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MOZAMBIQUE: Malaria - A Race for the Cure


Photo by Jacqueline M. Koch Photo by Jacqueline M. Koch Photo by Jacqueline M. Koch Photo by Jacqueline M. Koch Photo by Jacqueline M. Koch Photo by Jacqueline M. Koch Photo by Jacqueline M. Koch Photo by Jacqueline M. Koch Photo by Jacqueline M. Koch Photo by Jacqueline M. Koch Photo by Jacqueline M. Koch


Mozambique is a stunning country, where people are warm and generous. But the picture isn’t so pretty in terms of health. The disease burden—exacerbated by HIV/AIDS, TB, and malaria—has also led to a drop in the average life expectancy: 44 years for men—nearly half of many developed nations.

Cerebral malaria, caused by the deadly plasmodium falciparum parasite, takes an exceptional toll on children: in some regions as many as one in four will die of it. But exciting developments are underway. An experimental, but promising, malaria vaccine might be on the way. RTS,S is now in the phase III stage of testing, and 16,000 children are involved.

Malaria brings scores of mothers and sick children to the Manhiça District Hospital, a hour north of the capital, Maputo. The most common strain is plasmodium falciparum, commonly referred to as “cerebral malaria.” Across the street, a malaria research center is vigorously researching the disease while preparing for Phase III trials of RTS,S, an experimental serum that has proven to be 53 percent effective in preventing malaria.
Testing positive for malaria and suffering a very high fever, this toddler’s life hangs in the balance. However, access to a hospital puts the odds in his favor. Mozambique is largely rural and remote, and often children are beyond the reach of medical care.
Just below the hospital grounds, the languid waters of the Incomati River wind through a swampy valley. Dawn’s cool tranquility belies the river’s danger to the surrounding population—an ideal breeding ground for malaria mosquitoes.
Small boats ply the river, which separates the town of Manhiça and the fields where locals tend their crops. Noting that malaria mosquitoes are crepuscular, researchers fear that mothers working in the fields inadvertently bring the illness home, exposing their children.
Called the witch doctor by her neighbors, Miss Palmyra “reads the bones” to diagnose a patient’s condition and says she has seen many patients with malaria, which she treats with herbs. Witch doctors and traditional healers still play key roles in community health in Mozambique and physicians are in critically short supply. The World Health Organization 2004 figures found only 514 doctors for a population of 20 million.
The daily threat of malaria makes for an uncertain future for Mozambique's children. This little girl, 3, has been lucky so far. She's been lucky so far. But there is a 90 percent chance she’ll be infected with malaria by her fifth birthday.
Dr. Jose Munoz performs a spinal tap to determine if a young boy’s fever and convulsions are symptoms of malaria or meningitis. Both are possibly fatal. The Spanish doctor works with the Centro de Investigação em Saúde de Manhiça to provide staffing support in the pediatric ward.
Blood samples taken from sick children in the hospital’s triage section are taken to the malaria research center for proper screening. The center’s collaboration with the hospital allows it to improve its capacity for and quality of care for malaria patients.
Filipe Arone is a medical technician at the hospital working on yet another front in the battle against malaria: drug-resistant strains. These strains threaten to undo all the advances to date in the quest for widespread, successful treatment of malaria.
Many mothers have lost more than one child to malaria—a source of great shame. But news of an experimental and possibly successful malaria vaccine is spreading through communities bringing hope.
The Incomati River, a child’s playground on a hot day, will pose less of a health threat if a successful vaccine is developed. The next phase of clinical trials, the largest in Africa’s history, begin in early 2009 and will involve 16,000 children in seven countries.