Ebola deaths in Sierra Leone made international headlines. But there’s no doubt what the bigger killer is: malaria. Each death is its own tragedy. I felt it immediately when stepping into the Koroma’s home. Family members were trying to cope with the loss of Kadiatu, their breadwinner who, after a brief illness, had died two weeks before. In life, she’d taken care of the bills and put food on the table with her fruit and vegetable earnings. For the first time, they felt vulnerable.
When Kadiatu fell ill, her family looked after her at home because they thought it was just a fever. But her condition got progressively worse, so they took her to the hospital where she was diagnosed with severe malaria. She died three days later.
Her passing left her husband, Abdulai, struggling to make ends meet. “Her death is still a shock to me and the children. She was very devoted to our family and didn’t mind making sacrifices just to make us happy. Now things are harder for us,” said Abdulai. The children, especially her son Amidu (18), feels the impact: “My mother was the one providing almost all of my school needs. I have even just been driven away from school because I owe school fees. I want to be a lawyer after I complete school but I wonder if that will happen now without my mother,” he said.
I was on assignment but asked if Kadiatu’s grave was nearby. Abdulai took us on a fifteen-minute walk along the outskirts of town. “That’s the place,” said Abdulai, pointing to a heap of soil, close to tears.
Later, we met Alfred and Kadiatu Juo. Their 12-year-old son completed his primary school exams but then succumbed to malaria a few days later. “George was very helpful in the house,” said his father Alfred. “He was also very studious and wanted to become a banker in future. We believed in him and were hoping he would do well and help look after us when he got older. But all of that has been crushed because of malaria.”
Listening to Alfred brought back my own memories of malaria, including nursing my 6-year-old son through the bouts he has had. Each time he’s fallen sick, I’ve had no option but to take time off work. In my part of the world, nursing sick children is considered a mother’s duty.
Malaria is one of Africa’s deadliest diseases, at an estimated cost of about $12 billion every year.
According to WHO, Sierra Leone is one of seven countries in sub-Saharan Africa where more than a quarter of the population is infected with malaria at any given time. The parasite increases the risk of complication and death during pregnancy and childbirth. It causes nearly four in ten hospital consultations country-wide and contributes to about 20 percent of child mortality. This hampers the nation’s productivity as it prevents people from going to work, and children from going to school.
At the children’s ward of the Kenema Government Hospital, we met Hawa Conteh (8), who had been admitted with malaria. “I feel bad that I am missing school,” said Hawa. But she is not the only person affected. Like many people in Sierra Leone, her mother Fatmata Barrie, is self-employed and looking after her daughter has cut off her income. “I have not been able to go about my regular business for about a week now. It is not convenient but I have to do it each time she is sick,” said Fatmata.
Mariama Brima, a nurse on the ward, said many cases are malaria related. “More than half of the children brought here have malaria or complications caused by it. We fight hard to save their lives but sometimes they are brought in very late and we can’t do much,” she said.
There are proven ways to combat malaria. People who sleep under insecticide-treated nets have significantly lower risks of infection. This is particularly important for pregnant and lactating women because malaria increases risks of death and complications during pregnancy and childbirth. In 2017, UNICEF, with UK aid funding from the British people and the Global Fund, helped procure and distribute more than two million treated bed nets as part of a country-wide campaign targeting every household. In addition, UNICEF helped organise an intensive media campaign to encourage children, pregnant women and lactating mothers to sleep under mosquito nets every night and go to the hospital if they feel sick. Additionally, UNICEF with financial support from UK aid, assists the Government of Sierra Leone in increasing preventive treatment in infants (IPTi), which reduces malaria and anaemia among children under one year — the most susceptible to infection, illness and death. IPTi has been a success in four districts, with plans to reach the remaining 10 districts through health-worker training and social mobilisation.
Meeting families hit so hard by malaria makes me even more proud of the work we’re doing with partners so that every family in Sierra Leone has more protection from this deadly disease.
Harriet Mason is a Communications Officer working with UNICEF in Sierra Leone.