Why are so many people still dying from malaria in Sierra Leone?

25 April 2008

Poverty and transportation are two key reasons why malaria remains a constant threat in Sierra Leone.

Each morning since the beginning of the rainy season, Antoine jumps on his bicycle to visit villages which are isolated. He is one of the 18 "Malaria Agents" trained and equipped to screen and treat malaria. They are all members of the community of which they are in charge.

In Sierra Leone, malaria is rife. It is the biggest killer of children under five and causes a massive burden on families and the country's barely functioning health system.

Malaria is preventable, detectable and treatable. Rapid Diagnostic Tests make diagnosis simple and effective, even in hard to reach rural settings. Artemisinin-based Combination Therapy (ACT), a treatment that works in just three days, is supposedly available for free to under five year olds and pregnant women from the Ministry of Health. So why are so many people still dying from malaria in Sierra Leone?

"People are very poor and even if the ACT treatment is given free to pregnant women and under five year olds in the Ministry of Health clinics, people still cannot afford the registration fees, the doctor's consultation, the cost of other drugs that they might need, etc," said Willemieke van den Broek, Head of Mission for MSF in Sierra Leone.

"Another problem is that transport and roads are very bad and people often have to walk several miles to reach a rural health post or clinic. Some villages are completely cut off during the rainy season."

MSF is tackling this with a new community malaria programme, currently being piloted in Bo and Pujehun districts. Two people from each community are chosen to be Community Health Volunteers. They are trained by MSF in how to diagnose and treat uncomplicated cases of malaria, using Rapid Diagnostic Tests and ACT treatment.

With the training and a community health kit, the volunteers are able to diagnose and treat uncomplicated malaria cases in children under five and pregnant women, the two groups most at risk.