BWAISE: Malaria Therapy – An costly price ticket for lower-income households

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Despite numerous government interventions to end malaria in Uganda, it is still a leading cause of mortality and morbidity in the country.

In 2017, it was estimated that malaria-related deaths under five years of age were 7%, while newborn mortality (under 12 months) was 11%.

While it’s a no-brainer for the affluent families, the cost of malaria treatment is a nightmare for people who even try to put food on the table for their families to survive.

Grace Nakachwa, a resident of Bwaise II, is the mother of three children. She represents a number of people who are experiencing economic hardship when the need arises to seek and obtain malaria treatment.

The Department of Health notes that the cost of treating malaria is high, with a single episode of malaria costing a family an average of Shs 30,000, or nearly 3% of the annual household income of the majority of families.

Because of this, most families have resorted to self-medication at home. accompanied by a selection of herbal medicines as they cannot afford adequate medical treatment in health care facilities.

Care for malaria infected children at home

After discovering that her 12 year old daughter had a fever, she wasn’t too worried as she was confident enough that the local herbs would do the magic.

Nakachwa administered Panadol and some herbs for a few weeks until her daughter got better.

“When the girl was recovering, her sister; Who they shared a bed with told me that she was also uncomfortable. I realized that those who had recovered had the same symptoms, ”she said.

She took the second victim to a nearby clinic, where a blood sample was taken where malaria parasites were found in her blood. Treatment was procured and “after almost two weeks my second daughter was feeling much better”.

Episode 3 of Malaria

Two weeks ago, Nakachwa’s last son developed a fever. The two-year-old boy, like his older siblings, had symptoms similar to malaria.

Nakachwa notes that even when she knew it was malaria, due to the high temperature the boy developed in one night, he was not treated immediately because the family did not have enough money to receive the treatment.

“I used a damp cloth all over my body first and stayed strong for at least three days before taking him to the hospital. I could treat it myself with a small dose of Panadol, even though I hadn’t established the cause of the fever, ”said Nakachwa.

Days later, however, the mother of three managed to get a few thousand shillings, and she took the boy to the hospital, where the doctors did blood tests.

“I was so surprised when the doctor spread the news because we were sleeping under a mosquito net. I realized that it could possibly roll closer to the edges of the mosquito net. So I put a pillow as a border between it and the net, ”she explained.

The doctor prescribed Coartem and other drugs. Nakachwa attributed the infection to the numerous mosquito breeding sites in their area, in which there are stagnant water and unkempt grasses.

“Sleeping in a treated mosquito net can help prevent malaria. However, people should be careful as mosquitoes are everywhere. They can even bite you while you are watching TV in your living room, ”warned Nakachwa.

The government of Uganda has intervened over the years to reduce the burden of malaria in the country. This has been achieved through, among other things, advocacy, pampering from cultural and religious leaders, mass awareness raising and providing information about malaria, its dangers and how to prevent it.

The government is currently distributing free mosquito nets to people through the Ministry of Health through a campaign known as “under the net”.

Another malaria victim in Bwaise

In Bwaise II, a mother and wife, Betty Namaganda was found to be suffering from malaria in the early days of the Covid-19 pandemic. This was a time when the President had declared the lockdown and therefore public transport banned.

This meant that Namaganda could barely move to run her small business in the town where she was making some money. Her sick condition could not allow her to move anywhere either.

Betty Namaganda

The small savings she had would only be enough to support her children’s meals, since they had also returned home after the schools closed.

Dealing with malaria when dealing with Covid-19 effects

Since it was right at the beginning of the lockdown, with a fever and general weakness, Namagembe was afraid of going to the hospital, “who knows if I have contracted the virus,” she thought to herself.

“I felt very uncomfortable with a fever and constant stomach ache. The pain was too great for me to hold it. This was a time when the lockdown had only just begun. I finally decided to have an investigation because I was also suspicious of the coronavirus, “she explained.

“The health care worker confirmed that I had malaria parasites in my blood when I ran tests,” she added.

Obtaining treatment has been a burden due to the family’s finances.

“The situation at home was bad. The lockdown had just started and there was no money. The children were all at home and had to look after them at all costs. Because of this, I decided to sell some of my items so that I could raise enough money to receive treatment, ”Namagembe said.

That way she could get her full sleep and get back on her feet.

Namagembe said that since then she has learned to be more careful because mosquito bites can be caught from anywhere. “I’ve learned that I have to be careful enough. I now know that anyone can get malaria; regardless of age and size, ”she added.

What the VHTs say

Samson George Bukenya, 32, lives in Bwaise II (Lufula Zone). He is also a member of the Village Health Team in his area.

Bukenya had an episode of malaria and shared some important details about his experience.

“Basically, I got a fever and went to a clinic where they did blood tests and they found out that I had malaria. I was so nervous and in pain, “he explained.

Bukenya said that starting his treatment was a “tug of war” as it placed an economic burden on the breadwinners in the house he was staying in at the time.

“It has financially affected my legal guardians because to undergo this treatment you have to buy medication, and the money for doing so affects the parents’ budgets. In most cases, when it is severe malaria, you have to be admitted to a fairly expensive health facility, ”he said.

Bukenya said he was certain he had malaria for not sleeping in a mosquito net, so he took up the practice of using mosquito nets after two weeks of recovery.

“Around 2014, the government distributed nets to people, but not everyone can afford nets. If you follow house by house, most of the people have no networks. The areas we stay in have stagnant water. As mosquito breeding grounds, malaria cases are high here in Bwaise. Even diseases like cholera can develop easily, ”he said.

He therefore noted that more awareness is needed to prevent malaria.

The drainage situation in Bwaise.

“We need to educate our people about the dangers of malaria. We need to spray around our homes and make the environment clean, ”advised Bukenya.

“I don’t believe that sleeping under mosquito nets will eliminate malaria. The question is; Have we cleared the breeding grounds from which these dangers emanate? As much as the government distributes the nets without people clearing these dangerous places where mosquitoes breed, it doesn’t help, ”he said.

As a member of the Village Health Team, Bukenya said that mass cleansing of the environment, locally known as “bulungi bwa nsi”, is critical. only that some leaders enforce it when campaigning.

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