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Medical assistance related to Malaria in Indonesia

It kills a child every 30 seconds, and some 3 million people a year - the large majority in the poorest countries!

Malaria in Indonesia, a major public health risk

Although the cases have decreased since 2010, the current situation sees an upsurge in cases of malaria, linked to the economic situation of the country and the crucial lack of access to basic medical care.

Extract | Risk is present throughout the country, excluding urban areas, and excluding the areas specified: Jakarta, Surabaya, Denpasar (Bali), and other large cities are risk-free, including the beach resorts in southern Bali. Sporadic cases of malaria in travelers have been reported from rural areas of Java, Bali (Padangbai area), Bintan, and Lombok islands. The WHO data does not take into account the situation in eastern Indonesia, which is linked to the lack of existing data. Nevertheless, malaria in the regions of Flores, Sumba Timur, and Kupang is important in rural villages...

*Malaria is a life-threatening disease, that spreads when an infected mosquito, bites a person. The mosquito transfers parasites into that person’s bloodstream.

Symptoms of malaria include fever and shaking chills. Malaria is common in tropical countries such as Africa and Asia. Malaria is treatable if it’s caught early.

What is malaria?

Malaria is a serious disease that spreads when an infected mosquito bites a human. Tiny parasites can infect mosquitoes. When it bites, the mosquito injects malaria parasites into the person’s bloodstream.
*What type of mosquito cause Malaria?

If left untreated, malaria can cause serious health problems such as seizures, brain damage, difficulty breathing, organ failure and death. Malaria is often referred to as the epidemic of the poor while the disease is largely determined primarily by climate and ecology, and not by poverty per se, the impact of malaria wreaks havoc on the poorest, those who can least afford preventive measures and medical treatment.

The impact of malaria is not only felt in terms of human suffering and deaths caused by the disease, but also in terms of the economic impact on areas with high rates.

Malaria is a devastating disease with some 40 percent of the world’s population in 107 countries at risk today. It kills a child every 2 minutes, and some 410’000 people a year – the large majority in the poorest countries!

How common is malaria?

Malaria is common in tropical areas where it’s hot and humid. Worldwide, more than 230 million people get malaria annually, the majority of these cases occur in Africa and South Asia.

What causes malaria?

People get malaria when an infected *mosquito bites them. A *mosquito becomes infected by biting someone who has malaria. The infected mosquito transfers a parasite into a person’s bloodstream, where the parasites multiply. Five types of malaria parasites can infect humans.

In rare cases, pregnant women with malaria can transfer the disease to their children before or during birth. Very rarely, malaria can transfer through blood transfusions, organ donations, and hypodermic needles.

“Malaria and poverty are intimately connected. As both a root cause and a consequence of poverty, malaria is most intractable for the poorest countries and communities in the world that face a vicious cycle of poverty and ill health”. –  Fair Future Foundation

Fair Future and Malaria

Although the cases have decreased since 2010, the current situation sees an upsurge in cases of malaria, linked to the economic situation of the country and the crucial lack of access to basic medical care.

In 2020, 256,000 cases of malaria were recorded in Indonesia. This figure should nevertheless be taken in the conditional because in a large number of regions of the country, people do not have an identity card or family record book, or people do not have access to medical care. Mortality, for example in the eastern regions, is still high: Fair Future can regularly notice this during medical visits to the outskirts of the region, or through testimonies from villagers. It should be noted that Alex Wettstein, founder of the Foundation and member of the medical team on site, can attest to this since he himself caught malaria on the island of Flores.

So far, there are still challenges to be overcome as the most worrying challenge is how to reduce the number of cases of active or passive malaria, such as the distribution of mosquito nets and the strengthening of human resource capacities of the medical field areas.

We also note that in some endemic areas people think that malaria is a common disease. And although malaria can be prevented and treated, it can also lead to death. Therefore, the concept of how to prevent this disease from occurring in the community is a challenge for all of us on the ground, today but especially tomorrow.

A challenge simply because medical resources are rare, health centers too far from the villages. People do not own vehicles, the roads are often difficult to navigate. The truck is most of the time the only way to get to a health center, at the cost of a difficult trip, if not impossible for a person suffering from malaria. Read about the “Truck of Life” program here.

The economic cost of malaria on countries

Malaria can be an economic disaster. Countries with high malaria transmission have historically had lower economic growth than countries without malaria. Countries that succeeded in reducing malaria showed substantial growth and improved prosperity thereafter;
  • Malaria is estimated to cost millions of dollars in the gross domestic product (GDP) in Indonesia every year. Illness slows economic growth due to loss of life and lower productivity – this is what economists call a “growth penalty”. When it is repeated from year to year, it constitutes a serious constraint on economic development;
  • The direct costs of malaria (but also of other diseases such as starvation issues, tuberculosis, Covid-19 pandemic, AIDS, and other childhood diseases such as asthma linked to the air pollution in Indonesia), include high public expenditure to try to maintain the health facilities and infrastructure, manage effective malaria control campaigns and provide public education;
  • For countries with a high malaria burden, the disease can account for up to 40 percent of public health expenditure, with malaria accounting for up to 50 percent of outpatient visits;
  • The indirect costs of malaria are also widely felt as worker productivity declines with increasing sick leave, absenteeism, and premature labor mortality. For many, the period of malaria transmission coincides with the planting season, further reducing agricultural productivity.


How is malaria treated?

Treatment for malaria should start as soon as possible. To treat malaria, your provider will prescribe drugs to kill the malaria parasite. Some parasites are resistant to malaria drugs. The type of medication and length of treatment depend on which parasite is causing your symptoms.

All malaria infections are serious illnesses and must be treated as a medical emergency. In offering guidance on the choice of antimalarial drugs, the main concern is to provide protection against **Plasmodium falciparum malaria, the most dangerous and often fatal form of the illness.

Atovaquone-proguanil Brand names: Malarone, Malanil and others; generics available.
TAKE 1 TABLET DAILY (ATOVAQUONE 250 mg + PROGUANIL 100 mg).

START 1-2 DAYS BEFORE ENTERING THE MALARIOUS AREA, CONTINUE DAILY DURING YOUR STAY AND CONTINUE FOR 7 DAYS AFTER LEAVING.

Note: Take at the same time every day with food or milk.

Doxycycline Brand names: Vibramycin and others; generics available.
TAKE 1 TABLET DAILY OF 100 mg.

START 1 DAY BEFORE ENTERING THE MALARIOUS AREA, CONTINUE DAILY DURING YOUR STAY AND CONTINUE FOR 4 WEEKS AFTER LEAVING.

Note: When taking this drug, avoid exposure to direct sunlight and use sunscreen with protection against long-range ultraviolet radiation (UVA) to minimize the risk of photosensitive reaction. Take with large amounts of water to prevent esophageal and stomach irritation.

Mefloquine hydrochloride Brand names: Lariam, Mephaquin, Mefliam and others; generics available.
TAKE 1 TABLET OF 250 mg (228 mg base) ONCE A WEEK.

START 1-2 WEEKS BEFORE ENTERING THE MALARIOUS AREA, CONTINUE WEEKLY DURING YOUR STAY AND CONTINUE FOR 4 WEEKS AFTER LEAVING.

Note: Side effects include nausea and headache, including neurological side effects such as dizziness, ringing of the ears, and loss of balance. Psychiatric side effects include anxiety, depression, mistrustfulness, and hallucinations. Neurological side effects can occur any time during use and can last for long periods of time or become permanent even after the drug is stopped. Seek medical advice if any neurological or psychiatric side effects occur.

For further details, cautions, contraindications, or alternatives, including guidelines for pediatric dosages and Emergency Self Treatment, download our whitepaper

How to Protect Yourself Against Malaria.

The recommendations for malaria prophylaxis outlined here are intended as guidelines only and may differ according to where you live, your health status, age, destination, trip itinerary, type of travel, and length of stay. Seek further advice from your physician or travel health clinic for the malaria prophylactic regimen most appropriate to your needs.

If I get malaria, will I have it for the rest of my life?

No, not necessarily. Malaria can be treated. If the right drugs are used, people with malaria can be cured and all malaria parasites can be cleared from their bodies. However, the disease can continue if left untreated or if treated with the wrong medication.

Some drugs are not effective because the parasite is resistant to them. Some people with malaria can be treated with the right medicine.

Two species of parasites, ***Plasmodium vivax and ****P. ovale, have liver stages and can stay in the body for years without causing disease. If left untreated, these liver stages can reactivate and cause malaria attacks (“relapses”) after months or years without symptoms. People diagnosed with P. vivax or P. ovale are often given a second medication to help prevent these relapses. Another type of malaria, P. malariae, if left untreated, is known to stay in some people’s blood for decades.

Pregnancy, preconception and breastfeeding

Malaria in pregnant women can be more serious than in non-pregnant women. Malaria can increase the risk of serious pregnancy problems, including prematurity, miscarriages and stillbirths. This phenomenon is exacerbated in the regions where Fair Future works, as people live a precarious life in terms of health, access to water, lack of quality food, lack or absence of medical care and information.

Lexicon

* Usually, people get malaria by being bitten by an infective female Anopheles mosquito. Only Anopheles mosquitoes can transmit malaria and they must have been infected through a previous blood meal taken from an infected person. When a mosquito bites an infected person, a small amount of blood is taken in which contains microscopic malaria parasites. About 1 week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.
** Plasmodium malariae is a parasitic protozoan that causes malaria in humans. It is one of several species of Plasmodium parasites that infect other organisms as pathogens, also including Plasmodium falciparum and Plasmodium vivax, responsible for the most malarial infections.
*** Plasmodium vivax is a protozoal parasite and a human pathogen. This parasite is the most frequent and widely distributed cause of recurring malaria.
**** Plasmodium ovale is a species of parasitic protozoa that causes tertian malaria in humans. It is one of several species of Plasmodium parasites that infect humans including Plasmodium falciparum and Plasmodium vivax which are responsible for most malarial infection.
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One of the Foundation's tasks is to ensure equitable access to water in quantity and quality, in order to prevent diseases such as cholera, diarrhea, dysentery, hepatitis A, typhoid, and poliomyelitis. With, for children and vulnerable people, a high mortality rate., and maintain lives and livelihoods. This is to reduce environmental risks to health, by managing sanitation safely and with dignity. Still, the foundation seeks to involve women and men in the management of water resources, in sanitation by the implementation of safe hygiene practices in order to maximize the benefits for their communities.

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After building a new school, bigger, stronger, with materials resistant to storms, bad weather, earthquakes, Fair Future and Kawan Baik, as part of the program, we named “Rebuild MbinuDita “, continue to provide basic things for the lives of thousands of people there.

The program “Rebuild MbinuDita” is to give access to clean water to all the inhabitants of the community, but also to medical care, to healthy food through the creation of organic gardens. These activities have no other objectives than to increase the quality of their life, to provide better health to people (especially children, vulnerable people, pregnant women), access to health and medical care, and for people to be able to increase their income.

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Antimicrobial resistances. What happens when drugs stop working?

Bacteria, viruses, parasites, and other microbes are constantly changing to ensure their survival, we have seen this with variants of influenza, COVID-10, etc. Some have adapted so well to medical treatment that the drugs commonly used for preventing or killing them are no longer effective. These microbes cause drug-resistant infections. Their ability to survive the drugs used against them is called antimicrobial resistance (AMR). In the case of bacterial pathogens, for which antibiotics are the most common and important drugs available for treatment, this is called antibiotic resistance (ABR). We mustn’t wait until it’s too late to tackle this major health challenge.

Massive pest attacks that destroy all crops and starve the people

In East Sumba, for several days now, grasshoppers have been destroying all crops, vegetable gardens, soybeans, and corn. For three years, it has come back regularly. During high population years, they feed and severely damage almost all crops, trees, shrubs, and vegetable gardens. We are in contact with the most affected populations who tell us how the fruit of their work, their fields But also their garden, are totally destroyed in a few minutes. The impact is enormous for these poor families since their income is not enough to buy food. Rice in particular is expensive, therefore corn harvests are very important and vital for families. A new trade is in the process of being born: The sale of grasshoppers by the kilo; this is in order to eat and be nourished. The price is IDR. 5,000,000.- per kilo, i.e. less than 50 cents.

Fair Future and Kawan Baik change the nature of water

Clean water is life, health, food, leisure, energy… Water covers more than 70% of the Earth’s surface. It is in water that life on Earth began, so it is not surprising that all living things on our blue planet need water. Water is indeed many things: it is a vital need, a home, a local and global resource, a transport corridor, a climate regulator. And, over the past two centuries, it has become the end of the journey for many pollutants released into nature and a newly discovered mine rich in minerals to exploit. To continue enjoying the benefits of clean water and healthy oceans and rivers, we must fundamentally change the way we use and treat water.

There will always be people who live too far away, we are here to help them!

There are no toilets here, everyone practices open defecation. Furthermore, no one has direct access to water of any kind, and no access to a source of clean, drinkable water. Fair Future and Kawan Baik Foundations are changing that with the #waterconnections program, but there will always be people who live even further than far. We meet those people, all those families that we don’t forget. Thanks to all of you and our teams who are there, on the ground at the time of writing this line, they will also have access to one of our solutions, a borehole, a reservoir connected to the network…

Water is when we don’t have it that we realise how important it is!

Water we do not realize how important it is when we have access to it like that, by opening a simple tap and sometimes forgetting to close it. Water is when we don’t have it that we realize how important it is, how vital it is for our everyday life. So for a moment, let’s try to imagine what our life could be like without water. And if we have access to it, that this water is not consumable! This is what the families experience here, the children of all these villages in which Fair Future works almost 24 hours a day. The health of people, the prevention of diseases, the reduction of infant mortality, offering a better quality of life, food every day, a shower every day and for everyone are just a few aspects that oblige us to work and develop. innovative and sustainable solutions, relating to access to water in quantity and quality for families in the poorest and rural regions.

Magic works, construction continues, people are happy, there is water!

Having clean water close to home is a real challenge that Fair Future and Kawan Baik have taken on, so that the more than 2,200 villagers of Mbinudita can have clean water in their homes for the first time in their lives. This is so that everyone’s life is healthier, happier on all fronts, clearly more harmonious. Even if it is very hard physically, sometimes morally because we are isolated from everything and everyone, there is not a day during which we are not happy to be able to work within the framework of this immense project, one of the largest ever conducted by the Swiss foundation and its Indonesian twin sister, Kawan Baik Indonesia foundation.

Without or with very little water and food, it is very difficult to go to school!

Go to school, learn, concentrate, walk… All this with little water and food! This is the challenge faced by thousands of kids, their teachers and families. Not having enough water when you are a child, sometimes having to walk several kilometres to get to school. Not having enough to eat, not being able to wash. The difficulties of the teachers, their testimonies are revealing of the food, economic and access to water crisis which the children and their families have to face every day of their lives. Fair Future and Kawan Baik try to respond in the best possible way to these vital problems. Avoid malnutrition, improve health, provide access to a source of clean water so that children can go to school and learn in the best possible conditions.

Lifestyle habits: “-Because we’ve been doing it for a long time”

Pollution of streams and natural springs and everywhere. It is rare to find still pure sources whose water is not dangerous for health. Fair Future, within the framework of its prevention programs and access to better health, meets people from the most rural and poor regions of this immense country, offers affordable, simple and understandable solutions for all. At the same time, we are building clean water networks, we are drilling deep wells to provide access to quality water, in quantity, to families, children and vulnerable people.

The Water Crisis in Indonesia – Focus in Napu, Wunga, Sumba Timur

Drinking contaminated water can lead to serious health problems. Cholera, diarrhoea, dysentery, hepatitis A, typhoid, scabies, onchocerciasis, schistosomiasis, trachoma, typhoid and paratyphoid fevers, hepatitis, malnutrition and poliomyelitis, significant metabolic fatigue causing disorders of all vital systems, to death.
In the long term, consumption of water loaded with heavy metals, pesticides, nitrates and other chemical components such as arsenic are likely to cause serious congenital malformations in newborns: Limb deformation, hydro-encephalitis and other physical or mental disabilities.

Water Connections, the ongoing project on the MbinuDita Site

Where are we with MbinuDita’s Water Connections project? What are the funds that we have already collected, those that we have already invested in this vital project like never before for more than 2000 people without access to clean water? We present to you via a small infographic what we have already done, what remains to be done and the schedule for the next steps.

Common diseases we work on

Tuberculosis in Indonesia: A social disease affects the poorest communities, those living in difficult conditions. There are hundreds of thousands of new cases in Indonesia, such as HIV, which is not often mentioned here!

Dengue virus infection: DENV is a real major cause of acute febrile illness here. In the most affected regions, mortality is very high & affects the most vulnerable. Especially for those who do not have access to medical care.

Malaria and the vulnerable: Every year, malaria kills thousands of people in Indonesia, in all regions, even the richest. 70% of all deaths are children under five, and affect people and families who cannot access medical care.

Antimicrobial resistances. In here, this is a real health emergency, almost all drugs are available over the counter! This scourge turns simple wounds and easily treatable diseases into causes of death.

Air pollution and health: Plastic that burns, everywhere! Air pollution is responsible for almost 50% of mortality here. Dioxins, furans, mercury, and polychlorinated biphenyls are highly toxic!

Malnutrition and famine: Malnutrition causes serious illnesses where we are! The phenomenon, creating a vicious cycle of starvation & disease. This is a major problem in which we deal with!

Medical care for children: Far too many children still die from easily preventable problems, especially in their first few days/weeks of life, as well as from diarrhea and pneumonia. Access to clean water and good sanitation solutions is one of the future goals to help them get better.

And about the Dengue fever?

Quick facts about Malaria

Click to open it

FFF Base Camp NTT, East Sumba

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