SUCCESS STORIES

Community Health Workers Help Keep Communities Malaria-Free

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Written by Susan Walters, with Photos by Bonnie Gillespie

Malaria is a fast moving disease. It starts with the bite of a female Anopheles mosquito and quickly turns into a debilitating attack on the victim’s red blood cells.

In the body of a child, the parasite is particularly fast acting, producing high fever that left untreated, will yield a case of severe or complicated malaria, a condition accompanied by life threatening symptoms including coma, acute kidney failure, circulatory collapse and repeated convulsions. An adult can expect to experience symptoms such as respiratory distress, severe anemia, generalized convulsions, and even shock.

For Ethiopians living outside cities, getting to a hospital from a rural village when malaria symptoms emerge is usually a long and arduous walk; often it requires others to carry the sick person. But since 2005, when the Ethiopian Ministry of Health began a coordinated effort to distribute long lasting insecticide treated bed nets, new anti-malaria combination therapy medicines, and rapid malaria diagnostic test kits, they also included village-based health workers as the first interception point for new malaria outbreaks.

Today, 17,500 community health workers are helping to turn once malaria ravaged villages into places of improved health, one family at a time.

Lomita is one person in Ethiopia’s growing team of community health workers and works in the village of Adah Wared. She is well-known as the person who can help when a family member is sick. “I work with 638 households in this village,” she said, “and every one of them has a new net this year.”

Nets are making a difference in Ethiopia where two-thirds of the population lives in malarious areas. A rapid and large scale distribution of 18 million insecticide treated nets began in 2005 when Ethiopia’s malaria outbreaks were epidemic in some areas. Millions more will be handed out in the next 18 months.

“TB and malaria are the main diseases affecting this community, but we are seeing much less malaria this year, only one or two cases,” says Lomita. “I take good care of my village because I love them all and they love me.”

Lomita says she has no shortage of supplies and uses the rapid diagnostic kit to determine if a person’s fever is the result of malaria. If it is positive she provides the anti-malaria combination therapy drugs.

“Then, if the drugs do not make the fever go away, I then refer them to the clinic,” she said.

Lomita follows-up with the clinic to learn of a patient’s progress and with local families to see how their insecticide-treated nets are being used.

“I can tell that 70% of the households use their nets correctly, and the women are particularly welcoming of the protection the nets bring for their children.”

Through established antenatal clinics and well-attended child survival programs where immunizations, supplemental feeding, and vitamin A is offered free of charge, mothers and pregnant women in rural Ethiopia are receiving insecticide treated bed nets and multiple face-to-face demonstrations reinforcing proper use and care of the nets.

By 2008, the Ethiopian government expects to have a total of 30,000 community health workers trained and working throughout the country. Nearly all households in malarious areas are expected to have at least two nets by the end of 2007.

“I had malaria six years ago and that was enough,” said Lomita. “I will use my training and my own experience with malaria to help my village be healthy.”