Malaria Strikes Impoverished Villagers

Doctors are struggling to stem a malaria outbreak that’s ravaging the country’s rural poor.

Malaria Strikes Impoverished Villagers

Doctors are struggling to stem a malaria outbreak that’s ravaging the country’s rural poor.

Naseer Ahmad lies in the dusty road outside a makeshift laboratory in the remote northern city of Taloquan. The 15-year-old boy has a fever and his body is wracked with pain. His skin is pale and his lips are cracked. He cannot speak.

His father suddenly hears his son's name called out and runs towards the laboratory only to return a few moments later with a sad expression. "The doctor says he has got PF - plasmodium malaria - and I have to admit him to the hospital. I don't know what PF is,” he said.

"If it is a dangerous disease I don't have enough money to buy him medicine. I have 40,000 afghani (one US dollar), 20,000 of which I gave for the test and with the remaining 20,000 I will buy some malaria pills."

Naseer is about to become another statistic in an increasingly frustrating battle against malaria in the northern provinces of Afghanistan. Numbers of cases are rising alarmingly in Kunduz, Takhar and Badakhshan - all poor provinces with inadequate communication, transport and medical facilities.

In Takhar alone, nearly all the 9,000 people tested for the disease so far this year have been found to have it. Up to three hundred of them will die, admits the director of public health of Takhar province, Dr Abdul Ahad Atif.

"We have made a development plan for the year 2002 in which we have many suggestions for prevention and cure. So far, a welfare organisation by the name of Marlin has promised to help. Eradication of malaria needs big projects and a lot of money," he said.

Dr Mana Zarkua moved to Taloquan after four months in Tajikistan to take charge of Marlin's malaria branch in Takhar. "The disease is a big problem in this area and its prevention needs a lot of work," she said.

Marlin has eight clinics in the north-east of the country - six in Takhar and a couple in Baghlan and Kunduz. They have trained 48 people in three teams to set up 24 more medical centres.

"Soon we will have accurate and complete surveys and be able to distribute new and effective medicine. We also want to train people to teach other people how to prevent themselves from catching malaria," said Dr Zarkua.

But those prevention plans are already too late for 12-year-old Shamsuddin, one of 15 malaria patients in the central hospital of Takhar province. "He got fever three days ago in the morning and was delirious," said his brother Nizamuddin. "Sometimes he would shout and get frightened. We took him to the mullah of the village, who said that the boy should be taken to hospital. So we immediately brought him here.”

In neighbouring Kunduz, Mohammad Moqeem, a technician in the malaria laboratory in Kunduz city's central hospital, said, "Just so far today we have tested the blood of 42 people and 12 of them have malaria. Maybe 20 more will be checked in the afternoon.

"Last year we were testing the blood of 150 to 200 people a day and about 40 of them would have the disease. About 150 people are checked in the malaria clinics and half of them test positive."

Najeeba is one of those patients. The 12-year-old girl lies beside the entrance to a big tent behind the central hospital. She has been there for four days with her father, Mohammad Sharif, who is also stricken with the disease.

"Many people in our district, Ishkamish, are suffering, especially in our village, Samandaw, where there is an epidemic. There is no doctor or laboratory nearby and we had to walk for three hours to reach help," he said.

The story is not much better in Badakhshan province, stuck out in the far north-east of the country. At Keshm clinic, Dr Abdul Jamil reports that so far this year five people have died in his district alone.

"People at first thought that it was the plague, but later they realised that it was malaria. More than ten people come each day with the disease, but our clinic is limited and we don't have good doctors, laboratories or medicines," he said.

Back in Taloquan, Sarajuddin sells malaria pills and painkillers outside a clinic. "Most of the people come here from far away places. We sell malaria pills only for 20,000 afghani (50 US cents) but sometimes people can't even pay that amount," he said.

Rahimullah Samandar is an IWPR trainee reporter

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