Inside Rwanda’s malaria success story

Imagine this; back in 2005 the total number of Rwandans that suffered from malaria was 1,700,000 patients. Last year, according to the official statistics from the Ministry of Health, the figure was just 477,000 patients—representing a phenomenal decline of 75 per cent.In a related development, whereas 11,450 people died of the Africa’s number one killer disease, just only 459 died of the disease last year. The government aims at totally eradicating malaria by 2017—the timeframe for the EDPRS II (Economic Development and Poverty Reduction Strategy II). Notably, the Rwanda malaria success story is a concerted effort, not only by government but development partners and the population as well.Presently, the Ministry of Health is working closely with development partners and some corporate companies in an intervention drive, dubbed the Rwanda Malaria Forum. Dr Corine Karema, the xirector of the National Malaria Control Programme, recently told the press that more than six million treated mosquito nets were to be distributed to households between 2012 and 2013, and around 500,000 Long Lasting Insecticidal Nets were actually given to pregnant women and children under five years in 2012. Distribution of mosquito nets has reportedly reached 82 per cent now. These initiatives are supplemented by indoor residual spraying and diagnostic testing. Now, the cloud cover signals that in a few weeks the skies will open yet again and the rainy season will start—it may go on way until early January perhaps. Remember, wet seasons are conducive for mosquito breeding. Water, and particularly stagnant water, are ideal conditions for mosquito breeding. That explains why during rainy seasons, cases of malaria are reported in various health centres across the country. Countrywide indoor residual spraying commences on September 2. Misconceptions Fighting malaria effectively has a lot to do with the populace. It goes beyond just distributing mosquito nets. For instance, initially when the programme of distributing mosquito nets had just started, the populace, especially rural folks, were resistant to sleep in them. Some argued that the insecticidal drug on the nets could have adverse effect to human life. Others, mostly couples, claimed that nets cause uncomfortable sleep as a result of excessive “extra” warmth in the wee hours of the night. The lazy ones did not bother hanging them on their beds—they simply kept them in wardrobes. Absolutely, this necessitated n aggressive and systematic sensitisation and awareness.The Society for Family Health (SFH) Rwanda, the first ever indigenous social health marketing entity in Rwanda strongly believes that making citizens appreciate and understand why they need to sleep under mosquito net is the most ideal and sustainable way of preventing and eradicating malaria. Musanze malaria experience In its outreach programmes, SFH works through community-based organisations (CBOs). These are residents living in areas of operation volunteering to work with SFH to implement its activities. CBOs, in their daily interactions with the people and families of Musanze, have a lot of experiences to share. Perusi Mukarwabikana, a CBO health worker, says residents of Musanze have responded quite well to SFH outreach campaigns to Fight against Malaria. Healthy Times caught up with Perusi at a roadshow organised by SFH in Musanze town.“Such campaigns targeting masses have a played a significant role in sensitising our people, but we still visit home—door-to-door–in a more focused way,” Mukarwabikana says. She says although she is certain almost all homes now have nets, there could be some folks not using them. “We still have cases of Malaria in the area, and a few deaths caused by it. That signals some resistance.” Role of primo, cortem and SiroThese are recommended tablets for treating malaria. Primo is for children of five and under. Cortem is for children above five years and adults. Both are pharmaceutical brands of SFH distributed across the country at health centres and pharmacies. Mukarwabikana says part of malaria awareness and sensitisation campaign residents are advised to take patients for blood test before taking any of the malaria tablets. “The symptom of malaria is high temperature. But high temperature could be caused by other illnesses. So we sensitise residents to always first go for blood check within 24 hours,” she added. Joseph Sebomana, a father, says no member of his family has fallen sick of malaria for more than three years now. “I don’t need primo or cortem in my family anymore. I make sure that we all sleep in treated mosquito nets and drinking water treated with Siro,” Siro is another product distributed by SFH—solution that purifies water automatically without boiling it. “Before, we could boil the water but you can’t be a 100 per cent sure like with the use of Siro,” Sebomana says.FeedbackSome residents reportedly use mosquito nets that were given to them freely for fishing. Impeccable sources also indicate that Rwandan nets are sold on black market in Tanzania. The Ministry of Health issues a strong warning to such bad people that once nabbed they would face serious legal penalties.