Insect Wars in Eastern Province

People in the eastern province of Nangarhar have welcomed the first campaign against malaria in two decades, and are calling for more work to raise awareness of the disease.

The campaign was announced following a survey conducted by the local health office last year which showed that 23 per cent of all patients in hospital care were suffering from malaria. Before years of fighting through the 1980s and 1990s stopped it, the government ran a programme of regular spraying to kill mosquitoes, with the result that only five per cent of hospital cases involved malaria.

Malaria is a dangerous and potentially fatal infection in Afghanistan, where adequate treatment and prevention is not always available. This is especially true in Nangarhar, where the climate is ideal for the malaria-carrying anopheles mosquito.

The new campaign, funded by the World Health Organization, the UN Development Programme, and Nangarhar’s own health department, is intended to teach people how to protect themselves from bites by using sprays and mosquito nets. It will also attack the insects themselves, clearing stagnant waters, spraying pools where they lay their eggs, and introducing “mosquito-fish”, a species which eats the larvae.

Some local people say this is not enough and have asked for the programme to be expanded to include door-to-door education.

“It is such a dangerous disease that there should be door-to-door campaigns and those who contract it should be treated as they were in the past,” said 50-year old Mohammad Sadiq, who lives in the village of Nehar Masio just outside the regional centre Jalalabad.

Mohammad Sadiq himself nearly died of cerebral malaria, the worst form, 20 years ago.

Hidayatullah, a 40-year teacher, wiped tears from his eyes as he remembered how his nephew died of the disease last year.

He recalls how effective the authorities used to be, “I remember 20 or 25 years ago when the government conducted spraying, and malarial paramedics went from house to house taking blood samples from people. Depending what their slides revealed, the medics distributed preventive and curative medicines. And they didn’t leave without examining everyone.”

That was before Soviet troops moved into Afghanistan in 1978, after which Dr Fazl Ahmad Ibrahimi, director of Nangarhar’s health department, said, “No effective measures to combat malaria took place, and outbreaks skyrocketed.” Successive rulers culminating in the Taleban were just as uninterested in the disease.

Last year, 4,369 out of 107,276 people tested proved to have malaria, and 2,379 of those had the potentially fatal cerebral form. “Thirty of those patients died,” said Dr Ibrahimi, “Ten of them were children.”

Shershah Hamdard, Ghulam Rasool Rasikh and Abdul Qadir Wafa are independent journalists in Jalalabad who recently completed an IWPR basic journalism training course.