Rural farmers turn malaria medics in Sierra Leone

MALLAY, Sierra Leone (Reuters) - A year ago Adama Jongo, a rice and cassava farmer in Sierra Leone, almost died from malaria while pregnant.

Jebbeh Amara sits with her two children in her mud-hut in Mallay village, southern Sierra Leone, on April 8, 2008. REUTERS/Katrina Manson

Now, the 37-year old mother of seven has turned volunteer medic to fight the disease under a pioneering scheme to bring life-saving healthcare closer to rural communities.

Malaria is the number one killer in Sierra Leone, a former British colony in West Africa ranked by the United Nations as the least developed country in the world.

Under a pilot scheme run by aid group Medecins Sans Frontieres (MSF), Jongo has been given a tester kit and trained to care for the most vulnerable in her village, a collection of mud huts 200 km (124 miles) southeast of the capital Freetown.

Instead of resorting to traditional medicine and “pehpeh doctors” who deal in out-of-date or fake medication, pregnant women and young children too weak to travel to far-off health centers can turn to Jongo for effective drugs and care.

If the tester kit shows they have malaria, Jongo administers a 3-day course of drugs she keeps locked in a special box.

Although free treatment is sometimes available in Sierra Leone to fight the mosquito-borne disease -- whose deadliest strain is common in the country’s mangrove swamps and tropical forests -- many cannot get to health clinics in time.

“Some women are child bearing and pregnant so it’s difficult for them to get to a clinic because they are attacked with malaria and fever -- it gives them problems to walk,” Jongo said, her 9-month old baby in her arms.

The program is one of a number aimed at eliminating malaria, ranging from handing out insecticide-treated beds to prevent mosquito bites to providing greater access to potentially lifesaving drugs.

The idea in Sierra Leone is to ensure free medicine is available on the spot for pregnant women and children aged under five -- those most likely to die if not treated within the first 48 hours -- who live in communities more than 3 km (2 miles) from the nearest clinic.

Jongo’s fellow villagers have no mobile phone signal or vehicle and have to be carried for hours in a hammock by four men to reach medical treatment. Some arrive too late.

“My people are always attacked with malaria. They are not getting drugs and the distance is too far: they die,” she said.

The scheme will be piloted in more than 200 villages across southern Sierra Leone and the government hopes to introduce this sort of free home-based care and medication across the nation.

“I want to help my people,” Jongo said. “That’s why I have given up (my time). Now mothers can come to me any time of the night when their baby is attacked with fever.”


According to the World Health Organization, prompt and effective treatment of malaria can reduce death rates by half.

But a recent study by Sierra Leone’s Ministry of Health showed that only 12 percent of children aged under five received efficient and appropriate treatment.

Worldwide, more than 500 million people become severely ill with malaria every year. One child dies of the disease every 30 seconds.

Many Africans suffer several bouts a year, not only making them seriously sick but also taking them away from jobs or work.

Continent-wide, the Global Fund to fight AIDS, Tuberculosis and Malaria estimates the illness costs Africa more than $12 billion every year in lost gross domestic product, even though the fund says it could be controlled for a fraction of that amount.

“Malaria is a major threat to the socio-economic development of the country with an estimated 7-12 days lost on average per episode of malaria,” said Edward Magbity, Monitoring and Evaluation Specialist at Sierra Leone’s Ministry of Health.

“It is a disease of poverty as a cause and a consequence.”

According to World Health Organization’s Commission on Macroeconomics and Health, up to $2 billion is needed a year to halve the burden of malaria by 2010. Currently, there is an annual shortfall of $1.4 billion.


Innovations in drug technology have produced malarial treatments for less than $1 a course and test kits for $0.75.

But in a continent where many live on less than $1 a day, that can be too much. Faced with long distances and the expense of traveling, many resort to traditional medicines or the untrained pehpeh doctors.

“We are going into competition with the drug peddlers,” said Willemieke Vandenbroak, head of the MSF’s Sierra Leone mission.

“They are quite cheap but they stock either expired drugs, those that are not recognized or allowed or fake ones and bring them in over the borders. It can poison children and they can end up dying of that before the malaria.”

A government survey found that 11 percent of fever sufferers still go to a drug peddler as their first port of call. In one district near the border this was as high as 45.5 percent.

Jebbeh Amara’s baby died of malaria last year after she walked miles through the bush to a drug centre only to find it had run out of treatment.

For her, home-based care could not come too soon.

When both her children fell ill with fever last month, she took them to the volunteers straight away. Her 5-year old son Foday was diagnosed with malaria and immediately treated.

“I don’t have money for drugs so I am very glad this box is with us here,” she said, sitting inside her mud-brick hut.

“Now the children I have left will be alright because whenever they are attacked with fever I will run to these people even at night.”

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Editing by Nick Tattersall and Chloe Fussell