Malaria: One NGO worker's fight

GENEVA — Awa Marie Coll-Seck’s first epiphany about malaria occurred when she was 4 years old, at home in Senegal. Her father, a doctor, forced each of his children to swallow a spoonful of the anti-malarial drug chloroquine daily. “The kids would run in all directions when we saw it coming,” she recalled.

Her brother, who was just under 3 years old at the time, mastered the art of holding the bitter–tasting medicine in his mouth, then spitting it out when no one was looking. That all stopped when he developed cerebral malaria. Coll-Seck watched in horror as his body went into convulsions. He survived, but the experience turned everyone in her family into a chloroquine believer.

Not everyone has been so lucky. In sub-Saharan Africa, malaria kills thousands of children (estimates vary). “You can think of the two twin towers of the New York World Trade Center, filled with 5-year-olds, going down every day,” said Prudence Smith, an advocacy specialist at the Roll Back Malaria Partnership. “That is basically what we are talking about.”

Coll-Seck, the partnership’s executive director, compares the casualty figure to the equivalent of four Indian Ocean tsunamis every year. “It is a million children dying each year, without anyone being shocked or feeling that they need to do anything concrete,” she said.

Between 80 and 90 percent of the children who die from the disease are in Africa. It is a vicious circle. The poor are worst affected, and malaria itself is largely responsible for keeping them in poverty. The geographic spread has influenced the attention focused on malaria: It has been virtually nonexistent in Europe and the U.S. since the early 1950s. Unlike for HIV/AIDS, there is hardly anyone who has had direct experience with malaria who is pushing for immediate action.

Even for Coll-Seck, it took a while for the full impact of the disease to sink in.

After finishing medical school, she went to work in one of Senegal’s district hospitals. She realized that on a daily basis nearly half the cases she dealt with involved malaria. A desperate parent would rush up holding an infant in her arms, not realizing the baby was already dead. The stress on the doctors was enormous.

But Coll-Seck realized that the problem was also greater than the parasite responsible for the disease. “It was the weaknesses in our health system,” she said. Patients had to be sent to a referral center for medicine, but often there was no ambulance, or if one was available there was no gasoline. Sixty percent of the medicine had to be bought in the private sector, but by the time parents had raised the money, the child was already dead.