Enoch battles malaria in WSP

HEALTH

One man does his bit to reduce what remains a huge public health burden in PNG and the region

By LULU MAGINDE
IN light of World Mosquito Day on Aug 20, the fight against malaria is again brought to the forefront, but we need no reminder of a disease humans have been fighting for centuries.
According to the Asia Pacific Leaders Malaria Alliance (APLMA), malaria continues to be a challenge in Papua New Guinea, with over 750,000 cases reported in 2020.
According to Dr Sarthak Das, Chief Executive Officer of APLMA, a regional non-profit organisation which works with governments and stakeholders to end malaria in the Asia-Pacific by 2030, there are three things that must be addressed in order to prevent the further increase of malaria in PNG.
First, to strengthen infrastructure with investments from governments, foundations and funders to support the on-the-ground efforts that medical professionals and other experts provide.
Das, a public health and infectious disease expert, also believes that sustained funding is needed to help build detailed malaria elimination programmes with rigorous milestones to achieve lasting results for example hiring more people to engage with local communities and track results.
Thirdly, he states that there is a need for strong leadership and sustained political will at multiple levels. This includes at the sub-national and community levels as strong local leadership will ensure that interventions are targeted to local needs and that way the most vulnerable can be reached.
PNG still has the highest malaria burden in the Asia Pacific region. The National interviewed Enoch Waipeli, a malaria specialist in West Sepik who shed some light on the ongoing fight against malaria in the province and PNG.
For the past six years, Waipeli has been a malaria supervisor working with Rotarians Against Malaria, to provide care and awareness to a community that has, for so long had limited access to health services and interventions, which may not necessarily cater to their needs.
What is the situation like in West Sepik, in terms of current data on malaria and other infectious diseases? Are people in the province more prone to getting malaria compared to other diseases?
Generally, people in the province, especially mobile populations and migrant workers, are more prone to getting malaria due to the coastal and lowland inland areas which are breeding grounds for mosquitos.
I have been infected once with malaria while on a supervisory visit and caught it again two weeks later. I was fortunate to have been able to obtain Primaquine, a key medication to treat mixed malaria infections and recovered from it but many are not as fortunate.
This is why, it is so important for people in these areas to remain vigilant against malaria because they are limited in accessing health services and interventions that may not be catered to what they need.
How do you keep the community interested, besides awareness, in staying vigilant against malaria or other common tropical diseases?
Besides awareness, we try to keep the community in PNG interested through engaging them in conversations and understanding their living conditions and situations when we visit the provinces.
We also have ideas to engage children through a mobile application that allows them to learn more about staying vigilant against malaria.
What are some of the challenges that you face that hinder you from effectively carrying out your duties?
There a 38 malaria treatment facilities in West Sepik and so I usually spend twice a year travelling around to supervise. However, only 18 of them are actually accessible by road.
Ten of the 38 facilities have not been visited at all facilities due to the difficult terrain, distance, budget limitations or ethnic tensions and differences.
Once, it took me three days to reach a facility using a car, a dingy and finally on foot. Some of these visits can be further delayed by bad road conditions and unpredictable weather, which then affects the delivery of treatments and services to the most rural communities.
Another challenge that I face is achieving effective communication with local communities, especially those who speak a different languages/dialect sand struggle with low literacy levels.
Which is why, consistent funding and good technical advice and support is needed in order to close the gaps at the facility and community level.
How important is it to maintain a certain level of awareness about elimination efforts across the country?
It is hugely important to keep the level of awareness of elimination efforts high in PNG, especially in remote areas and among vulnerable communities. When communities are educated about the efforts, they can protect themselves and prevent infection.
For example, using the insecticide treated bed net is the simplest and most effective way to prevent malaria. If people are aware about the need for continued malaria elimination efforts and how they can play their parts, they will find out about bed net distributions in their community.
This will hopefully encourage neighbours and others to collect and use them every night.
People need to be educated about malaria symptoms and be encouraged to find help as soon as they notice signs of a fever and malaria infection.
Knowing about the efforts, will provide them with information to seek advice on the most appropriate course of action from the closes malaria treatment facility, community health worker or volunteer at a rural aid post.
How do you keep the community interested, besides awareness, in staying vigilant against malaria or other common tropical diseases?
Besides awareness, we try to keep the community in PNG interested through engaging them in conversations and understanding their living conditions and situations when we visit the provinces.
We also have ideas to engage children through a mobile application that allows them to learn more about staying vigilant against malaria.
Together, these efforts will greatly help to prevent the rise of malaria cases in PNG and ensure that the country and the Asia-Pacific region continue on our path to malaria elimination by 2030
What would you claim are some of the accomplishments in malaria elimination efforts for the province and country that you have noticed?
For West Sepik, one accomplishment would have to be the introduction of the Home-Based Management of Malaria programme to fix the challenge of effective communication with local communities.
The programme trains volunteers to communicate in the local language and administer testing and the first line of treatment to local communities. These community health volunteers receive training in colleges and nursing institutions and are given a chance to contribute to their communities.
There are currently 450 volunteers in the programme and we are committed to maintaining the routine service for testing and advocacy.
Department of Health authorities have also initiated effective programmes targeted towards vulnerable populations, including a mass screening programme for children in high burden areas, intermittent preventive treatment for malaria during pregnancy through ante-natal care services and the distribution of Long-Lasting Insecticidal Nets, to name a few.
PNG is also working closely with Global Fund, Rotarians Against Malaria and APLMA secretariat to carry out extensive malaria elimination efforts in the national, sub-national and community level as we continue to in our path towards malaria elimination by 2030.