Despite the numerous government interventions to end malaria in Uganda, it is still one of the leading causes of mortality and morbidity in the country.
It was estimated that in 2017, Under-five deaths due to malaria was at 7% while neonatal (under 12 months) mortality was at 11%.
Much as it is a walkover for the well-to-do families, malaria treatment costs are a nightmare for people who strive to even put food on the table for their families to survive.
Grace Nakachwa, a resident of Bwaise II is a mother of three children. She represents a number of people who experience economic hardships when the need to seek and procure a malaria treatment arises.
The Ministry of Health notes that the cost of treating Malaria is high, as a single episode of malaria costs a family an average of Shs 30,000 or close to 3% of the household annual income of majority of families.
Because of this, most families have resorted to self-medication at home; accompanied by taking an assortment of herbal medicines because they cannot afford proper medical treatment in healthcare facilities.
Nursing Malaria infected children at Home
Having realised that her 12 year old daughter had a fever, she did not worry much because she was confident enough that the local herbs would do the magic.
Nakachwa administered Panadol and some herbs for a few weeks until her daughter got better.
“When the girl recovered, her sister; with whom they were sharing a bed, started telling me that she was also feeling unwell. I realised that the symptoms were the same with the one who had recovered,” she said.
She took the second victim to a nearby clinic where malaria parasites were discovered in her blood, upon taking blood samples. Treatment was procured and “after close to two weeks, my second daughter was feeling much better.”
Episode 3 of Malaria
Two weeks ago, Nakachwa’s last born started to feel feverish. The two year old boy had malaria-like symptoms, just like his elder siblings.
Nakachwa notes that even when she knew it was malaria due to the high temperature the boy developed on one night, he did not get treatment immediately the family didn’t have enough if any, money to get the treatment.
“I first used a wet cloth all over his body and I stayed strong for at least three days before I took him to hospital. I could give him treatment myself, with a small dose of Panadol, although I had not ascertained the cause of the fever,” Nakachwa narrated.
Days later, however, the mother of three managed to get a few thousand shillings and took the boy to the hospital where the doctors did blood tests.
“I was so surprised when the doctor broke the news, because we sleep under a mosquito net. I realised that there could be a possibility of him rolling over nearer to the edges of the mosquito net. I therefore put a pillow to act as a boundary between him and the net,” she explained.
The doctor prescribed Coartem and other drugs. Nakachwa attributed the infection to the numerous mosquito breeding spots in her area that has stagnant water and unkempt grasses around the place.
“Sleeping in a treated mosquito net can help to prevent malaria. However, people should be careful because mosquitoes are everywhere. They can even bite you while watching TV in your sitting room,” Nakachwa warned.
The government of Uganda has over the years intervened to reduce the malaria burden in the country. Among others, this has been done through advocacy, indulging cultural and religious leaders, mass sensitisations and provision of information about malaria, its dangers and how it can be prevented.
The government, through the ministry of health is also currently distributing free mosquito nets to people under a campaign dubbed ‘under the net’.
Another malaria victim in Bwaise
In Bwaise II, a mother and wife, Betty Namaganda was found to be suffering from Malaria in the early days of the covid-19 pandemic. This was a time when the President had declared the lockdown and therefore public transport had been banned.
This meant that Namaganda could hardly move to attend to her small business in town where she was earning some income. Her sickly condition could not enable her to move anywhere either.
The little savings she had would only be enough to cater for her children’s food since they had also returned home, upon closure of schools.
Dealing with malaria while grappling with Covid-19 effects
Since it was right at the beginning of the lockdown, with fever and general body weakness, Namagembe dreaded going to the hospital, “who knows if I have contracted the virus,” she thought to herself.
“I was feeling very unwell with a fever and constant stomach ache. The pain was too much that I could not hold it. This was a time when the lockdown had just started. I eventually decided to go for a check up because I was also suspicious of the coronavirus,” she explained.
“The healthcare worker confirmed that I had malaria parasites in my blood upon carrying out tests,” she added.
Procuring treatment was a burden, due to the limited finances in the family.
“The situation was bad at home. The lockdown had just started and there was no money. Children were all home and there was need to take care of them at all costs. Therefore, I decided to sell a few of my items so that I could raise enough money to enable me get the treatment,” Namagembe said.
That way, she was able to accomplish her full doze and get back to her feet.
Namagembe said that since then, she has learnt to be more careful because one can get mosquito bites from anywhere. “I learnt that I had to be careful enough. I now know that everyone can get malaria; regardless of age and size,” she added.
What the VHTs say
Samson George Bukenya, 32 is a resident of Bwaise II (Lufula Zone). He is also a Village Health Team member in his area.
Bukenya has had an episode of malaria and he shared some key details about his experience.
“Basically, I developed some fever and I went to a clinic, where they did blood tests and discovered that I had malaria. I was so nervous and was in pain,” he explained.
Bukenya said that starting his treatment was a ‘tug of war’, as it was an economic drain to the breadwinners at the home where he stayed then.
“It affected my guardians financially because to undergo that treatment, you have to buy medicines and the money for such affects the guardians’ budgets. In most cases if it is severe malaria, you require admission at a health facility which is quite expensive,” he said.
Bukenya said that he is positive that he contracted malaria because he was not sleeping in a mosquito net and therefore adopted the practice of using mosquito nets upon recovering after two weeks.
“Around 2014, the government distributed nets to people, but not all can afford nets. If you trace house by house, most people don’t have nets. The areas we stay in have stagnant water. Being the breeding places of mosquitoes, malaria cases are high here in Bwaise. Even diseases like cholera can easily develop,” he stressed.
He, therefore, noted that in order to prevent malaria, more sensitisation needs to be done.
“We need to educate our people about the dangers of malaria. We need to spray around our homes as well as maintain a clean environment,” Bukenya advised.
“I don’t think that sleeping under mosquito nets alone will eliminate malaria. The question is; have we cleared the breeding places where these dangers come from? However much the government distributes the nets, without people clearing these dangerous places where mosquitoes breed from, it does not help,” he stated.
As a Village Health Team member, Bukenya said that mass environmental cleaning, locally referred to as “bulungi bwa nsi” is crucial; only that some leaders enforce it when they are going in for election campaigns.