Will Malaria strike back | Daily News

Will Malaria strike back

As we mark World Malaria Day today, the satisfying feeling that malaria has been completely eliminated may create a false sense of security in our minds. We should not forget the devastation that the scourge of malaria generated in the past which resulted in abandoning of villages and a massive death toll.

History reveals that over an 80 year period from 1930 to 2010 malaria had raised its ugly head several times challenging the medical and political authorities to take various steps to eradicate the menace. Up to now, measures taken have been successful in stopping the tiny insect from wreaking havoc - spreading disease and death. Hence a shivering patient with high fever has become a rare occurrence even in remote hospitals.

But can we hold onto a sense of complacency

According to history of malaria in Sri Lanka, the most damaging epidemic occurred during 1934-35, with its beginning at Alawwa, and also resulting in 80,000 deaths. Due to the organised malaria control efforts such as the establishment of the malaria control unit, distribution of anti-malarial drug quinine and the spraying of Dichloro-Diphenyl-Trichloroethane (DDT) to control the vector mosquito Anopheles Culicifacies, the incidence of malaria showed a marked decline.

It also may have provided the background and confidence to initiate the malaria eradication programme launched in 1958. Due to a reasonably well-controlled malaria situation and infrastructure facilities existing in the country there was no evidence of active transmission of malaria in those areas.

Hence spaying of DDT was not considered as a requirement. As one reputed journalist commented, by the early '60s malaria became a “forgotten disease” and medical students studied about malaria without seeing a single patient.

Within months of halting the spraying of DDT in 1963, the appearance of new cases of malaria prompted the resumption of spraying in the affected areas. The number of malaria cases continued to increase in the following years with the vector density with over half a million cases of malaria reported in 1966.

The disease with drug-resistant Anopheles Vivax entered the Sri Lanka health arena with a vengeance. The second epidemic swept the country in 1967-68 but although the resistance to drugs was a problem, the resulting fatalities were not as bad as during the 1934-35 epidemic.

Despite initial successes, the malaria incidence continued to rise in the 1980s. The efforts to control the disease faced a new challenge when chloroquine resistant Plasmodium Falciarum strains were detected in newly constructed dams built to promote agriculture. As a result, new vector breeding pools were created.

Again the dreadful upheavals in the North and East due to the 1983-2009 war between the government and the LTTE was instrumental in the breakdown of malaria control and treatment. Accordingly a serious malaria epidemic afflicted those areas from about 1991, reaching a peak in 1998-1999 before beginning to subside.

These several upsurges in the incidence of malarial cases show that whenever a feeling of complacency occurs the malarial vector appears in the scene with the resistant power. But due to the scientific findings on the nature of the disease, its method of infection and remedies found after the discovery of the bacteriological modes of its transmission, the country was able to face the malaria threat successfully.

In addition to the strategies of prevention and control of malaria such as quinine treatment, DDT spraying, prevention of stagnant pools of water, destruction of mosquitoes and their breeding places, setting up malaria centres and health education efforts too helped to bring down the numbers of malaria incidence.

The contributions of agencies such as the World Health Organisation and the IDA/ World Bank which included malaria mobile clinics were useful in treating the malarial victims in remote areas.

In the battle against this deadly enemy a key role was played by the public, voluntary organisations and national figures in providing relief to the affected villages. Especially during the 1934-35 great epidemic the All Ceylon Buddhist Congress under L.H.Mettananda and the Suriya Mal Movement led by Philip Gunewardena, Dr. N.M. Perera and Dr. S.A. Wickramasinghe were able to awaken the country towards implementing more people-oriented measures to the well-being of the common man with regard to the health issues.


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