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Archive for the ‘community health workers’ Category

Cambodian Daughter Brings Music and Malaria Messages to Hometown

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CONTAINMENT’s Moeun Chhean Nariddh caught up with Dengue Fever’s Chhom Nimol in Battambang.

Chhom Nimol endorsing a poster urging Cambodians to visit a Village Malaria Worker or the nearest health centre if they have fever. Pix by WHO/sonny krishnan

Oh, oh, oh, Chumno kadeuk oi own neuk srok, neuk dol yeay ta, mingmear, pa’own bong…Yeung thloip roth leng trosorng, eilov nuon la’orng khleath tov sen chhnay. Oh, oh, oh…

“Oh, oh, oh, winter breeze makes me miss my home town, miss my grandparents, aunts and uncles, brothers and sisters. We used to go for a walk together, but now I am far away from you. Oh, oh, oh…”

Cambodian singer Chhom Nimol of the Dengue Fever begins to sing the first few lines of her newly recorded song “Uku without music at the request of a journalist from in the studio of Battambang’s National Radio of Kampuchea before her scheduled performance in the evening.

“I used to have malaria in the refugee camp … I was shivering and it was hard for me to endure the fever and chills…”

With or without music, her voice can easily draw attention from the keen audience and listeners through sound waves that travels hundreds of kilometers away from the studio and the open-air live concert.

What makes her performance in Battambang special is that the sound waves not only carry her beautiful voice to the audience, but they also bring along messages about malaria to many people most at risk of getting the disease in remote areas along Cambodia’s common border with Thailand.

Dengue Fever at the free open-air concert in Battambang. Pix by WHO/sonny krishnan

On November 16, Nimol was giving her third performance in Cambodia to Battambang after Kampot and Siem Reap provinces as the front-lady for the Dengue Fever band – a popular US west coast Khmer-American psychedelic rock band. Dengue Fever’s trip to the Mekong region is sponsored by the US Embassy to bridge cultural ties between Cambodia and the United States.

Noting the important occasion and the popularity of the music band, USAID-funded University Research Co., LLC, or URC, had approached the music concert organizers and asked for malaria messages to be read during the event.

“This is a very rare occasion that the Dengue Fever has come to perform in Battambang,” said Kharn Lina, URC’s communications specialist. “Many people in the audience who watched the performance might be working in the malaria-affected areas and could take the messages back to their relatives and friends.”

She said that the recent floods in Cambodia made it even more crucial for people to get enough information and knowledge about how to protect themselves and to get treatment for malaria since there could be more mosquitoes that transmitted the disease to people.

For Nimol, malaria is an illness that will always stay in her mind.

“I used to have malaria in the refugee camp,” she recalls. “I was shivering and it was hard for me to endure the fever and chills when I was young.”

She said it was very important that people sleep in insecticide treated nets so that they could protect themselves from getting malaria.

Nimol said she had spent one year with her family in the refugee camp on the border with Thailand before returning to Battambang in 1992, to resume her education at junior high school level. Cambodia then was under the administration of the United Nations following the end of a 12-year proxy-civil war where battlelines were drawn on then Cold War rivalries. After three years, she said she went to Phnom Penh and continued her studies for another two years.

With encouragement from Chhom Chorvin, her elder sister who was also a singer, Nimol said she started to learn to sing old songs from the 1960s and 1970s by the late Cambodian singers.

Though she was a new singer, Nimol’s voice hadn’t gone unnoticed.

In 1997, she said she decided to register in a song contest organized by Apsara TV in Phnom Penh and won first prize as the best female singer.

She was 16 years old then.

In 2001, she went to the United States and performed at a Cambodian restaurant in Long Beach with her elder sister.

Then, her golden opportunity arrived.

Nimol said Dengue Fever was looking for Cambodian singers at different restaurants in California and they finally came to the Dragon House Restaurant, where she was singing.

“[Dengue Fever] became interested in my voice and body movements,” she said with a smile.

Dengue Fever then invited her to join the band.

In addition to the old songs and music, Nimol said she had also composed new songs like “Uku” herself with help from her American band-mates who composed the music.

“I just do ‘noy, noy, noy’ and they will come up with the music,” she said.

Nimol said she had performed in many countries in Europe apart from the US. However, she said her chance to return and perform in Battambang was just like a dream.

“For me, I am very happy. I just can’t tell you how excited I am,” she said as the cool dry wind started to blow outside, signalling a change in the usual hot humid weather.


Written by malariacontainment

November 21, 2011 at 4:29 pm

Community Malaria Workers Use SMS to Report in Real-Time

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Malaria Consortium’s Ngor Pengby demonstrating how to charge a mobile phone using a solar panel. This project is in collaboration with Mobitel.Photo by WHO/Moeun Chhean Nariddh

Moeun Chhean Nariddh reports on a mobile phone-based frontline reporting system for detected malaria cases, implemented in Kampot province.

From her house in Snay Anchit Village, about five kilometers from the health center in Kampot provonce’s Chum Kiri district, 20-year-old village malaria worker Kong Lida can clearly hear the noise of a generator roaring in the distance. This generator is an important source of power where Lida and other villagers have their car batteries charged everyday so that their houses can be lit up at night from electric lamps and at the same time charge up their mobile phones.

But soon Lida and other village malaria workers in her village and other communes will not need to pay the generator owner to have their car batteries charged anymore. Now, all these VMWs will get their power from a ubiquitous source of energy – namely solar power.

As part of the country’s malaria elimination strategy, the National Center for Parasitology, Entomology and Malaria Control or CNM, with technical support from Malaria Consortium (MC) and WHO, has launched a pilot program to train VMWs in Kampot, Siem Reap and Kampong Cham provinces on how to send simple mobile phone text messages (SMS) to report in real time on detected malaria cases. These SMS messages also support the paper reporting that feeds into the health information system from the health centers.

CNM and MC also provide each of the VMWs with a solar panel and a lamp together with a mobile phone and a charger since there is no electricity in their villages.

The SMS from a village malaria worker in Khmer script. Photo by Malaria Consortium/Steve Mellor

Cambodia is currently seeing a revolution in communications with the roll-out of affordable wireless services to much of the rural population. The potential of approaches based on mobile phones and web-based technology to address the gaps in field data collection for malaria is now widely recognized.

“I think using a mobile phone is good, because I can report immediately when I come across a malaria case,” said village malaria worker Lida. Previously, the VMWs would record the data in a logbook which they would then report to the health centers at the end of every month before it was sent to the operational district hospitals and finally to CNM.

InSTEDD, an innovative humanitarian technology NGO, designed the system, utilizing SMS messages in Khmer script that interact with mapping software to generate maps on the World Wide Web for the locations of malaria cases reported by the VMWs. These malaria cases are also known as Day Zero cases, to indicate the locations of the patients before they are given appropriate and effective treatment.

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Dr. Char Meng Chuor: ‘We Need Community Support to Eliminate Malaria’

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CONTAINMENT recently spoke to Dr. Char Meng Chuor the new Director of the National Center for Parasitology, Entomology and Malaria Control (CNM).

Dr. Char Meng Chuor. Pix by WHO/sonny krishnan

One big concern is malaria on the move. How important is the role of village malaria workers or VMWs in the early diagnosis and treatment of mobile migrant workers?

Yes, indeed, malaria on the move among mobile migrant workers is worrying. But first let me clarify one thing on terminology. I like to refer to the village malaria workers as community health workers because they can also work on other diseases at the community-level. At present in each health centers there are only seven to eight full-time health staff as first-line health workers. And as you know most of the villages are far from the health centers. So we need these community health workers to support the work of the health centers.

When Khmer people fall sick, they end to seek treatment from the nearest source available to them. And most often, these community health workers are nearest to them. For that reason they are so important in the fight to contain multi-drug resistant malaria. These community health workers not only carry out early diagnosis and treatment, but they also provide vital information to the mobile migrant workers on how they can protect themselves against malaria.

Counterfeit and substandard anti-malarials are one of the causes for the emergence of MDR-falciparum malaria. What are the efforts to eliminate these counterfeit and substandard drugs sold by the private sector and also enforce the ban on oral artemisinin monotheraphy?

First of all, we have to ensure that communities must have access to genuine medicines. This is essential. We can ban oral monotherapies, but if sick people do not know where to get effective anti-malarials, we will go back to square one. Secondly I need to emphasize the importance of law enforcement. The elimination of malaria by 2025 is a government priority and so it’s important that legislation is in place for the law enforcers to start the crackdown of counterfeit malaria medicines.

But let us not forget that we have to also work with the private sector through partnerships. We are now drafting the strategy for the public-private mix, in terms of malaria. We’re still in the learning process, when it comes to dealing with the private sector. But there’s a lot of donor goodwill to provide technical assistance. The chink in the armour is the private sector because most Khmers when they fall sick go to the pharmacies or drug stores first. We have to convince the private sector on why they need to be good and responsible providers to prevent a public health emergency that could cross borders.

What are the lessons learnt from the Containment Project, and how can these lessons be used as we move from malaria control to elimination?

CNM has been implementing the containment project since January 2009, and we have many lessons to share. The first and most important lesson is that it is possible to reduce malaria incidence in the target zones through good management and implementation of proven strategies in malaria control, such as high-level coverage of long-lasting insecticide treated bed nets, provision of free diagnosis and treatment at the community level, and engagement of the community through malaria education and awareness programs. CNM, through the support of the Bill and Melinda Gates Foundation and the assistance of technical partners such as WHO, Institute Pasteur and Malaria Consortium, and others, has helped us achieve this.

We have also found that, when malaria cases begin to decrease, the role of systematic gathering of health information, including malaria surveillance and response becomes very important. As malaria cases decrease in Cambodia and we are on our path towards elimination, we need to strengthen surveillance systems to capture information on cases up to the village level, and also concentrate on responding to increases in cases through distribution of bed nets and indoor residual spraying.

Another lesson learned is the need to engage and work closely with the private sector in order to be informed of those malaria cases treated by the private sector, in pharmacies and private clinics, and to provide incentives to the private sector to help in the fight against the sale and manufacture of artemisinin monotherapies, as well as fake and substandard drugs.

Also, we need to be sure to have the full support and participation of communities in the fight against artemisinin-resistant malaria, and also move towards elimination. This can be facilitated through wide-ranging media awareness campaigns, community mobilization through local community organizations and distribution of information, education and communication materials, as well as advocacy by involved leaders and authorities.

Responding to Day 3 Falciparum Malaria Positives in Real-Time

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Malaria Consortium, with the support of the Bill & Melinda Gates Foundation-funded Containment Project, is pioneering a Day 3 positive alert system in Ta Sanh district, western Cambodia, using mobile phone and web-based technology to facilitate response in real-time. CONTAINMENT’s Sonny Inbaraj reports.

Diagram showing how a text message from the Ta Sanh Health Centre gets disseminated with FrontlineSMS. Source:WHO/Sonny Krishnan

EFFECTIVE containment of multi-drug resistant falciparum malaria depends on timely acquisition of information on new cases, their location and frequency. This is to plan interventions and focus attention on specific locations to prevent an upsurge in transmission.

Response in western Cambodia’s Ta Sanh district involves combining the process of positive diagnoses through microscopy of Day 3 positives at the Ta Sanh health centre from blood slides sent by Village Malaria Workers, to an alert system using mobile phone and web-based technology to help pinpoint potential outbreaks of malaria and target interventions to foci where parasite reservoirs are likely to be present.

The proportion of patients who still carry malaria parasites on the third day of treatment is currently the best measure available of slow parasite clearance and can be used as a warning system for confirmation of artemisinin resistance.

In Ta Sanh, the Village Malaria Workers or VMWs play a crucial role in the early detection and treatment of the killer falciparum malaria. In September 2010 the USAID-funded Cambodia Malaria Prevention and Control Project (MCC), implemented by University Research Co., LLC (URC), trained these VMWs to prepare blood slides from those who tested positive for falciparum malaria from rapid diagnostic tests. They were also trained to carry out a three-day directly observed treatment (DOT) of the Pf cases with the co-formulated ACT dihydroartemisinin – piperaquine.

Chou Khea, a 21-year-old Village Malaria Worker, trained by MCC in Ta Sanh district’s remote Ou Nonoung village tells CONTAINMENT how she carries out DOT.

“Immediately after a villager tests positive for falciparum malaria in a rapid diagnostic test (RDT), I prepare the blood slides. Then I give the drugs, which the villager has to take in front of me,” says Khea.

“On Day 2 and Day 3, I’ll go to the villager’s house and make sure that the drugs are again taken in my presence,” she adds. “After 72 hours from the first intake of the anti-malaria drugs, I’ll be at the villager’s house again to take his or her blood sample for preparing another blood slide.”

Chou Khea then takes the Day Zero and Day 3 slides, together with the used RDT, to the Ta Sanh Health Centre 30-kilometres away from her village.

“I usually take a motor-dop (motorcycle taxi) to the health centre. But most of the motor-dop drivers are reluctant to use the track to health centre in the rainy season because of the slippery mud. Also many of them are scared of the wild animals and land-mines in the area,” she tells CONTAINMENT with concern. “I hope to have my own motorcycle soon, so that I’ll be able to transport the slides and RDTs faster,” she adds with a smile.

A validation, from the database, of the SMS sent from the Ta Sanh Health Centre. Pix WHO/MERG

At the Ta Sanh Health Centre, the Day 3 slides are examined by a microscopist and if asexual malaria parasites are seen they are graded as positive. The microscopist immediately sends out an SMS on a mobile phone, using a dedicated number, to a database indicating the village code and the sex of the patient.

Malaria Consortium pioneered the use of this alert system in Ta Sanh, with support from Cambodia’s National Centre for Parasitology, Entomology and Malaria Control (CNM) and the World Health Organization’s Malaria Containment Project funded by the Bill & Melinda Gates Foundation.

Malaria Consortium’s Information Systems Manager Steve Mellor explains the use of cellular text messaging (SMS) as a viable tool to send alerts and map Day 3 positives in real-time on Google Earth.

“We use FrontlineSMS, an open-source software, that enables users to send and receive text messages with groups of people through mobile phones,” Mellor tells CONTAINMENT.

“FrontlineSMS interfaces with an MS Access database system that was developed to host the SMS data and to provide validation on the data received and to send an automatic reply to the sender containing any validation errors found, or to confirm that the data has been accepted,” he adds.

There are plans to upscale this mobile phone and web-based alert system with InSTEDD, an innovative humanitarian technology NGO, to map all Day Zero cases…

Day 3 positives, in the Access database, mapped in real-time on Google Earth. Pix/Malaria Consortium

In the Access database, a script interfaces with Google Earth and maps out the locations of the Day 3 positives based on the village code. The mapping on Google Earth is essential as it gives a clear visualisation of the terrain and helps CNM, WHO and the USAID-funded Cambodia Malaria Prevention and Control Project (MCC) to plan coordinated interventions in terms of case follow-up on Day Zero and Day 3 and carry out epidemiological and entomological investigations.

“All this happens in real-time and alert text messages are sent out simultaneously to the operational district malaria supervisor, the provincial health department, CNM and the administrators of the database,” Mellor points out.

There are plans to upscale this mobile phone and web-based alert system with InSTEDD, an innovative humanitarian technology NGO, to map all Day Zero cases. Malaria Consortium and CNM are also in direct talks with Mobitel, one of Cambodia’s main telecommunication carriers.

“We are in negotiations with Mobitel for a free number and also free SIM cards to be distributed to health centre staff and village malaria workers,” Mellor reveals. “After all, this is for a public good.”

Besides plans to map all Day Zero cases, Malaria Consortium is also exploring the possibility of sending alert messages in Khmer script.

“This will be a breakthrough and we hope this will help facilitate a quick response mechanism from CNM and other partners,” says Mellor.

Jill-of-all-trades: A Mother, Midwife, Microscopist, and More Medical Skills

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Chhean Nariddh Moeun profiles Ta Sanh Health Centre’s microscopist Tith Phanny.

Microscopist Tith Phanny…from the battlefield to the laboratory. Pix WHO/Chhean Nariddh Moeun

In this remote village in Samlaut district where Hollywood actress Angelina Jolie adopted a Cambodian boy, pregnant women come to Ta Sanh Health Center to give birth to their babies or get their pregnancy checked. Other patients come here to get their blood tests and treatment for malaria, TB or HIV/AIDS.

However, many of them have one thing in common: the health centre worker who sees and treats them is the same person. And that person is nobody other than Tith Phanny.

As a former Khmer Rouge medic, Phanny says she had been trained as a midwife, a microscopist, and to provide blood tests and treatment for malaria, TB and HIV/AIDS.

Phanny, who thinks she is 50 minus or plus a year or two, reckons that she has helped several hundred women deliver their babies since she became a midwife in the early 1990s.

She says that she remembers helping deliver a baby for a pregnant woman who came to Ta Sanh Health Center 18 years ago. The baby was born as a healthy girl and grew up in the village near the Cambodian-Thai border once controlled by the Khmer Rouge.

“Some babies of the women I helped with their childbirth in the past have grown up, got married and come to deliver their own babies,” she proudly talks of the two generations of mothers she has helped.

Due to the lack of health workers, Phanny says she had learned her different medical skills from her hands-on experience working with various Khmer Rouge medics during the civil war in Cambodia.

She was assigned to do various things, including taking care of wounded soldiers and treating malaria patients who she thinks sometimes outnumbered the wounded…

Back then, she says she was assigned to do various things, including taking care of wounded soldiers and treating malaria patients who she thinks sometimes outnumbered the wounded.

Phanny says it was her own tragic past that had encouraged her to determine to help others.  While living in a children’s mobile unit in Kandal province under the Khmer Rouge, she says she was separated from her family when the Vietnamese forces defeated the Khmer Rouge in 1979.

She says she had to follow others to the Thai border, where the fighting was very tense. In the 1980s, she says she was wounded twice — first in her head by shrapnel from a rocket fired by the Vietnamese and second when she stepped on a landmine and lost her right toe.

Miraculously, she survived the two incidents. Yet, it was not the end of her ordeal.

Phanny says she almost died several times from the scourge of malaria in the 1990s. She says she once went into a deep coma and had to receive successive intravenous drips several months before she regained her consciousness and recovered.

In 1996, the Khmer Rouge struck a deal with the government to end the war. It was the first time Phanny says she could enjoy peace after more than two decades of civil war and fighting.

After the Khmer Rouge was reintegrated into the Cambodian society, Phanny says she was sent to Phnom Penh and Battambang province for one month each to attend formal training in midwifery.

However, Phanny says she still juggles between different jobs at the Ta Sanh Health Center, from midwifery to microscopy, to blood tests and treatments for malaria, TB and HIV/AIDS.

She is indeed a busy woman. As Phanny is working on her microscope in the laboratory, she receives an urgent call to help deliver a baby for a woman.

“I run back and forth from the laboratory to the delivery room,” she says, adding she stays at the health center seven days a week.

Dr. Pov Pheng, deputy Chief of Ta Sanh Health Center, speaks highly of Phanny.

“She is very active,” he says, “She is very diligent in her work.”

Despite the hard work, Dr. Pheng says Phanny and other health workers at his hospital receive the same monthly salary of about $70. Yet, he says the amount is almost ten times more, compared to 10 years ago when they were paid only about eight dollars per month.

Regardless of the money she gets, Phanny never complains about her job.

“I am here 24 hours [a day],” she says, “I am always busy [but] I am happy with the work.”

Written by malariacontainment

March 25, 2011 at 1:44 pm

Day 3+ves in Ta Sanh, Western Cambodia

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Throughout the year for rice cultivation and agricultural activities villagers stay overnight in temporary shelters. Pix WHO/Sonny Krishnan

The drive to Ou Nonoung village in Western Cambodia’s Ta Sanh district is not for the faint-hearted. The almost 45 degree climbs and the steep plunges on the dirt track certainly calls for skilled driving of the 4-WD.

One wrong turn and the vehicle could turn turtle. One wrong detour into the bush and the 4-WD could set off one of the hundreds of unexploded ordinances in the soft dirt – a stark reminder of the war-torn years that almost sent Cambodia back to the Dark Ages.

Ou Nonoung village, in the foothills just below the Cardamom Mountains, lies at the fringe of the forests. In this ’old village’ that goes back to the dark Khmer Rouge-era, villagers have their farms in forest clearings. Throughout the year for rice cultivation and agricultural activities they stay overnight in temporary shelters. These movements in relation to agricultural activities have been identified as risk factors associated with malaria infection.

In these harsh conditions, village malaria workers or VMWs play a crucial role in the early detection and treatment of the killer falciparum malaria. But developments lately have been disturbing.

A warning on the presence of land mines around Ou Nonoung village.

Records from the Ou Nonoung VMW between September 2010 to February 2011 indicate that six villagers had tested positive for falciparum malaria. The results were from rapid diagnostic tests (RDTs). And out of the six Pf positive cases, three still had plasmodium parasites in their blood after a three-day course of treatment with dihydroartemisinin-piperaquine – the artemisinin combination therapy for uncomplicated falciparum malaria currently used along the Thai-Cambodian border.

The Day Three positive cases were verified by microscopy in the Ta Sanh district health center, from blood slides prepared by the VMW from the patients’ blood samples after the three-day course of treatment.

Though the Pf positive cases are relatively small due to active interventions in the Bill & Melinda Gates-funded Containment Project, the presence of Day Three positive patients is a cause for concern.

WHO’s ‘Guidelines for the treatment of malaria’ indicate that: “To eliminate at least 90 percent of the parasitaemia, a three-day course of the artemisinin is required to cover up to three post-treatment asexual cycles of the parasite. This ensures that only about 10 percent of the parasitamia is present for clearance by the partner medicine, thus reducing the potential for development of resistance.” This is the rationale for using dihydroartemisinin and its partner drug piperaquine that is available as a co-formulated tablet.

Host immunity and splenic function are important contributors to parasite clearance after artemisinin treatment. Reduction in herd immunity, perhaps resulting from reduced transmission, could decrease parasite clearance in Cambodia

The question asked is that if symptoms persist 3-14 days after initiation of drug therapy in accordance with the recommended treatment regimen, is that an indication of resistance?

A village malaria worker making a blood slide after doing a rapid diagnostic test. Pix WHO/ Sonny Krishnan

In a recent interview with CONTAINMENT, in Pailin in western Cambodia, Dr. Robert Newman, WHO’s Global Malaria Program director, warns of a worse case scenario.

“The worse case would be the spread of the delay in clearance of the [plasmodium] parasites. Right now we are finding an increase in the percentage of patients who are still positive on Day 3. That will be the hallmark of this problem [of resistance],” said Dr. Newman.

Added Dr. Newman: “If that were to continue to worsen, artemisinins would become less and less efficacious. It would then take longer and longer for patients to clear [plasmodium parasites in their blood], and we could get to the point of truly having failures to ACTs.”

But Dr. Newman clarified that though there is resistance to artemisinins, artemisinin-based combination therapies (ACTs) still remain efficacious. “That is a very important message,” he stressed.

But he issued a stark warning. “If that situation worsens, if were to lose ACTs, and if it spreads to the shores of Africa, we could have a public health catastrophe.”

Acknowledging that there is slow clearance rate in Western Cambodia, Anderson, et al. (2010) [1] ask whether slow clearance rate results from parasite, host, or other factors specific to the population in that part of the country.

Writing in the ‘The Journal of Infectious Diseases’, quoting previous studies on the comparison of parasites in Western Cambodia to that in the western part of Thailand along the Thai-Myanmar border, the authors point out that: “ Parasites with slow clearance rate after ACT do not show increased resistance to artemisinin compounds with conventional in vitro testing compared with parasites from western Thailand, which show rapid clearance rate.”

The authors offer several explanations for slow clearance rates.

“Host immunity and splenic function are important contributors to parasite clearance after artemisinin treatment. Reduction in herd immunity, perhaps resulting from reduced transmission, could decrease parasite clearance in Cambodia,” they write.

[1] Anderson, T., Nair. S., Nkhoma, S., Williams, J., Imwong, M., Yi, P., Socheat, D., Das, D., Chotivanich,K., Day, N., White,N., Dondorp, A. 2010, “High heritability of malaria parasite clearance rate indicates a genetic basis for Artemisinin resistance in Western Cambodia”, The Journal of Infectious Diseases, vol. 201, no. 9, pp. 1326 – 1330.

Schoolgirl’s Malaria Knowledge Helps Family Avoid Getting Sick

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Fourteen-year-old Seub Saren who educates her family in Pailin about malaria. Pix by WHO/Sonny Krishnan

“Malaria is spread by female ‘nail’ mosquitoes during nighttime.”

“To avoid getting malaria, people should protect themselves from being bitten by female ‘nail’ mosquitoes by sleeping in a mosquito net.”

“People who have malaria must take proper medicines as prescribed by a physician.”

This is Lesson 11 at Grade 5 in Cambodia which young Cambodian students are taught at school as part of the curriculum for their “Applied Science” study.

However, like other lessons about such diseases as typhoid and dengue fevers, malaria is not an interesting lesson for many students who live in non-malaria infested areas.

But for 14-year-old Seub Saren who has attended a school in Siemreap Province’s Srey Snom District, she finds this knowledge about malaria particularly interesting and useful for her family when they moved to Pailin, where malaria posed a serious health threat to migrant workers like her family.

“After she returned from school, she told the family how to protect ourselves from malaria,” says her father, Se Seub, who is now living and working in Pailin with his wife and four children.

Seub says he was sick with malaria when he came to work in Pailin three years ago and that he had to go back to Siemreap for treatment.

However, he says he has never been sick with the disease during the last few years after learning to protect himself and his family as his daughter taught them.

Seub Saren says she knows very well about malaria from the lessons she has learned at school, which was why she could educate her family how to prevent the disease.

Like Seub Saren, other fifth graders in Pailin can also easily score a good mark for the lesson about malaria.

Unlike many other lessons about Science that is complicated and difficult to learn, Nuon Phon says teaching malaria as a subject in Pailin is very practical and relevant.

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Written by malariacontainment

November 28, 2010 at 10:57 am