Naw Mu Lar, a 24-year-old woman living in a village on the Thai-Myanmar border, faced a major health challenge during what should have been one of the most joyful times of her life. Her pregnancy, typically a period of hope and excitement, was overshadowed by the recurrence of malaria.
The main livelihood of her village is agriculture, and many villagers, including Naw Mu Lar and her husband, work on farms located deep in the forest, where malaria is common. Naw Mu Lar had been infected with the Plasmodium vivax (Pv) parasite, which had relapsed three times, leaving her fearful for her health and that of her unborn child. However, thanks to the timely intervention of a local malaria post, part of a broader network established under the Malaria Elimination Task Force (METF), she successfully recovered and regained hope.
The METF, initiated in 2014, was launched to tackle the alarming rise of drug-resistant malaria and eliminate malaria on the Thai-Myanmar border. With the support of the Global Fund’s RAI4E grant, Shoklo Malaria Research Unit (SMRU) has been operating the METF, a consortium involving Karen Community Based Organizations (KCBOs) which runs a network of over 600 community-based malaria posts staffed by trained health workers who have provided testing and treatment to thousands of people like Naw Mu Lar.
She was promptly diagnosed at the malaria post in her village, which covers 400-500 populations. Because of the complexity of her pregnancy, she was referred to the Maw Ka Thai Migrants Clinic in Tak Province, Thailand. The clinic, operated by the SMRU, is offering malaria treatment, tuberculosis services and antenatal care services to the migrant population along Thai-Myanmar border, which played a crucial role in her recovery.
After weeks of close monitoring and follow-up care, Naw Mu Lar’s health significantly improved. She felt stronger, and more importantly, she hadn’t experienced any relapses since her referral to the clinic. “It was a huge relief to finally feel like I could move on with my life and prepare for my baby’s arrival,” she said. Her recovery demonstrates the importance of accessible healthcare, particularly for pregnant women in malaria-endemic regions.
“I was so afraid when the malaria came back again and again, especially because I was carrying my baby,” Naw Mu Lar said. “But the malaria post and the clinic took care of me. I am so grateful for their support.”
The malaria post where Naw Mu Lar received her initial treatment is part of a larger effort by the METF to tackle both Plasmodium falciparum (Pf) and Plasmodium vivax (Pv) malaria in some of the most challenging environments. Since its launch, METF health workers have tested over 1 million fever cases and treated more than 180,000 malaria-positive patients.
Despite these successes, the fight is far from over, especially with Pv posing unique challenges. The long-course primaquine treatment required for the radical cure, coupled with the need for G6PD testing to avoid side effects, makes Pv elimination more complex. The METF’s strategic approach, which includes early detection and treatment, community engagement, and vector control interventions, has been instrumental in reducing the malaria burden in these areas.
Naw Cha Mi, a village malaria worker at the post who treated Naw Mu Lar, highlighted the importance of community awareness. “The villagers here know about malaria and what to do when sick. They come straight to the malaria post because they trust the services we provide,” she said.
Community engagement is a key factor in the METF's success. The Community Engagement (CE) team provides education to the communities on the benefit of early access to malaria services, the importance of treatment completion for Pv malaria and engagement of the community to be actively involved in malaria control and elimination activities as well as training of the malaria post workers. The community-based malaria post workers are the key pillar of the elimination program; these health workers not only offer treatment but also take part in community meetings, health events, and exhibitions to raise awareness about the importance of early diagnosis and treatment, helping to strengthen malaria prevention efforts in the region.
Given that Naw Mu Lar had been infected with Pv, the malaria post took extra precautions by testing her family members as well. To her relief, only her younger sister was diagnosed with malaria. “I was so relieved that my baby and the rest of my family were safe,” she shared. Her younger sister began treatment right away, preventing further spread and relapse within their household.
Naw Mu Lar’s story reflects the broader challenges of malaria control in the Greater Mekong Subregion and underscores the essential role community-based health systems play in tackling them. Her recovery is not just a personal success but a testament to the success of the collaborative efforts between local malaria posts and cross-border health initiatives.
Her experience highlights the vital importance of malaria elimination, especially in remote and border areas. Naw Mu Lar’s story calls on us all to support initiatives like the METF, ensuring vulnerable communities can access the care they need. Together, we can continue the fight against malaria and protect future generations.
