Since the programme began in 2014, RAI/RAI2E has trained more than 33,000 malaria volunteers and established malaria posts for the most vulnerable communities in the hardest-to-reach areas across the five countries of the Greater Mekong Subregion: Cambodia, Lao PDR, Myanmar, Thailand and Vietnam.
Mr Y Bun Toan Nie is a member of Health Poverty Action’s mobile outreach team in Krong Na Commune, Dak Lak Province, Vietnam. He told us of one of the patients he treated for malaria, Mr Y Kong Eban from Ea Rong B village, who makes his living by logging timber and hunting, and used to sleep overnight in a small hut in the forest.
One day, Y Kong Eban had a fever and went to Y Bun Toan Nie, who made blood slides and performed a rapid diagnostic test for him, and confirmed that he had been infected with Plasmodium falciparum malaria. Therefore, he immediately had to take the antimalarial drugs provided by Y Bun Toan Nie, who also guided him through malaria control measures.
Since learning the control measures, whenever he goes to the forest, he now brings an insecticide-impregnated hammock net, wears long-sleeved clothes and applies mosquito repellent. When he comes back from the forest, he always goes to see Y Bun Toan Nie to test for malaria and recommends his friends to do so, too. Now, he understands the importance of taking malaria control measures to protect his health.
Chin Srey is a 42-year-old farmer who lives with her three daughters in Anlong village, Por Chrey commune, Pich Chenda District in Cambodia. Chin Srey had a bad experience when she got infected with malaria during her pregnancy. At that time it was difficult to get treatment for malaria, and that motivated her to become a village malaria volunteer, receiving training from the health centre in her area.
“I am proud of my volunteer work. People in my village can now get easy access to malaria diagnosis and treatment. I want no more malaria in my village,” Chin Srey said.
Chin Srey spends on average two hours a day as a village malaria volunteer. As her village is far from the health centre and does not have its own health post, she is the only caregiver there for malaria. Her main challenge is that it is difficult to travel during the rainy season to attend the regular health centre meetings. Chin Srey is very pleased that malaria cases in her village are decreasing and she is proud to be respected by her fellow villagers.
Mrs Phomma, 43 years old, is a village malaria worker for Health Poverty Action in Lao PDR. She is a mother of five from Houypai village, Pathoumphone District, one of the high-risk districts for malaria in the southern Champasak Province.
Before she became a village malaria worker, Phomma was a well-known traditional birth assistant in her village. She explained that almost 10 years ago, many people who worked in the forest were coming back to the village sick. Even though she wanted to help, there was no way to help them. The health centres were difficult to access because they were far from the village and the road conditions made travel hard. Some people died within a week of getting sick. Back then, she did not know what caused the illness and thought it might be because of a ghost or something supernatural.
Fortunately, six years ago, Health Poverty Action staff came and explained about the malaria elimination plan for the village. Phomma immediately offered her help and became a volunteer. Through Health Poverty Action, she was trained in malaria prevention, testing and case management.
Her daily routine is to test villagers and forest-goers for malaria and provide treatment in her village for those who test positive. In her six years with Health Poverty Action she has tested and treated many people, both from her own village and others nearby.
Now she knows that the disease is caused by the malaria parasite, spread by the bite of an infected female mosquito, and not because of a ghost. She is very happy for her community, and proud of her role as a village malaria worker. However, she finds her main challenge is that some villagers and forest-goers still do not pay enough attention to this deadly disease. Phomma wishes to thank Health Poverty Action and donors for their support towards eliminating malaria in her village and country.
U Chit Shwe has seen the number of malaria cases significantly reduce over his 10 years of malaria volunteer work. He is an integrated community malaria volunteer (ICMV) in charge of Gyo Chuang village in Taikkyi Township, Yangon Region.
He previously worked in Kyar Inn Seik Gyi Township, Tanintharyi Region, which is one of the malaria endemic areas. His wife is a midwife and U Chit Shwe has followed her to every health post to help her, and his interest in volunteer work stemmed from that.
Where health centres are far and few between, ICMVs like U Chit Shwe are frontline malaria service providers. U Chit Shwe shared his experience of 10 years back in Tanintharyi Region. “Back in 2007–2008, malaria was all too common but today we are gradually winning our battle against it. People in malaria endemic areas now have better quality of life as they are free from malaria.”
In those days, malaria microscopy was the mainstay of diagnosis, though it required special equipment and skilled microscopists. These conditions often could not be met at the peripheral health posts where U Chit Shwe used to work as a malaria volunteer. “People have poor health knowledge and, due to late referral, some very ill patients may have died on the way to the health centres where malaria microscopy was available.”
The main treatment at that time was quinine, notorious for its side effects like loss of appetite and dizziness. It took one to two months for patients to recover and get back to work.
But today, thankfully, a new chapter has opened in malaria control: RAI2E trained ICMVs and established malaria posts to ensure malaria service coverage for once vulnerable rural communities. They provide long-lasting insecticidal nets (LLINs), malaria diagnosis with rapid diagnostic tests (RDT) and treatment with artemisinin-based combination therapy (ACT)—all free of charge, supported by the Global Fund.
“I have seen my patients recover quickly after treatment with ACT. They can resume their normal life and work within a few days after treatment. Consequently, we are trusted in our communities because the services we provide save lives and create new opportunities,” explains U Chit Shwe, thankful for the Global Fund’s life-saving malaria support to communities in need in Myanmar.
