Last year, our country witnessed one of the worst floods in its history. Starting from the north, the waters made their way, mercilessly and menacingly, down to the plains and eventually the coast along the Arabian Sea; all along the way rooting out trees, drowning out entire villages and destroying millions of lives in the process.
One year on, amid alarmingly increasing number of flood warnings, I wanted to highlight one after-effect of the floods that we have yet to properly address: the spread of contagious diseases, particularly malaria.
For those who are not aware, malaria is a mosquito-borne infectious disease caused by eukaryoticprotists of the genus Plasmodium. The cause of the disease is a protozoan, discovered in 1880 by Charles Louis Alphonse Laveran. Basically, as the malaria parasites enter the blood stream, they infect and destroy red blood cells. Destruction of these essential cells leads to fever and flu-like symptoms, such as chills, headaches, muscle aches, tiredness, nausea, vomiting and diarrhea. These initial symptoms are non-specific: in other words, they are self-reported symptoms that do not indicate a specific disease process.
Each year, there are more than 225 million cases of malaria, with around 781,000 people dying from the disease, according to the World Health Organisation’s 2010 World Malaria Report, which concludes that 2.23% of deaths worldwide are caused by malaria. Since the floods last year, large areas of the country remain submerged, especially in southern Sindh, resulting in stagnant pools of standing water which, combined with the heat, prove to be powerful incubators of malaria. Sadly, since then, around 195,000 cases of malaria have already been reported in the country.
To add salt to the country’s already festering wounds, the floods managed to dilapidate large parts of the country’s already flimsy public health system, with more than 500 clinics damaged, while the government estimates that 30,000 ‘lady health workers’– a programme that is the backbone of the community health system – have been made homeless. “Pregnant woman are a major concern and coupled with children, they are the most vulnerable to malaria.
An estimated 50,000 flood-affected women gave birth, 7,500 of whom had to have surgery for pregnancy-related complications. Add malaria to the equation and you are looking at complications and early child deaths in numbers that you cannot cope with,” says Dr Sajeel, an endocrinologist and physician at Al Razi Healthcare.
The sole silver lining in this otherwise sinister scenario is that malaria is an entirely preventable and treatable disease with affordable solutions. Bed nets to protect against mosquitoes cost Rs 850 and medicines to cure malaria cost roughly Rs 500-800 per dose. Millions more people now have access to these tools thanks to an increase in resources available to fight malaria, and as a result, certain countries are beginning to see dramatic improvements. Malaria transmission can also be reduced by preventing mosquito bites by distribution of insect repellents, or by mosquito-control measures such as spraying insecticides inside houses and draining standing water where mosquitoes lay their eggs.
“While there certainly are methods and means of both preventing and curing malaria, and these methods and means are doable in Pakistan, the health system prevalent in the country and the infrastructure are so weak that any movement launched to counter this epidemic faces an uphill challenge. We need more awareness, more government support, more private participation, for that is the only way that we can even hope to defeat this deadly disease. Otherwise, we could be looking at having lost the battle against the first floods, right before we are faced with a second wave that could be stronger and deadlier than the first,” says
Dr Sajeel.
