Obstacles to malaria control

Health officials say they are working fast in parts of Afghanistan to prevent a possible outbreak of a potentially fatal strain of malaria. "Whenever you have [a movement into] endemic areas, there are always people who have never been exposed to the disease, and they don't know what it is so they don't treat it," Dr Rana Kakar of WHO-Afghanistan told IRIN on Thursday. She added that the massive displacement inside Afghanistan, with people fleeing to rural areas due to the threat of US strikes against Afghanistan, would make it more difficult to treat those infected. "There are two peak seasons for malaria - we have just passed one in September," she said. It is the cerebral (falciparum) strain of malaria carried by mosquitoes that causes particular concern as it is potentially fatal if not treated quickly. "It can be treated easily with chloroqine, but it needs to be treated fast," Kakar said. The worst-affected areas are said to be the northern Afghan province of Kunduz, the eastern city of Jalalabad and the central province of Vardak. The UN estimates a million people to be on the move in Afghanistan, many in search of what they feel would be a safer place to live in the event of a retaliatory strike. Kakar said those travelling were the most vulnerable, particularly women and children, as they could not seek medical help easily. She added that preventive measures were already being adopted, with thousands of tonnes of extra supplies being sent into Afghanistan this weekend. "We are distributing mosquito nets which are covered in insecticide, which not only protects the person but also kill the mosquitoes," Kakar said. Some 10,000 family mosquito nets would be distributed in the north of the country alone, she said. Kakar noted that although communications with national staff in Afghanistan had been limited following the pull-out of international aid workers, and Taliban restrictions on communications, WHO workers were "back to a workable mode". She said although numbers of staff in the country had decreased, she believed there were still enough operational clinics and people to be able to treat cases of infection. The massive displacement inside Afghanistan had also led to an increase in illnesses in general, with health clinics in rural areas in the east reporting double the usual number of patients, as Afghans continued to flee to more remote parts of the country. Kakar added that the WHO was also planning ahead in moving supplies in for the winter months when access would be restricted by expected heavy snowfalls. "Pneumonia is the biggest killer in the colder months, and we want vulnerable Afghans to be prepared," she said.