Malaria in Indonesia is a significant public health risk, especially during the rainy season.

Although cases have decreased since 2010, the current situation sees an upsurge in malaria cases linked to the country’s economic crisis and the critical lack of access to primary medical care.

What is Malaria?

Malaria is a severe 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. Malaria can cause serious health problems such as seizures, brain damage, difficulty breathing, and organ failure if left untreated. Malaria is often referred to as the epidemic of the p, or. At the same time, 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!

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. Malaria can rarely move 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 crisis of the country and the crucial lack of access to primary medical care.

In 2020, 256,000 cases of Malaria were recorded in Indonesia. This figure should nevertheless be taken conditional because, in many regions of the country, people do not have an identity card or family record book or 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 area or through testimonies from villagers.

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 in the medical field areas.

A challenge simply because medical resources are rare, health centres are too far from the villages. People do not own vehicles; the roads are often difficult to navigate. Most of the time, the truck is the only way to get to a health centre, 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 in Indonesia: Malaria is estimated to cost millions of dollars annually in Indonesia’s gross domestic product (GDP). 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 severe constraint on economic development;

The direct costs of Malaria (but also of other diseases such as starvation issues, tuberculosis, the Covid-19 pandemic, AIDS, and other childhood diseases such as asthma linked to 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;

The indirect costs of Malaria are also widely felt as worker productivity declines with increasing sick leave, absenteeism, and premature labour mortality. For many, the period of malaria transmission coincides with the planting season, further reducing agricultural productivity.

Local issues related to water: Mosquitoes breed in dirty or standing water, particularly abundant during the rainy season here in East Sumba. In principle, to combat malaria, the insect’s natural breeding ground must be eliminated. Insecticide spraying and drying up standing water sources are strategies used to control mosquito breeding. The problem is that water here in East Sumba is very scarce, and families often store it in several thousand litres of retention tanks. (ref. Water Connections project and Deep drillings wells project)

Pregnancy, preconception and breastfeeding: Malaria in pregnant women can be more severe 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 precarious life in terms of health, access to water, lack of quality food, and lack or absence of medical care and information.

How do we treat malaria and related difficulties? All malarial infections are severe and should be treated as a medical emergency. In offering advice on the choice of antimalarial drugs, the main concern is to protect against Plasmodium falciparum malaria, the most dangerous and often fatal form of the disease.

The disease is relatively easy to treat if drugs are available, but access to the most effective therapies remains very low. Here in Indonesia, the current problem is that the medical teams do not have drugs against malaria. The treatments needed to treat infected people are not available. And in rare cases, when they are, they are prohibitively expensive.

Malaria in East Sumba, Indonesia