I guess no one likes mosquitoes. That’s really annoying creatures. I don’t quite understand why they exist and they are beneficial to nothing. Well… everything should have some reason for its existence, but for mosquitoes, I cannot find even a slight credit for them. At least cockroaches don’t harm you. They are just ugly… Oh, do they spread some kinds of disease from one site to another? I am not sure. I need more research, but I don’t want to know more about cockroaches at this point. When I was in Africa, I had a cockroach story. They were everywhere and they lived with me. A big giant cockroach made some sound of a footstep whenever they walk around the floor, and I was freaked out to see they even walk on the wall.
Of course, I also had a mosquito story. I was mobbed by mosquito troops, and I was a fragile prey to them every night. Luckily, I didn’t get any disease – malaria, dengue, or chikungunya – from mosquitoes. Did Long Lasting Insecticidal Nets (LLIN) save my life? Or thanks to malaria pill? Repellent? Long sleeves and pants? I have to admit that I didn’t thoroughly use any of them. Protecting myself from mosquitoes needed a lot of dedication. LLIN disturbed my sleep because my feet or arms always touched the net, and I felt like I was a captive animal. Taking malaria pills for a long period damaged my lung slowly, so I couldn’t always rely on them. Repellent stunk and was bad for my skin. One day, I thoroughly applied repellent to my whole hand, and then began to use the computer mouse, and I was surprised that the surface of the mouse melted and it stuck to my palm. Wearing long sleeves and pants was the easiest one but you know, mosquitoes were really clever to find my area of bare skin! Do you really want to wear socks and gloves under the scorching sun? When you get a mosquito bite on the toe, it is not itchy, but strangely, it is chronic pain. Lastly, I hate to say this: mosquitoes can even bite you through your shirt… How is it possible?! I got many mosquito bites on the middle of my back, and sadly, I couldn’t scratch that itchy area. Though you have very good interventions to prevent malaria, ensuring high fidelity by implementing them as planned is a whole different story.
Mosquitoes are much more than annoying insects. Bothering your sleep in the middle of the night is not a big deal because they threaten your life in Africa and the Americas. I haven't experienced how it feels when I get malaria, but I heard how it is. I realized NGO Korean staff in Africa (needless to say for native Africans) who don’t get malaria must be so abnormal because malaria is so common, and I guess they suffer from this at least once during their lifetime. One of Koreans who I met experienced malaria and gave a talk to me graphically. “You can’t even have the energy to move your body from your room to the kitchen to drink water because you were seriously dehydrated… With an awful crashing headache, sweats, and shivering, you are able to know what the hell is…” They are still staying there, overcoming several times of malaria, to accomplish 5-year of development plan from NGOs. I feel so sorry for them because I feel like only I escaped that area and be in a malaria-free comfort zone now. What can I do for them? I pray that they always maintain good health, be safe, and be happy on the barren soil. I count on them!
“Malaria Day in the Americas 2016” commemoration took place on November 3, 2016 at the PAHO/WHO Headquarters in Washington D.C. to share the malaria intervention strategy and celebrate each country’s effort to eradicate malaria. To decrease the burden of malaria in the Americas, PAHO/WHO, United Nations Foundations, the George Washington University Milken Institute School of Public Health, and the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP) have been working together to identify and implement the best malaria prevention, control, and elimination strategy.
The forum of this year was “End Malaria for Good.” Five countries in the America experienced malaria outbreak, in Venezuela, Colombia, Dominican Republic, Ecuador, and Nicaragua. The malaria control is difficult because there are P. vivax (malaria parasite) technical challenges, the risk of emergence of drug resistance to P. falciparum (another malaria parasite), and social processes through mining, agriculture, and migration. Plan and action for malaria elimination 2016-2020 (5-year plan) in the Americas are 1) malaria core interventions (diagnosis), treatment, vector control, 2) surveillance, 3) Health systems strengthening, 4) Advocacy, communications and partnership, and 5) Tailored approaches to elimination and prevention of re-establishment.
At the regional level: advocacy, networking, capacity building, technical groups, pilot experimentation, operational research, communication strategies, monitoring and evaluation, certification and other standardized processes, guideline development, and direct technical cooperation should be established, while at the country level: development of political and strategies platform, and technical support of control of foci should be established. The two key elements are 1) Priority foci as key interventions, and 2) Early detection, timely investigation, and prompt response to core intervention.
USAID also shared their Latin America and Caribbean Regional Malaria Program. Their primary focus is tailoring interventions to elimination through analysis of the epidemiology of malaria to determine the most effective set of intervention, developing evidence, and strengthening capacity to implement the selected approaches and activities. Tailored approaches are through expanding passive case detection networks, private providers strategic behavior change communication strategies. For capacity and evidence, quality assurance programs, tailored guidelines for implementation of a rapid diagnostic test and quality assurance systems, therapeutic efficacy studies, and molecular surveillance have been implemented. For vector control, entomological and insecticide resistance monitoring systems, leveraging other investments in the region, prioritizing countries with high levels of transmission and significant investments in vector control for malaria are good examples.
Malaria Champions of the Americas Award this year went to Costa Rica, El Salvador, and Suriname, and Costa Rica received the top prize. These three countries were exemplified in malaria control. Costa Rica has achieved a 100% decrease of malaria since 2000 through the robust implementation of the national Plan to Eliminate Malaria, El Salvador has achieved a 98.9% of malaria since 2000 through the National Malaria Program affiliated to the Ministry of Public Health, and Suriname has achieved to drop the Annual Parasite Index from 88 in 2004 to 1.06 in 2015 through the Ministry of Health malaria Program.
I look forward to seeing malaria-free world in the near future!
