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Malaria
and Emergencies.
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The
risk of emergencies /
disasters in Southern
Africa is high, with drought,
cyclones and flooding
having all occurred in
the last 10 years in one
or more countries within
the region. These natural disasters all have
an influence on the malaria
transmission pattern in
an area, with increases
in malaria transmission
and possible epidemics
occurring in the post-acute
(Rehabilitation) phase.
More specifically, in much
of Southern Africa,
the cyclone and flood
season is directly related
to the malaria season,
and can result in favourable
conditions for malaria
transmission.
However, drought
may not result in an increase
in cases immediately,
but the first rains following
a drought period have
traditionally shown to
produce an epidemic. |
Emergencies
compound on the response to
a malaria epidemic, because
depending upon the nature
of the emergencies. Increases in
the populations vulnerability,
and in the cases of cyclones
and flooding, damage to infrastructure
reducing the capacity to respond,
such as physical damage to
clinics, hospitals and service
routes for logistical support
and patient referral all contribute
to this.
In addition, it is
possible that medical personnel
could have also been affected
by the disaster, again reducing
the local capacity to deliver
a service.
In
a disaster / emergency situation,
internally displaced people
can also become a significant
area of concern. This creates a very specific problem
that requires a very special
approach, with large numbers
of people confined in one
area, a mixture of immunes,
non-immunes and a possible
move of infected people.
A response in this
situation is a priority, to
prevent a large increase in
cases occurring quickly.
Medical services serving
these populations or at risk
groups should have the capacity
to respond to malaria cases,
which may well be high initially,
as a large group of malaria
patients move to a central
location, already carrying
the infection, then slow down,
until the conditions for transmission
to occur in the local area
become favorable (Typically
when the rainfall slows or
stops and the waters begin
to recede)
Responding
to a malaria emergency is
a process that occurs before,
during and after the event.
Preparedness should
occur as part of epidemic
preparedness, and where epidemics
are not deemed a priority
problem, preparedness should
be included as part of the
civil protection / disaster
preparedness activities.
Early warning systems
should be monitored by health
personnel and warnings be
taken serious. In the event of a situation, the
medical priorities outside
of the immediate stabilization
of trauma injuries become
the control of the communicable
diseases, including malaria,
which can increase following
a few weeks of impact, depending
upon the local situation. During this time, the malaria control
units should be undertaking
assessments, planning, mobilizing
resources and implementing
preventative activities, while
also ensuring the affected
area is prepared for the possible
outbreak.
Essentially in this
situation, the epidemic cycle
is compounded into four - six weeks period, based upon.
Prior preparation and
planning can reduces the pressure
to undertake all these
activities in such
a short space of time.
It
is essential to be prepared
and plan ahead…
Malaria
Epidemic Emergency Control
Guidelines
Emergency
Response
Any
emergency response programme
has several immediate
priorities:
- Rescue
- Food
- Water
- Shelter
- Health
- Clothing
- Sanitation
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Emergency
Health Response
- Within
the context of emergency
health response, there
are again several
critical priorities:
- The
urgent strengthening
and reinforcement
of existing medical
care facilities, drugs
stocks and staffing
levels
-
The
establishment of basic
medical care in areas
without existing medical
care facilities through
temporary or mobile
clinics, and within
the community.
- Maintenance
of normal nutritional
levels
- The
control of epidemics
such as malaria, diarrhoeal
diseases, cholera
and dysentery
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Malaria
Emergency Epidemic Response
- The
response should be
co-ordinated by the
Ministry of Health
through the malaria
advisory committee's
and the national malaria
control programs
- Support
should be provided
to all levels, national,
provincial, district,
rural health centre
and community / camp
level
- The
ministry of health
should act as the
focal point, co-ordinating
all support from other
UN agencies and NGOs,
with the assistance
of WHO if required
-
The
MOH, with support
from the WHO, should
maintain active surveillance,
assessments, monitoring
and evaluation of
the situation throughout.
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Priority
activities for the
control of malaria
epidemics are malaria
epidemic prevention,
treatment and
education.
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Malaria
Prevention Priorities
-
Residual
Household Spraying
in certain situations
-
Insecticide
Treated Nets be distributed
according to guidance
-
Repellents
be distributed as
necessary
-
Drug
prophylaxis for pregnant
women and children
under five*
-
Fogging
in camps and densely
populated areas
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Priorities
for the Treatment and
Cure of Malaria
-
Establish
and maintain adequate
buffer stocks of anti-malarial
drugs down to the
rural health care
facilities
- Early
Treatment of simple
malaria cases by volunteers
and community health
workers within communities
and emergency settlement
camps.
-
Ensure
the correct management
of severe and complicated
malaria at health
facilities
-
Where
access is a problem
or existing health
facilities are non-functional,
utilise temporary
and mobile treatment
centres
-
Where
the referral systems
are not functioning,
consider the treatment
of complicated malaria
cases at temporary
clinics and rural
health centres
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Malaria
Education Priorities
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Information
and education to health
workers for their information
and also on how and what
to advise others |
-
On
how to correctly diagnose
and treat simple and
complicated malaria
(according to level
of training the health
worker has)
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The
role of personal protection
and what to do
- The
role of vector control
and how it will be
done
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Information
to the public on
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The
current situation
in terms of malaria
risk, what is being
done and what the
community can do to
help
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The
value of personal
protection, what to
do and how.
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The
signs and symptoms
of malaria
- The
need for early treatment
and how to get treated,
including the location
of the nearest health
centre (In the case
of temporary shelters
or where existing
treatment centres
have been damaged
and are no longer
functional
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Information
to NGOs
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Information
on priority messages
for malaria prevention
and control
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Information
on priority activities
for malaria prevention
and control
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Code
of practice for communicating
with the MOH - NMCP
to facilitate sustainable
malaria control activities
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