Health Ministry poised to expand malaria fight in face of ‘gold rush’
Acquired at a cost of US$50 per net, the Ministry of Health’s impregnated net programme has been deemed a success by Minister of Health Dr Bheri Ramsaran.
His comments came despite observations that the disease is being driven by an increase in gold mining activities in the country’s interior locations.
Introduced a few years ago as a means of helping to reduce the threat of malaria in Guyana, the treated bed nets are made of a special material which retains WHO-approved insecticides. These are, according to the Minister, “dangerous, injurious and lethal to the mosquito that causes malaria but is not harmful to human beings.”
Minister Ramsaran said that efforts to expand the programme this year should see some 50,000 bed nets being distributed to the growing mining locations.
The main vector of malaria in Guyana is the Anopheles darlingi which was described by Director of Malaria, Indal Rambajan, as perhaps the most virulent vector in the Western Hemisphere. He was at the time speaking at the Ministry of Health’s end-of-year press conference held at its Brickdam, Georgetown, headquarters, yesterday.
According to the Malaria Director, the Ministry of Health’s Malaria programme expends in excess of $180 million to combat the disease each year. The health sector’s spending capacity is however complemented by about $300 million from Global Fund. Additional financial support is gained from the United States Agency for International Development and the Pan American Health Organisation which together affords the Ministry about another $100 million, he said.
“It is a large, large budget, it involves fuel and transportation too,” Rambajan added as he emphasised that a great sum is needed to sustain the programme. He said, too, that to date the Ministry in collaboration with its partners has been able to distribute in excess of 115,000 treated bed nets which is a figure more than the combined populations of Regions One, Seven, Eight and Nine where the disease is endemic.
Even as he addressed the impact of the disease, Rambajan said that health officials are challenged to combat malaria as it is required of Health officials to access some hard-to-reach mining camps.
He said that some camps have a depth of about 200 feet and health officials are forced to access these in order to do mass blood surveys of fever cases.
He observed that over the past four years the number of persons engaged in the gold mining sector in the affected malaria endemic areas have significantly increased from 20,000 to about 130,000.
“This is a direct result of the unprecedented increase in world market gold price from US$114 in 2005 to the present US$ 1,800. In 2013 it is expected that the price of gold on the world market will reach as high as US$3,000 driven in the main by demands from China and India,” Dr Rambajan said.
Consequently he believes that the number of persons engaged in the sector will continue to increase significantly.
According to the Malaria Director, since miners are among the target population for the Ministry’s programme some of the treated bed nets are specially designed for hammocks in which a number of them sleep.
“Nets do not only perform by killing the mosquitoes they also form a barrier between the human host and the vector so it is very important because it is two-fold.”
The specially treated nets, Minister Ramsaran, said has the potential to annihilate other vectors as well thus tangentially controlling to a measured but lesser extent other diseases. Over the course of this year, he said that more than 1,000 nets were distributed to areas where there are a large number of reported malaria cases.
These, according to him, include the mining areas and certain indigenous areas where documented positive effect has been observed. He said that the Ministry has been working towards consistent continuance and expansion of its treated bed nets programme over the years.
“We will continue to send nets in measured numbers to certain communities especially where we note a continuously high report of malaria cases like in Regions Seven and Eight particularly where there are significant mining activities and a mobile population,” said Dr Ramsaran.
However, a noticeable reduction of the disease, the Minister asserted, cannot be credited to the use of treated bed nets alone. During an interview with this newspaper he noted that the reduction can be mainly attributed to the fact that the Health Ministry in collaboration with its international partners has created a large extensive network of health care providers who are trained specifically to fight malaria.
There are some health workers who have had general training but have been additionally trained to support the malaria workers. Among those with additional training are the Community Health Workers and Medexes who have skills in microscopy and who complement the efforts of medical practitioners and the vector control workers.
These health officials, he said, are tasked with training and educating while at the same time diagnosing, using the microscope, even as treatment is made available.
“First and foremost it is the continuous persistent effort over the past few years and more especially in the past five to eight years by the Ministry to create that workforce that has brought the situation under control…They go out at not only fixed locations but they visit the mining areas, they visit logging areas too…sometimes we forget that loggers are as exposed as the miners,” said Minister Ramsaran.
The Minister said that the Ministry has made available the best legal medication obtainable to those infected with the disease.
The Ministry estimates that from the present trend that there will be a 15 to 18 per cent reduction in the number of malaria cases for 2012 when compared to 2011.
Also sharing the spotlight yesterday were Chief Medical Officer, Dr Shamdeo Persaud, Medical Officer; Dr Rayand Rahman and Chief Vector Control Inspector Mr Karanchand Krishnalall along with Director of Regional Health Services, Dr Irv Chan.