaria with rapid diagnostic tests (RDTs). The closest health centre is 7km away at Pékesse.

"If the test is positive I give anti-malarial medicines appropriate for the person's age," she told IRIN. "I ask the person to take the medicines for three days, then I visit the person's home to check whether he or she has taken the drugs properly." Treatment costs 300 CFA francs (66 cents) for adults, and half that for children.

"I was ill for two days. Fortunately, Fatou is here; I did not have the means to get to the health centre," a Nekhe Nian resident who identified herself as Madame Nian told IRIN.

Pape Djibril Gueye, a nurse at the Pékesse health centre, said the training made a difference because previously communities had not treated malaria and other fevers properly.

"All cases of fever were treated as malaria," he said. "The RDTs have helped us do good diagnoses - of 738 cases of fever [recorded] from January to October 2009, 100 were malaria."

Malaria is endemic in Senegal, and is a top public health problem that peaks during the rainy period from July through September. However, according to the Global Fund, the death rate declined from 30 percent in 2001 to 20.7 percent in 2005.

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