Pa. Rotarians treat malaria in Uganda
Editor’s note: Susan Schrack Wood is an environmental sciences instructor at Elizabethtown College and a member of the York East Rotary Club. She and her family, who live in Hellam Township, joined other local Rotarians this month for a medical mission to Uganda, where the team is treating locals and teaching good health and medical practices. Wood is documenting the trip for The York Dispatch.
Marvin, 13, can barely keep his eyes open. He has stomach pains and gastroenteritis and is exhausted. He is sent for a malaria test.
One of the Ugandan medical assistants said she could tell just by looking at him that he had malaria.
“He has the look of the fever,” she said, gazing into his face.
“The fever” is the local term for malaria, a disease caused by the Plasmodium parasite and spread by mosquitoes.
Marvin is just one of hundreds of villagers waiting to see Rotarian doctors working in a free clinic set up at St. Luke’s Primary School. Rotary International awarded global grant money to the Lancaster and York East Rotary clubs to send a medical vocational training team to Uganda. The team has people from central Pennsylvania, Brazil and Denmark training Ugandan doctors on medical issues.
The children here suffer from the usual childhood complaints, coughs, fever, influenza, but complicating those illnesses is the fact that many are sick with malaria. The World Health Organization estimates that 90 percent of the world’s malaria cases are in sub-Saharan Africa. The school has no medicine to give the children, so the adults simply send them home.
The medical team has trekked from village to village examining hundreds of patients, most of whom have never seen a medical professional.
Treating malaria: Most treat the fever with folk remedies, a mix of several herbs and leaves from mango and avocado trees. The leaves are boiled in water and steeped for several hours.
The symptoms of malaria, fever, body aches, headaches, no appetite and stomachache, are similar to other conditions and diseases, so many patients are tested for malaria. A drop of blood is collected, and a few drops of a buffer are added to the sample. Twenty minutes later, the results come back: two bars for yes, one for no.
Marvin’s test comes back negative. Dr. Guilherme Cortes Fernandes of Brazil says that doesn’t necessarily mean he does not have the disease.
“Patients can test negative and still have the disease," Fernandes said. "We only have tests for one strain, the most common one in Africa, so if the patient has a different strain, the test won’t show a positive.”
Treatment for malaria involves Lumefantrine and artemether tablets — a medicine that kills the parasites. The government makes it available, but Ugandan health workers say it is difficult to keep it in stock because it is needed by so many. Although health clinics dot the landscape, many are empty.
In Uganda, doctors make very little money in public hospitals and clinics, less than $500 a week, not enough to support a family. So most doctors operate private practices, charging fees that only the wealthy or middle class can afford.
Mosquito nets: Prevention is always better than treatment alone, but how to do it in a country whose wet, tropical climate is a perfect breeding ground for mosquitoes? The World Health Organization recommends mosquito nets. The Rotarian team has brought 2,000 nets to give to villagers.
Abbie Wood, from Hellam Township, is only 14, but she has learned a lot on this mission. She demonstrates to the native women how to put together the nets and warns them to let the net air out so that the pyrethroid insecticide coating the nets doesn’t irritate their skin. Her own hands have red, bubbly spots from handling the nets.
“It doesn’t hurt or itch, it’s just there, and this is important work,” Abbie said.
Abbie went with one woman to help her hang the net in her home, and the woman proudly invited her in. Abbie found it small and dark, about the size of her bedroom at home.
“That’s not very much space for four people to live in," she said. "There’s just one bed and a dirt floor.”
As the word spreads around the village and the pile of nets dwindles, the crowd starts to push and shove, desperation setting in.
Victoria Dick, from York, says its sad to watch,
”They all need nets, and they know it, to keep them safe from malaria. It’s such a small thing, but it’s so very important to them. Everyone should get one, but there’s just not enough,” Dick said.
Back at the clinic at St. Luke’s, 31-year-old Agatha Natukunda waits for hours to see a doctor. She is sure she has the fever. Her chills, headache and body pain tell her so. She only has ever been treated with the herbal folk medicine, but it’s not working this time. She hopes to get medicine, but after several hours, the clinic has run out. A Rotarian volunteer finds a mosquito net for her to take home. Perhaps at least her children will stay healthy.