Chad: Alarming increase in malaria, MSF launches response

ALT Prosper Ndumuraro/MSFHalima Ibrahim, a woman in her late forties, and her eight-year-old daughter, Salimata Ali, who was treated by MSF for malaria.  

Médecins Sans Frontières (MSF) has launched an emergency intervention in southeast Chad to respond to an alarming escalation in malaria cases. Since the beginning of August, MSF has seen a drastic jump in malaria at its long-term project in Am Timan, Salamat region, where malaria has accounted for more than 80 per cent of consultations. Many of the severest cases are being seen in children under the age of five. At its outreach sites, MSF teams say 73 per cent of all patients they are treating are also suffering from the mosquito-borne disease.

“The goal of our emergency response is to improve the early diagnosis and treatment of non-severe malaria and to improve the management of severe and complicated forms of the disease,” says Jason Mills, MSF head of mission in Chad. “Many people who live outside the town of Am Timan have limited access to healthcare. The majority of those who are dying of malaria right now are dying in their homes.”

Number of cases jumps ten-fold

In response, MSF has sent an emergency medical team to respond to the situation. The team is supporting local health centres with malaria diagnostic tests and treatment supplies, training Ministry of Health staff and strengthening epidemiological surveillance. Since the emergency intervention began the number of malaria cases MSF staff have seen has jumped ten-fold. At the end of the first week of August teams reported 1, 228 new malaria cases and by end of the month MSF teams were reporting more than 14,021 new cases of malaria in August alone.

"While malaria is endemic in Chad, the rate of infections this year is beyond all forecasts," says Cristina Mach, MSF medical coordinator in Chad. “Existing diagnosis and treatment supplies in the country are severely strained."

MSF treats patients, distributes mosquito nets for prevention

In addition, MSF has also increased its capacity to treat severe malaria cases at the hospital in Am Timan town by erecting a malaria treatment tent within the hospital compound where uncomplicated cases can be admitted for treatment and observation on a daily basis. To date,within a two weeks period, more than 1,400 patients have been treated in the tent. MSF is also planning to distribute mosquito nets to households in affected areas and to conduct a public education campaign.

“Several weeks ago my eight-year old daughter Salimata Ali started to shiver and complained of a headache. We took her to a local healer who gave her tablets, but she continued to shiver and couldn’t speak properly,” says her mother, Halima Ibrahim.  “The next day the head of my village came to our compound with doctors from MSF. They tested her and then gave her medication and three days later she was a lot better. Without MSF, Salimata would have died, like so many other children in our village.”

MSF plans to carry out its emergency response to the malaria outbreak in Am Timan town and surrounding areas until the end of the rainy season, in late November.

Halima Ibrahim, a woman in her late forties, describes what happened to her eight-year-old daughter, Salimata Ali.

“Everything started in the month of July. Many people in our village were attacked by a strange spirit that made them shiver and act in a crazy way. Almost all the families were touched! The health educators said this was malaria and advised us to go to the hospital, but the closest is in Am Timan, about 50 kilometres away. It is very difficult to get there and people don’t have money to make the trip. Many people just died in their homes and we were all afraid. The government has built a health centre in our village, but there is no nurse and it stays closed.

My daughter Salimata started to shiver about a week ago, she also complained of a headache and pain in her joints. We prayed but the sickness remained and increased. I then decided to take her to the “choukou” doctor (local healer) who gave her two tablets. The following day, Salimata’s headache was better, but she was still shivering and unable to speak properly. It is then that the “chef de village” came to our compound accompanied by doctors from MSF. They tested Salimata to see if she had malaria. They showed me a machine with two red bars in the middle and told me this meant malaria was in Salimata! They gave me medication to give her for three days and now my daughter is looking much better.  She still can’t eat well but her condition has improved, it’s a miracle!

I am a widow, I don’t have much. Without MSF, Salimata would have died, like so many other children in our village.”