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Central African Republic: silent scourge – fighting malaria
11-01-2012 Photo gallery
Malaria is the number one cause of death in the Central African Republic. The ICRC has been carrying out a pilot project to tackle this scourge since September 2011 in Obo, in the south-east of the country. The idea is simple: diagnose the disease at the first sign of symptoms, administer anti-malarial drugs and provide medical care throughout the treatment, without it costing the patient anything. In three months, this programme has proved that early treatment of malaria drastically reduces the mortality rate. Scroll through this photo gallery to find out more about the region, which is also plagued by endemic poverty and violence linked to the presence of the Lord's Resistance Army.
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The apparent tranquility is deceptive. Half of the 12,000 inhabitants have either fled other parts of the Central African Republic or are refugees from the neighbouring Democratic Republic of the Congo.
People are desperately poor in this region. The violent acts committed by some weapon bearers and the wider violence arising from their presence further exacerbate the situation, particularly as regards health care.
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The doctor in charge of Obo regional hospital was killed in June 2011 by unidentified individuals. Today, a nurse and a pharmacist hold the fort as best they can. The Haut-Mbomou prefecture, in which Obo is located, has around 40,000 inhabitants and only three qualified nurses. Life expectancy in the Central African Republic is 48 years, which puts the country next to last on the world ranking. The lack of health-care facilities helps to explain this sorry state of affairs. -
The hospital has only 15 beds. This patient's wife had to buy his intravenous drip at the local market, with no guarantee as to the quality of the product.
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Joseph, the hospital pharmacist, shares his concerns: "It's disgraceful that we can't do more. We have to sit idly by, all day long, unable to do anything." The pharmacy receives an irregular and unreliable supply of medicines – a few anti-malarial drugs and some antibiotics.
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The ICRC launched an early-treatment programme for malaria in September 2011. Ten inhabitants of Obo received training. At the first sign of malaria symptoms (diarrhoea, extreme fatigue and fever), people in Obo can now consult one of these individuals, known as "distributors", free-of-charge.
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The distributors make home visits, day or night, if the patient is too weak to go to them. The patient's temperature and weight are recorded and, if the symptoms point to malaria, a blood test is carried out.
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The distributor takes a drop of blood and tests it on the spot using a simple but reliable test. Malaria is the number one cause of death in the Central African Republic. It wreaks terrible devastation among the weakest, especially children under five and the elderly.
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The drop of blood is analysed in this "mini laboratory", which shows the results in just 15 minutes. Early treatment means better treatment. It often prevents any potentially fatal complications.
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If the diagnosis is malaria, the distributor prescribes anti-malarial drugs and keeps an eye on the patient for the next three days. This is mainly to ensure that patients take the drugs properly, as prescribed, and that their condition does not deteriorate. The whole treatment process, including the drugs, is free.
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In just over two months, the team of ICRC distributors in Obo conducted 2,500 consultations and treated more than 1,500 patients. Three days after experiencing the first symptoms, this girl had a smile on her face again – as did her mother.
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