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Behavioral Impacts on Spread of Malaria

Behavioral Impacts on Spread of Malaria

Beyond Borders: Fighting Malaria Together in Eastern Indonesia. This new "Picture of the Day"  shows a young girl from Lapinu village who appears unwell. Taken in 2020, Alex examined her and used a stethoscope to listen to her heartbeat. In April 2023, we revisited the village as part of the Primary Medical Care program. Unfortunately, the girl contracted malaria and suffered from high fever, body pains, and poor overall health. However, after receiving treatment and giving advice to her mother, the little girl has shown significant improvement after just one month.

Our organisation is dedicated to promoting public health in ultra-rural regions of Indonesia (like here in East Sumba), and we're deeply concerned about the impact of malaria on vulnerable communities, as you know already. Sadly, malaria remains a leading cause of illness and death in Indonesia, particularly in East Sumba, where we are based.

Some little history: The word "malaria" originates in Italian. It comes from the expression "mal'aria", which translates as "bad air". This term was used historically to describe the belief that disease was caused by inhaling polluted or stale air in swampy areas. The Plasmodium parasite is responsible for causing malaria, and research suggests that it has been affecting humans for at least 4,000 years.

Several human behaviours contribute irreparably to the spread or persistence of malaria. Here are some of the factors that lead to an increase in malaria cases:

Failure to prevent mosquito bites, poor waste management, inadequate housing and sanitation, deterioration of hygienic conditions, deforestation, alterations to natural habitats, movement of people, drug resistance*** and misuse, limited access to health services, higher illiteracy rates among younger populations, and lack of community involvement and awareness can all lead to an increase in malaria cases… And this, among other examples!

As a result, many people, particularly children and pregnant women, continue to suffer from this preventable and treatable disease. Our program aims to tackle these issues head-on by implementing various activities to strengthen malaria control efforts in the region. It is crucial to highlight that combatting malaria demands a unified strategy encompassing preventive and therapeutic measures. It also involves initiatives to enhance the environment and living standards of communities affected by the disease.

***The problem of self-medication and the consequent development of resistance to antimalarial drugs are two interconnected challenges that significantly hinder the effective management and control of malaria.

Beyond Borders, Fighting Malaria Together in Eastern Indonesia

Beyond Borders, Fighting Malaria Together in Eastern Indonesia

Beyond Borders: Fighting Malaria Together in Eastern Indonesia. This new "Picture of the Day"  shows three kids between 8 and 12 years old. Children are among the most vulnerable malaria victims in Indonesia, especially in the east of the country and of course here, where we work with Fair Future, Kawan Baik foundations and all our partners and friends.

The health and well-being of children in eastern Indonesia are threatened by malaria, which hinders their growth, development, and quality of life. Our organizations have a deep understanding of the urgency to address this issue, and we are working hard on our disease control program, which is of utmost importance. We have a strong track record of working in these regions where the epidemic affects about 80% of children. Collaborative efforts are underway to combat malaria and prioritize the welfare of children in these areas.

Young children are at a higher risk of contracting malaria due to their underdeveloped immune systems. Living in rural and poor areas with limited access to preventive measures only exacerbates the severity of symptoms if infected. A contributing factor is that young children typically haven't been exposed to the malaria parasite enough times to build up immunity* against it.

It can be challenging for young children in our regions to communicate or identify the symptoms of malaria, and their parents may not be familiar with them either. As a result, affected children may display non-specific symptoms like fever, tiredness, loss of appetite, irritability, and vomiting, which could easily be mistaken for other common childhood illnesses like drinking contaminated water. Consequently, this can cause delays in diagnosing and treating malaria accurately

*Some additional explanation: People living in malaria-endemic areas gradually develop acquired immunity, which reduces their susceptibility to severe infections in the future.

Malaria in East Sumba: All villages turned Red!

Malaria in East Sumba: All villages turned Red!

This new "Picture of the Day" shows you a brave but sad mom who asks for care for her little boy. She is a courageous but sad mother who seeks care for her little boy, who suffers from Malaria. With pain and more than 40 fever, He is the example of the "typical patient" here: Under five years old, this family lives in an ultra-rural and marginalized area. She is poor, and they don't have access to medical care or enough food and clean water; They don't have toilets either. Moreover, the whole village does not have access to electricity.

The medical staff of Kawan Baik and Fair Future Foundation bring him relief and medicine to lower his fever and get better as soon as possible. We also talk to the mother and give her good advice.

Let me re-explain to you what malaria is and why this disease is hazardous, and the categories of people it affects in the first place:

Malaria is caused by parasites transmitted by the bites of infected mosquitoes. Although anyone can get malaria, specific categories of people are more susceptible to severe illness and complications. We find that the impact of malaria varies by geographic region and local health infrastructure. Our efforts to fight malaria focus on prevention through measures such as the establishment of the Primary Medical Care Program (PMC), mosquito nets, spraying in villages (fogging), and learning to wash with an "ani-malaria or disinfectant" soap, among others. 

1. First, children under five: This is because young children have a weaker immune system and have not yet developed immunity to disease. They are more likely to have serious symptoms and complications, including severe anaemia and cerebral malaria, which can be life-threatening. This is the case here: Infant mortality is very high in ultra-rural areas and marginalized populations of East Sumba.

2. But also pregnant women: Of course, malaria can have adverse effects on both the mother and the unborn child. Pregnant women are at an increased risk of developing severe malaria, leading to complications such as maternal anaemia, spontaneous abortion, stillbirth or low birth weight infants. I spoke to you about a similar case in Kabanda, right?

Public health interventions to provide vital advice to the most affected populations via the #kawansehat program are essential. You have to be close to people if you want to advise them on the best way to have a healthier life.

3. Ultra-rural and marginalized populations: Communities living in rural and remote areas, often with limited access to health care, such as here in East Sumba, are disproportionately affected by malaria. Factors such as poverty, lack of knowledge about preventive measures and limited access to health services contribute to malaria's higher prevalence and impact in these communities.

4. Immunocompromised people: People with weakened immune systems, such as those living with HIV/AIDS, are more likely to contract severe malaria. We are also talking about people with chronic illnesses. Malaria can also aggravate the progression of HIV infection. And concerning the rate of HIV-positive people here is also very high, even with very few tests being conducted.

Happy to have water without going far to get it

Happy to have water without going far to get it

This new "Picture of the Day" shows you a 12-year-old kid named Yaspan. He was born in a tiny village in East Sumba where Fair Future and Kawan Baik have worked for over four years. We built a new school for him a few years ago, #sdmbinudita, and now he and his family have clean water reaching his house, which was not the case before. Yaspan and all his friends from the Village of Mbinudita are lucky because children struggle to get water everywhere else. They have to find it very far on foot; to do this, they miss school, get injured, and fall ill.

There's something inexplicably satisfying about the heavy rains in ultra-rural East Sumba, especially when you live in a water-scarce area: The sound of raindrops hitting the roof is soothing, and the smell of wet earth is refreshing; plus, you feel good because you know that this rain will help the family. When it rains a lot, kids and families here can't help but be happy knowing that their water tanks will be filled and they won't have to worry about running out of water for a moment.

"-It's a small blessing for which I am grateful, and I always make sure to take advantage of the rain while it lasts…" a friend from the village told me last month.

Heavy rains like the ones we experienced last month in one of the ultra-rural villages in East Sumba, where we work with Fair Future and Kawan Baik Indonesia foundations, are also an opportunity to celebrate as these kids wade through the water. They are the first to be happy because they won't have to walk for hours to fetch water far from home.

With those heavy rains comes plenty of water and the relief of much-needed hydration. The floods will provide much-needed food for crops, wash livestock and provide villagers with general water and sanitation assistance. With the bonus of increased economic activity and improved social well-being from the new abundance of water, these small floods are becoming the opportunity of a lifetime for the villages of Sumba. With increased water storage, a healthier environment and better living conditions, small floods caused by heavy rains are the perfect way to improve the lives of villagers in these areas where water is absent.

It's interesting to consider that what may be a challenge for many of us is a helpful solution for these families.

The Truck of Life wants to go everywhere

The Truck of Life wants to go everywhere

This new "Picture of the Day" shows you the "Truck of Life", driven by Alex, the founder of Fair Future Foundation, which is active in the field almost permanently. In this image, we visit the Water Connections program sites in East Sumba, Mbinudita village. This is to realize the importance of having clean water and sanitation facilities in families. Indeed, it is in these villages that from now on, the "Truck of Life" gives a minimum of medical care because people are in much better health. Water is the cheapest and most effective medicine.

The "Truck of Life" is a unique and innovative Fair Future initiative. This vehicle provides medical care to the ultra-rural areas of Sumba; it saves lives and allows you to go anywhere where almost no one ever goes. With the help of this truck, medical teams can travel to remote areas and provide health services to those who otherwise would not have access; it is also used to bring medical equipment to participants in the PMC program (Primary Medical Care Program). One of the key benefits of the Truck of Life is that it can reach people in remote areas who would not otherwise have access to healthcare services. The team on board the truck can provide a wide range of services, including primary medical check-ups, vaccinations, maternal and child health services, and treatment for common illnesses.

The Truck of Life is an innovative approach to addressing the healthcare challenges faced by people living in remote and rural areas of Indonesia. By bringing medical care and health education to these communities, the Fair Future Foundation is helping to improve the health and wellbeing of some of the most vulnerable people in the country. It represents the foundation of what it wants to be on a daily basis: Close to people in rural areas. 

To ensure the "Truck of Life" successfully reaches those in need, working closely with the local community and building a solid relationship with them is essential. This is achieved by engaging with community actors and local health workers and conducting outreach programs in the villages where Fair Future and Kawan Baik work so hard to educate people on the importance of health care. In addition to providing health services, the Truck of Life also promotes health education and awareness in its communities. This is achieved through community outreach programs, where medical professionals engage with local people and provide them with information on staying healthy and preventing disease.

Another essential aspect to consider is the sustainability of the program. The "Truck of Life" is designed to operate efficiently and profitably over the long term, with a plan for maintenance, repairs and replenishment of medical supplies. The "Truck of Life" is a valuable initiative that significantly changes people's lives in Sumba's ultra-rural areas. With careful planning, collaboration with local communities and a commitment to sustainability, it has the potential to bring essential health services to those who need them most in the following years. 

Kullup is a hole in the rock to collect rainwater

Kullup is a hole in the rock to collect rainwater

This new "Picture of the Day" shows you kids from the village of Laidatang, who fetch water far from home in the "Kullup" of the village. Elthon, responsible for documentation (with the black t-shirt), and Alex, from the medical staff, are also present in this photo. With the kids and one or two adults accompanying us, we walk more than an hour to reach this place in the middle of a high hill. You must descend a steep path to access these hand-dug holes in the rock. In 30 minutes, we will have to go up the hill and walk back. But this time, loaded with several jerrycans filled to the brim.

The Fair Future and Kawan Baik teams spend two days with the families of the ultra-rural and isolated village of Laindatang to get to know them even better. In this village, we have the project to create a #WaterConnections project. I let you read here the articles related to this project and here to see what your want to do to save their lives,

In Laindatang, families only have access to rainwater. It's for everything: eating, drinking, cooking, bathing, washing clothes, drinking water, caring for children, sick people or watering animals. Therefore, one of the ways for women and young girls to have water at home to live on is to walk several kilometres to find the "Kullup".

Kullup, what is it? These are small stone basins, directly dug into the rock by the villagers, used to collect and store rainwater in rural areas. When it rains, the water seeps into the ground at the top of the hill and then is filtered through the earth and the basements. It flows drop by drop in these stone basins, the "Kullup". Then the villagers come to fill their jerrycans with five or ten litres.

The "Kuluk" are an essential water source for the local communities. But the quality of stored water can be affected by bacterial contamination, chemicals, animal waste or debris. Therefore, regularly cleaning these small holes in the rock is essential to maintain water quality. It is important to note that the "kuluk" is only a temporary solution to the water crisis in areas with limited access to drinking water. Indeed, the "kuluks" cannot fill up correctly without rain. They dry out about ten days after the last rains and remain dry for almost nine months. To find water, young girls, women and children, sometimes under five, will have to walk even further and longer.

Our two organizations work with local communities to implement longer-term solutions, such as constructing water supply networks using deep boreholes and sealed and healthy rainwater cisterns. The Water Connections program offers innovative and sustainable solutions. It includes promoting water conservation practices with “Kawan Sehat” and self-sustaining access to Primary Medical Care through the PMC program.

Helping ultra-rural families to have a healthier life

Helping ultra-rural families to have a healthier life

This new "Picture of the Day" features Kawan Ino, one of the Fair Future team members in Sumba (Rumah Kambera Leader), talking to health workers and the village community of Kabanda. To do this, he uses the "Kawan Sehat" book we produced at the end of 2022 for children in these regions. This book is an integral part of the program of access to primary medical care for children in ultra-rural areas.

We spend two days here, and you can read what we have done in Kabanda. This village is genuinely one of the most isolated I have ever seen. Getting it is difficult, even dangerous, at times. No road leads to this village; only extremely steep or steep stony paths allow us to go there. Kawan Ino explains how to have a healthier life thanks to implementing specific things in everyday life. This includes physical and mental health, body and home hygiene, daily habits and women empowerment.

Thanks to the Kawan Sehat program, we see a significant improvement in the health and well-being of rural populations. It is truly heartening to see healthy habits being encouraged and access to health care increasing. It is vital that everyone has access to quality health care, and we are happy that this program allows more people to receive the care they need.

Here, when a person is sick or injured while a woman is due to give birth, one of the only ways for her to receive medical attention is to carry her on people's backs for several hours or even a whole day until the nearest health centre. This person also does not know if he will arrive in time at the medical centre, called "Puskesmas or Pustu", as we have seen on several occasions.

This is why this book is necessary:Kawan Sehat” is intended for schools and teachers. It's an amazing teaching aid for them, and kids love it. Nothing is done here to give children the means to learn from an early age how to wash themselves, eat healthier, use soap, and learn not to pollute or brush their teeth etc… In the classrooms here in East Sumba, the book“Kawan Sehat” is the only one available for children; there are no others.

Access to clean water is vital for human health

Access to clean water is vital for human health

This "Picture of the Day" shows young children's struggles in East Sumba. The jerry cans are heavy and sometimes more prominent than the children themselves. With limited access to drinking water sources, the kids who live there (here in these images in the villages of Kabanda, Mahu, Laindatang, and Tana Mbanas) are forced to walk long distances to fetch water. Water in rivers or wells which are also contaminated. It takes up a lot of their time and puts them at risk of injury or illness by carrying heavy loads of water. Lack of access to clean water also contributes to poor hygiene and sanitation practices, further compounding the health problems of those East Sumba communities where Kawan Baik and Fair Future work so hard. Together, we are taking action to improve access to clean water sources, in these areas where no roads lead, to ensure the health and well-being of young children and their families. In addition to the physical hardship of fetching water, and as explained in this post, children in rural areas of East Sumba are often deprived of education and other opportunities because of this task. It is widespread (like in this picture of the day) that they miss school or other activities to help collect water, which affects their academic progress and social development.

Here people mainly only have access to contaminated water. This leads to many diseases, including gastrointestinal infections, skin diseases, parasitic diseases and other infectious diseases such as Malaria, Dengue Fever, Cholera, typhoid fever, hepatitis A or diarrhoea. Children and the elderly are particularly vulnerable to illnesses caused by contaminated water, a significant cause of infant mortality here.

In conclusion, ensuring access to clean water through a program like the #waterconnections project is our top priority that cannot be overlooked. Access to clean water is essential to sustaining life and maintaining good health for everyone here. Water plays a vital role in preventing the spread of the diseases mentioned above, ensuring people can lead healthier lives. Whether for drinking, cooking or cleaning, clean water is essential for everyday life. Without access, communities in the ultra-rural areas of East Sumba suffer from a lack of sanitation and hygiene, leading to various health problems.

Therefore, we must do everything we can to ensure that clean water is available to everyone who needs it.

Let’s prevent malaria rather than cure it!

Let’s prevent malaria rather than cure it!

In this "Picture of the Day" shows you three children from Kabanda Village in East Sumba (read this post here), where the PMC program is in place. In this village, very far from everything, especially health centres, malaria is very active and wreaking havoc. We are talking about 80% of children under 12 are affected. It is, therefore, essential to prevent and train families. This is what we are doing here.

The daily observations concerning the causes of malaria are multiple here. These include, in particular, the lack of access to health care, information on prevention methods, the unavailability of health centres and sanitation, and the growing resistance to antimalarial drugs for regions with access to these treatments.

A reminder for all Kawans: Malaria is transmitted by female mosquitoes of the "Genus Anopheles", throughout the East Sumba region. These mosquitoes breed in standing water, such as rainwater storage tanks and open water sources, most of the time in rural and deprived areas of East Sumba.

As Fair Future has repeatedly seen and repeated for years, the consequences of malaria are serious if nothing is done to treat it: High fever, severe headache, nausea and vomiting. If not treated quickly, the disease can progress and lead to severe complications, including kidney failure, anaemia, seizures and death.

It is essential to train families and rural communities to protect themselves from this disease to reduce its transmission. Also, by learning how to prevent and treat Malaria, rural families and communities will reduce the economic and social burden of the disease. Malaria entails high costs for families and communities, particularly medical expenses (if they can access them), school absenteeism, and reduced productivity.

As we apply it with the Primary Medical Care Program (PMC), training families and rural communities to protect themselves from malaria contributes to strengthening the resilience of these populations in the face of epidemics of infectious diseases such as HIV, Tuberculosis, Gastroenteritis, cholera etc… 

Alexandre Wettstein from the Foundation’s Medico-Social Camp in East Sumba, Rumah Kambera, Lambanapu, on the 2nd of May 2023

Reduce health risks with clean water for families

Reduce health risks with clean water for families

In this "Picture of the Day" shows you what children do several times a day: Fetch water for the family with some 5-litre jerrycans. Most of the time, the young girls take care of this. Here in this photo, it is a young child of ten years. There are no daughters in the family. He does this job instead of going to school. He and his family have only two litres or less of water a day for eating, drinking, bathing and everything else.

Unfortunately, like here in Tana Mbanas (Sumba Tenggah), there is still a vast majority of villages in Sumba that do not have access to clean drinking water. In these villages, the inhabitants often depend on surface water sources such as rivers, lakes or ponds, which bacteria, viruses, chemicals or by animals and insects mostly contaminate. 

The lack of clean water has severe consequences for the health of the inhabitants. Waterborne diseases, such as diarrhoea, cholera and typhoid, hepatitis A, Malaria and Dengue fever, are common where access to clean water and toilets is limited or absent. These diseases can be severe and even fatal, especially in children, pregnant women and the elderly.

To help villages without clean water in Sumba, Fair Future and Kawan Baik are implementing effective measures to improve access to clean and healthy water. Our solutions include drilling deep wells with our equipment, construction of water treatment plants, storage tanks, rainwater harvesting and storage, and installation of water management systems—irrigation and construction of healthy sanitation facilities.

We are still seeking funding and technical resources to set up sustainable, safe and clean water infrastructure in this region, one of the world's poorest and most dry.

Alexandre Wettstein from the Foundation’s Medico-Social Camp in East Sumba, Rumah Kambera, Lambanapu, on Mai 1st, 2023.

Medical care for children affected by Malaria

Medical care for children affected by Malaria

In this "Picture of the Day", Fair Future and Kawan Baik medical teams provide medical care to a child most likely affected by Malaria. He is less than two years old and has a fever of 40.6. Her symptoms fit this diagnosis of Malaria. We give him appropriate primary medical care to reduce his fever as quickly as possible. Then he will go for treatment tomorrow at the nearest health centre, more than three hours from the village.

Malaria is a severe public health problem, especially in the ultra-rural and impoverished areas where Fair Future and Kawan Baik Foundations work so hard. Malaria is a life-threatening disease caused by the Plasmodium parasite is transmitted to humans through the bites of infected female Anopheles mosquitoes. Children under five and pregnant women are also particularly vulnerable to Malaria, as their immune systems are less developed and may have more difficulty fighting infection. People suffering from chronic illnesses are also vulnerable (HIV, Hepatitis, malnutrition, etc.)

Ultra-rural and poor areas such as East Sumba are particularly vulnerable to the spread of Malaria due to factors such as lack of water or contaminated water, deplorable housing conditions, lack of access to healthcare health and preventive measures, inadequate sanitation… Moreover, here we do not have antimalarial drugs nor rapid tests to detect the disease. This makes our treatment and prevention work very difficult.

Check Blood Pressure as part of the PMC program

Check Blood Pressure as part of the PMC program

This new "Picture of the Day" shows you Mama Katerina, from the village of Lapinu, who is learning to take blood pressure with Dr Aldo. She knows what a systole is or a diastole is and from when and under what conditions there is hyper or hypotension. She will also learn to give appropriate medical treatment (Captopril) for high blood pressure.

As part of the Primary Medical Care program, Katerina and eight other "Kawan Sehat" health workers participate in this unique pilot experience. These women teachers can measure a patient's blood pressure and give appropriate medical treatment in case of hypertension.

It is a social and medical revolution, in our opinion. The fight and prevention of hypertension and cardiovascular diseases are essential here in the ultra-rural regions of eastern Indonesia. To be active and efficient, our medical teams provide knowledge and equipment (manual blood pressure measuring device, stethoscope) in each pilot village. They are five out of the thirty-five in which the PMC project is implemented.

This, for example, has led us to talk about active and passive smoking. To make it clear, tobacco is dangerous for your health, and it is also the cause of high blood pressure and, consequently, strokes, heart attacks, respiratory problems and a host of other related diseases at the cigarette shop.