The Rains Have Come, So Will Malaria

The rains have come to central Uganda. And
so will malaria.

Humble Place School–The rains have come to central Uganda. This is good. But it also means the menace of malaria will return as well. This is the experience of Rosette Kemigisha, school nurse at the orphanage and primary school known as Humble Place in Mukono District about 30 kms outside Kampala.

Last year she treated 279 children for malaria in a school with fewer than 200 students. It’s a persistent challenge to stay ahead of the mosquito-borne disease in this humid, wet climate.

She explains that the school administrators are attentive to her suggestions for environmental improvements that minimize the opportunity for mosquitos to breed in standing water or the rain catchment tanks the school uses to supplement its water supply.

When she saw standing pools around faucets where children wash their dishes, she advised school administrators to provide better drainage. They did. When she discovered the fittings for the rain catchment tank had spaces that allowed mosquitos entry points to the water, the school officials sealed the fittings.

On a larger scale, the Rev. Robert Ssajjabi, founder of the school, tells visitors how wetlands in the low-lying land owned by the church were major breeding grounds for mosquitos and required more substantial change. A stream runs through the area and adjacent soil was being dug by local brickmakers to make bricks, leaving deep pits which collected water. The bricks were formed and fired in tall stacks next to the pits.

When the church bought the property, Rev. Ssajjabi said the area was live with mosquitos. He hired workers to drain the pits and eventually leveled the ground so it drains to the stream. He also constructed two fish ponds stocked with tilipia and catfish. The fish eat the mosquito larvae, creating a natural preventative. Today, it’s possible to stand on the banks of the pond and never see a mosquito.

These and other small, but very important, changes can make a big difference, Rosette says. For example, the children are encouraged to wear long trousers and long sleeve shirts when they play outside. She teaches parent education classes on how to water gardens and trees to avoid standing water. She explains that tin cans and other debris provide breeding places. Areas around homes must be kept clean. She encourages children to stay away from the nearby stream and, most importantly, she encourages the whole family to sleep under insecticide-treated bed nets.

She has become an expert of sorts on the condition. She explained to me the categories of symptoms for which she looks and the various levels of treatment required for individuals at particular stages of the disease. While fever and nausea are common to all, malaria manifests itself slightly differently among people of different ages. Rosette knows each and keeps a watchful eye on the children in school and she takes preventive measures when they go home to their families.

Malaria is so common in the country that the Uganda Ministry of Health’s Clinical Guidelines tells health workers to assume that a person in a malaria infested area displaying symptoms has the condition and treat them with appropriate prophylaxis until proven otherwise. For more complicated symptoms the Commission recommends blood tests, but it’s important to get medication started as soon as symptoms appear to prevent the progression of the disease which the World Health Organization says results in the death of a child every thirty seconds worldwide.

Ms. Kemigisha has prepared for the return of children from the holiday break by laying in sufficient medical supplies for treating the condition. She knows that the rains have come, and so will malaria.

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