Sabrina Bakeera-Kitaka is a member of the decision-making framework team for the introduction of the malaria vaccine in Uganda and on the Global Alliance on Vaccines and Immunization Civil Society Steering Committee. The opinions expressed are her own.
Musawo omwana wange affa!’….(Doctor,my child is dying)
This is not an uncommon sentence when you are the doctor on call in the Acute Care Unit of Mulago Hospital.
It is a sound that beats any triage system, a call you must heed when you hear, and address the family’s concerns and try to save the child -- but this time it was not to be, malaria had claimed yet another child.
Mulago National Referral Hospital is ten minutes away from the City Center of Kampala in Uganda. It is the main teaching hospital for the Makerere University College of Health Sciences; the oldest of its kind in Africa!
It was this sentence that I heard late Thursday evening on December 20, 2011, five days before Christmas day, when the shortage of blood for transfusion is most severe, and a time when you wished desperately that you did not hear such a cry for help, because it implies fear, and desperation, invariably to remain unmet.
The mother, in her mid-twenties with an anxious look on her face carried in her arms a lifeless, two year old boy. The child’s father, following closely behind, held a referral note and with the anguish written all over his face narrated the story.
They had been referred two days ago from a hospital over 120 miles (193 kilometres) away because the child needed a blood transfusion and he had had to look for funds for transportation.
They had travelled for nearly 8 hours, but unfortunately the child had passed away during the transit.
On examination, he was extremely pale, cold clammy fingers, no breathing sound, no active heartbeat. His pupils were fixed and dilated.
He had passed away quietly, in his mother’s arms many hours before they reached the referral hospital. Another loss to malaria. A sad loss to the family. A loss to the nation.
Many questions went through my mind: How to tell the child’s parents? How will they travel back home? How can this sad scenario be avoided in future?
The truth is that malaria can be prevented. And malaria can be treated and cured.
A lot of efforts have been channeled into sensitizing the public on the use of insecticide treated nets, and residual in door spraying.
A lot more efforts need to be put into raising public awareness on case diagnoses which will enable rapid and appropriate treatment of malaria. In addition, families need to recognize the complications of malaria, such as cerebral malaria, and severe anemia.
We need to find a lasting solution to various stock outs, in this case the stock out of blood for transfusions.
Families like this also desperately await a time when the malaria vaccine will be developed and introduced into the Expanded Programme for Immunization saving many more children from death.
The theme for World Malaria Day 2012 - Sustain Gains, Save Lives: Invest in Malaria - marks a decisive juncture in the history of malaria control.
Whether the malaria map will keep shrinking, as it has in the past decade, or be reclaimed by the malaria parasites, depends, to a great extent, on the resources that will be invested in control efforts over the next few years.