Travel writer Karen Berger has spent nearly a year in sub-Saharan Africa, and always takes her malaria pills. Visit her at www.KarenBerger.com.
Traveling to Africa is always a little more complicated than traveling almost anywhere else. There are (sometimes) visas to arrange and (always) questions regarding climate and communications. And then there are the health issues. A trip to most parts of Africa requires a visit to a doctor and a long list of shots. But above all is the issue of malaria.
Malaria is perhaps the most urgent health issue for travelers and residents alike in sub-Saharan Africa. Due to constant lifetime exposure and because prophylactic malaria drugs are expensive in countries where the majority of the population lives below the poverty line, for many sub-Saharan Africans, malaria is simply part of life – and death. According to the UN Office for the Coordination of Humanitarian Affairs, in 2006, malaria was Zambia’s number one killer, with 50,000 fatalities a year.
But that may be changing, thanks to recent initiatives in Zambia that have reduced the incident of malaria by 66 percent since 2000, according to the World Health organization. The intensive, coordinated malaria-education effort has involved everything from high-tech drugs to low-tech mosquito nets to educating local faith healers to involving the highest levels of government health officials.
Malaria is spread by the bite of the anopheles mosquito which is active at and after dusk. Thus the activity that puts Africans most at risk for malaria is the simple act of sleeping. The heart of the Zambian initiative has been the dissemination of insecticidal mosquito nets. Other parts of the program have included spraying during the mosquito breeding season and the use of the drug Coartem, an artemisinin-based combination therapy. (Older chloroquine-based drugs have long since ceased to be effective in Zambia due to the emergence of chloroquine-resistant malaria strains).
Between 2006 and 2008, 3.6 million long-lasting insecticide-treated mosquito nets were distributed in rural areas. In that time period alone, malaria deaths declined 47 percent and childhood anemia (which in sub-Saharan Africa is usually associated with malaria) declined 68 percent. The initiative has not been without challenges. The UN’s Irin News and Analysis reported that rural residents, uninformed about how malaria was transmitted, at first used the nets for fishing or wedding dresses. To solve that problem required educating local headmen and traditional healers who could use their positions of leadership in the community to support the initiative.
Travelers to Africa can take a lesson from the Zambian initiative as well as reduce their risk of malaria by employing the two protective measures that have proved so successful in Zambia. First, see a qualified tropical disease doctor before your trip to ensure you are getting the right malarial prophylactic drug for the region. Second, keep in mind the following suggestions to avoid mosquito bites:
* Use insect repellent
* Wear long-sleeved clothing and long pants after dusk
* Try the new insect-repelling permehrin-treated clothing (available at outfiiting stores)
* Use mosquito nets when sleeping in camps or rustic lodgings
CONNECT THE DOTS
To learn more about the initiative, visit the website of Zambia’s National Malaria Control Centre and the UN News Centre. UNICEF has additional information on malaria programs.
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