NEWS - Uganda: Closing the net on malaria

Guardian Weekly

Malaria is a preventable disease, yet it kills at least one million people worldwide every year and is Uganda's biggest child killer. As people across the world mark World Malaria Day on 25 April, Agnes Suubi, senior operations officer at the not-for-profit Malaria Consortium in Uganda, describes the work health workers are doing to raise awareness of symptoms and the importance of getting treatment quickly. The Guardian is tracking similar work across Katine sub-county in rural Uganda.

I joined Uganda's Malaria Consortium as an administrator in 2004. At that time we'd been given some work by the Ministry of Health to do the first ever mass mosquito net treatment. It was a pilot project as the ministry had never done it before. We did a good job, treating about 481,000 nets in 20 districts.

Everybody in Uganda has caught malaria at some point. We have breeding sites all over the place. If you come to Uganda you'll see many beautiful hills, but at the bottom of those hills are swamps where mosquitos make themselves at home. And nowhere is safe: you can catch malaria at school, at home or in the office.

I've caught malaria myself many times. At first you feel tired and cold, your temperature shoots up, your joints and your head ache, you have no appetite and sometimes you throw up – and that's just the first stage. It's what they call uncomplicated malaria, when you are feeling the pain but you can still walk to hospital.

When it gets to the next level, you have convulsions and can't walk properly. You kind of blackout, and it is likely you'll find yourself in a hospital somewhere with a quinine drip. The longer it takes you to get to hospital, the worse it will be.

On a typical day, I'm working in the field with a district health officer. I help to prepare groups of people who will be in charge of training other people across the country. Once they know what they're doing we can go into communities and talk to people, educate them and redistribute mosquito nets.

Uganda has several levels of administration – country, district, county, sub-county, parish and village. We go to the district and train a group of people, then they go and train people in the sub-counties. We disperse trainers far and wide in order to reach as many communities as possible. If we're doing a big job like trying to distribute nets in five districts in one day, we have to authorise people in those places to help us, because we can't be everywhere. When we've got people on board who are properly trained we can distribute nets in as many as 17 counties in one day.

Mosquito nets are one of the most important types of prevention. We were previously doing mass net treatment across the country, but we now prefer to give out new nets and encourage people to buy their own long-lasting ones. If you give a family a treated net they're far less likely to catch malaria, the children can attend school, the parents can go to work.

I try to encourage people to seek treatment in time. If malaria is treated in the first 24 hours then it's not as bad. But if you have a kid who is convulsing and you have to walk 4km to hospital, you might get treatment but the kid could be affected in terms of development of the brain and body.

What we do at the Malaria Consortium is educate people about the disease – how to tell when you have it, what you can do, where the nearest health centres are. We give them any data available, like the fact that it's 'the number one killer' and they shouldn't mess around when it comes. But we only give them the simple facts; people don't have the time or the understanding to know everything about the disease.

Our biggest challenge in fighting malaria is resources. It would make such a big difference if we had enough funds, nets, well-equipped health centres and health service providers who are happy to do their job. There are people out there who want to help us in the fight against malaria but they don't have any information about how to do it.

And there's still so much that people don't know about malaria (such as which interventions are better than others, what can be done to control it). We should have reached every area in Uganda by now but because of the lack of resources we've only reached a certain percentage of the country.

Having said that, we have seen an improvement in the malaria situation in Uganda – especially in areas where we've been able to distribute nets. Health centres are telling us they're not as loaded as they were before.

The best thing about this job is when we arrive in a hard-to-reach community and we see that somebody is getting the service. When we went out to the communities, for example, we weren't sure if people would bring their nets to us – they didn't have the money. But to see someone who not only had a net but had walked 3km to bring it to usfor treatment, was thrilling.

Everyone dreams of a malaria-free world one day – we'd have more people working in jobs and more children going to school. I don't see what I do as a job, actually, but as a way to help people live better and to help children to be healthier.

• Agnes Suubi was speaking to Anna Bruce-Lockhart. Feel passionate about development in Africa? Why not leave a comment here.

• The Guardian is tracking Amref's three-year development project, in partnership with Barclays, to improve the lives of the 25,000 people in Katine sub-county in Uganda. It is explaining where donations go, how aid works, and how lives are changed. Visit the Katine website to find out more.