September 23, 2022 By Vaseline

AFRO 2 – Malaria Project changes lives

World Health Organization (WHO) - Namibia

About ten kilometers on the eastern outskirts of Rundu is the Mayana village, a floodplain area. In fact, Mayana means flood plains in the local dialect and is named for the low-lying ground surrounded by water.

“We have a lot of water down here and mosquitoes breed everywhere,” explains Johannes Lipayi, the AFRO 2 Malaria Project Coordinator for the Mayana and Sikondo Villages in the Kavango East and West Regions.

The village is in one of five districts among the five regions selected to participate in a study to reduce malaria cases due to the high rates of malaria cases and deaths in those areas. The other districts are in Omusati, Oshikoto, Ohangwena and Kavango West. The study was part of the World Health Organization’s (WHO) ongoing effort to support Namibia in the fight against malaria.

This three-year pilot project was conducted in 2018 with the goal of reducing malaria transmission through larvicicide while using eco-friendly chemicals.

“We were trying to see if the waters in which mosquitoes breed, if treated with a biological agent, would help reduce malaria-carrying mosquitoes,” explains Dr. Florence Soroses, Coordinator of the National Malaria Project at WHO.

“Before the project was implemented in this village, we had many malaria cases and deaths. But as soon as the program started, cases started to decrease,” Lipayi explained.

The community has always been open to initiative. As word of the project spread, the community gathered in large numbers at the chief’s house to ask how they could be involved, Lipayi explained.

“If we compare this village with others where this project has not yet been implemented, you can see the difference,” Lipayi said.

In 2020, 13,633 cases of malaria were registered in Namibia. Of these, 40 people died of malaria. In 2021, 13,740 cases of malaria were recorded in the country. The death toll dropped to 15.

“Even when we reported the data, we could see a decrease in malaria cases compared to previous years before the project was implemented,” Lipayi said. Markus Kamburu is now a 42-year-old father of five children. For the past three years, Kamburu has worked as a field worker for the Mayana Village Malaria Project. His work schedule started as early as 6 a.m., and sometimes he had to work night shifts depending on the work.

Kamburu’s responsibilities included larval habitat mapping, larvicidation, and setting up the CDC light traps to collect adult mosquitoes. In addition, Kamburu and two other teammates were also responsible for conducting larval surveys, a process that involves monitoring the activity and density of mosquito larvae in the hatcheries. They started counting the number of households in the village and found that the village had 3,365 houses. From these 20 houses were randomly selected to be part of the study. The team identified 65 hotbeds. These breeding sites hold water during the rainy season, which can range from December to May. Some hatcheries have year-round water.

“These are the hatcheries that we always monitor to see if there are larvae. If there are larvae, we larvae. However, at the very beginning, we started mapping and then did larvicidation for the hatchery, which we identified if there were larvae there,” explained Kamburu.

Kamburu says he has no prior knowledge of larvae identification, nor does he have any technical knowledge of malaria. He was appointed by the village head in 2018 at the start of the project.

“The chemicals we use for larvicicide have been very impressive because if we use them, we expect to find larvae in two to three days when we come back. We will find the larvae already swimming. We also collected adult mosquitoes. Even when the mosquitoes are grown, we still collect some. So this process fought the mosquitoes at all stages of their life, thereby reducing malaria,” explained Kamburu.

In addition to larvicidation, Kamburu said the team also uses the Prokopack aspirators, which act as a vacuum, to collect adult mosquitoes resting outdoors. This process is usually done in the early hours of the morning. For indoor mosquitoes that are dormant, they use the CDC light trap to capture the adult mosquitoes overnight.

“These are the methods we use to collect the mosquitoes in the village,” he explained. After collecting the data, the team records samples and sends them to their supervisor, Dr. Soroses in Windhoek. “We have an organized system in which we record the data and send it to Dr. Send Soroses,” Lipayi explained.

WHO contributed N$1 million to the project. Funding for the project officially ended in May, and the community and WHO hailed it as a success. The national representative, Dr. Charles Sagoe-Moses said the difference the project has made in the community demonstrates that “the biological agent used is effective in controlling malaria.”

Joseph Mbamba says the knowledge and experience he gained through the project is invaluable. “I go to church to raise awareness about malaria. I also take the equipment to demonstrate how we do our job,” he added. The project also helped him financially because he was able to pay for his son’s higher education.

“WHO has invested a lot in these people. I hope that the Ministry of Health and Human Services or the private sector will take on the project so their knowledge is not wasted,” Lipayi said. He also fears that malaria cases will increase again.

“These people know the methods of fighting malaria and are very well informed about it. They attended annual workshops and trainings, and now it’s up to the government to address their plight and take charge,” Lipayi said. Mayan village leader Berthold Shinimbo echoed similar sentiments and called for investment in the malaria project. “The community can take over. As you can see, we have a high unemployment rate,” Shinimbo said. The AFRO 2 project was implemented with the aim of strengthening national capacities for the implementation and scale-up of evidence-based, innovative, diversified and environmentally friendly measures to control malaria vectors, with a particular focus on winter larvicicide as an additional tool to control Vectors to achieve malaria elimination by 2022. The project has also been implemented in Botswana and Eswatini.

Distributed by APO Group on behalf of the World Health Organization (WHO) – Namibia.