Health workers start battle against malaria

Malaria accounts for between 30 and 45 percent of all illnesses reported at health centers for displaced people in the Liberian capital, Monrovia, a health worker leading the fight against the disease said on Thursday. “The majority of the cases are children below five years of age and pregnant mothers. There are also many cases of premature births due to malaria,” Caroline Lynch of the American John Hopkins University malaria programme, the MENTOR Initiative, told IRIN. MENTOR is coordinating an inter-agency response to malaria in Liberia, with the Ministry of Health and various non-governmental organizations. An estimated 300,000 displaced people live in more than 110 temporary shelters in Monrovia, after fleeing fighting between government troops and rebels belonging to two groups - Liberians United for Reconciliation and Democracy (LURD) and the Movement for Democracy in Liberia (MODEL). “Displaced people are more prone to malaria because they are outdoors and are more exposed to the mosquitoes that spread it," Lynch said. "Also in situations of displacement, the body immunity tends to be lower than normal,” Lynch said. “West Africa is a highly endemic region for malaria and Monrovia is right now in the middle of the rainy season. There are a lot more mosquitoes breeding within the city’s pools of stagnant water,” she added. LURD attacked Monrovia repeatedly between June and early August, overrunning the western suburbs in an effort to oust the government of former President Charles Taylor. Peace talks in the Ghanaian capital, Accra, eventually led to a ceasefire agreement between the warring parties and Taylor's departure to exile in Nigeria. But although the fighting stopped in this city of over one million people on 4 August, most of those who were previously living in camps for displaced people on the outskirts still fear to return home. To address the situation, the MENTOR Initiative, the Malaria Control Division of the Liberian Ministry of Health and other health agencies have developed a national strategic plan for malaria control. They are launching health education campaigns among the displaced and are stockpiling various medicines to treat malaria. These include 120,000 doses of combination therapy, which contain artesunate and amodiaquine, and 5,000 doses of artemether. They are also providing 120,000 rapid testing kits for the disease. Twenty sprayers and chemicals and 3,000 insecticide treated tarpaulins have also been brought in. At least 7,000 more tarpaulins are expected. These will be supplied to provide mosquito repellant barriers at shelters for displaced, such as schools and the national sports stadium. Outside Monrovia, the International Rescue Committee (IRC) this week started building shelters for 13,000 newly displaced people at the Science College of the University of Liberia, near Kakata, 45 km north of Monrovia using insecticide treated plastic sheets. These will form part of the ceilings and walls of the shelters and the partitions between family sleeping spaces. Lynch said intensive malaria control activities would be launched within two to three weeks, beginning in the city centre and spreading out to camps on the outskirts of Monrovia. Meanwhile, the World Health Organization (WHO) reported that the number of cholera reported cases in Monrovia rose to 1405 in the week to August 24 from 1203 in the previous seven-day period. Omar Khatib, the WHO representative to Liberia, said the rise reflected better reporting rather than an absolute increase in new cases. He noted that relatively few people were dying from the disease and this showed the epidemic was being managed properly. Only eight deaths from cholera were reported in August. “The increase in cases is because data is now being collected from more health centres as part of activities of the recently established active weekly surveillance data collection. There are now more health facilities reporting on cholera and diarrhea,” Khatib said. Ealier this week, Khatib said the number of cholera cases in Monrovia had stabilised, but there was still a serious epidemic in the city.