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Malaria in the heart of the country

31-year-old Silka Tati succumbs to malaria at least once every year, sometimes more frequently. A resident of Khadiapara, the inaccessible-to-reach Edesmeta – a village in the hills 15 km away with the nearest motorable road – Tati says she has a high fever and nightfall for at least three days each time. I tremble. Each household has a similar story of malaria, and each has “devised their own ways” to deal with it. Medical interventions, yet rare, started reaching the village only after the onset of ‘Malaria Mukti’ Bastar‘Campaign in 2020.

Malaria is one of the biggest killers in Chhattisgarh, with some blocks in Bastar district being the worst affected in the country. Even the security forces battling the Naxalites are in the grip of this disease. In India, it is in places like Adesmata where a first-time vaccine for malaria, now a possibility after WHO approval, could prove to be a game-changer.

Villagers say that once the monsoon starts, hardly a week goes by without being hit by malaria. In September 2019, the twins born to Soma Punem died following high fever a month after birth.

“He was ill for a few hours before he died. We could not even take them to the health centre,” says Poonam. While the infants were never tested, their symptoms were too familiar for anyone to be in doubt for Puneem.

Due to the distance of 15 km and two hills from Gangalur Health Center, very few villagers reach there. Tati says he has devised alternative “treatment” methods such as drinking hot country wine, being bitten by a local red ant called Chapra, and consuming the bark of specific trees from the surrounding forest. Her husband Budru says, “It is only when things are serious that we go to the health centre. Those who cannot walk or are passed out are taken to a cot or basket.

Malaria free Bastar campaign has already made some changes. Bijapur recorded a 71.3 per cent drop in cases between the first and second phases of the programme.

National Health Mission director Priyanka Shukla says the annual parasite incidence (malaria cases per 1,000 per year) fell from 5.21 in 2015 to 1.17 in 2020 – under an eradication program that not only advances preventive measures such as the distribution of mosquito nets but also ensures testing of the asymptomatic. Carriers with hotspots and active cases. “We call it passive testing, to root out parasites from an area and reduce disease recurrence. Our ground teams visit from time to time and conduct large-scale testing,” she says.

But the challenges are many, Shukla admits, from ensuring tribal families make it a habit to sleep under mosquito nets. “We noticed that villagers would not use nets if they were given packaged, so our ground staff are now directed to place nets after opening them, and regularly check to see if villagers use them. are doing.”

Even in Edesmeta, every home has a mosquito net, but few people use it. Villagers say that Anganwadi workers rarely come, but doctors have been coming sporadically for the last two years. “They come in the months of August and September and give us bullets. Sometimes, they do blood tests and give us mosquito nets,” says Budhru, “they always say they will come every week but they don’t. So after his visit, if anyone falls ill, we have to walk till the Gangalur health centre.”

Tati’s eyes lit up upon hearing that there might soon be a vaccine for malaria, thus ending her annual bouts with it. Camps are organized regularly for other vaccines in the market of Gangalur.

Tati is also ready to volunteer for the vaccine. “Illness breaks my body down and I feel weak for several days even after the fever subsides. Who likes being sick every week?” she says.

However, there are many obstacles in the way. Approved by the WHO only last week, with India’s timeline unclear, the vaccine is essentially for children. To be effective, four doses must be administered starting at five months of age, which can cause logistical problems in remote areas such as edemata, where completing a course of chloroquine to treat malaria is also necessary for the medical team. is a complex task. .

 

A health worker at the Gangaloor center admits, “We tell villagers to complete the course, but as soon as their fever subsides, they stop taking the medicines, leading to complications and severe recurrence of the disease. “

Shukla says she can’t comment on the strategy right now because they know very little about the method or efficiency of the vaccine. But, in the fight against malaria, she says, “a vaccine would certainly help”.

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