Burma's Other Silent Struggle: Malaria

All is not silent in Burma. There's malaria. Drug-resistant malaria, to be exact. It's the other silent struggle, and very few are talking about it.
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Drug-resistant malaria has researchers scrambling for a new drug, but what's being done to stave off the deadly disease until that drug becomes widely available?


A Google search for "Burma" brings up the following result:

There you have it. A BBC one-sentence description of the entire country features the phrase, "appalling human rights record." This is often the prism through which the country is viewed, especially in the context of its ongoing silent struggle to wrest power from the ruling military government and put it into the hands of 1991 Nobel Peace Prize winner Aung San Suu Kyi (and her National League for Democracy party).

But all is not silent in Burma.

Burmese factory workers are taking to the streets to shout slogans about raising the minimum wage, villagers are protesting the building of a coal-fired power plant and the U.S. Campaign for Burma continues its brilliant work to call attention to the plight of the Rohingya.

Then there's malaria. Drug-resistant malaria, to be exact. It's the other silent struggle, and very few are talking about it.

A study published in The Lancet this past April showed that drug-resistant malaria has spread throughout the country. Essentially this form of malaria is quickly becoming resistant to the antimalarial drugs doctors have relied on for over a decade. Researchers at last year's annual meeting of the American Society of Tropical Medicine and Hygiene all expressed their grave concern for what this might mean in the coming years.

Especially because of statements like this:

"I still think we are 5 or 6 years away from the widespread release of a solid alternative drug combination," said Gilles Delmas, board member of Médecins Sans Frontières/Doctors Without Borders.

"I've worked in Syria, in Somalia, in Cambodia after the devastation caused by the Khmer Rouge. But here at the Thai-Burmese border working to combat drug-resistant malaria is where I felt I needed to be."

Delmas now serves as project coordinator at the Shoklo Malaria Research Unit in Mae Sot, Thailand. When I asked him what other methods he believes will help stave off malaria, especially during these next 5-6 years, he brought up "malaria posts" and "hot spots."

The malaria posts are essentially small medicinal huts in the villages where a trained staff person has antimalarials and is available 24-hours-a-day in case someone has a fever. People who come to the huts are given a rapid diagnostic test. If they test positive they are treated immediately both so they can quickly recover and so they aren't carrying the parasite (which gives the mosquito a chance to take some of the parasite from their body and deliver it to someone else). Here's what the test looks like:

Delmas has helped set up over 500 of these malaria posts throughout Burma, and has plans for another 400. Here he provides his insights into why these posts are the backbone of his work at Shoklo:

The "hot spots" work in tandem with the malaria posts. Essentially a hot spot is determined when researchers take blood from a group of villagers and notice that a high percentage have the malaria parasite in their system. They may not feel a single symptom of malaria, but it tells the researchers that malaria is pervasive in the area. Delmas and his team believe that mass drug administration efforts in hot spots can help prevent the spread of malaria. Here he goes more in-depth and discusses the difficulties of implementing such a program:

See also:

This article was supported with funding from the International Reporting Project

-Photo: In Indonesia, malaria is controlled by filling in ponds with a mixture of earth and toxic paris green. 1940s. Tropenmuseum, part of the National Museum of World Cultures [CC BY-SA 3.0], via Wikimedia Commons

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