Hunting Malaria One Door at a Time
In a town in Ethiopia, a community health worker counters the disease through door-to-door visits
When someone falls sick with malaria in the small town of Dodota in Ethiopia, the first person everyone calls on is Tigist. Tigist meticulously shuffles through the thick notebook where she tracks the malaria cases in her small town. It’s as if not just the cases but the details of each malaria patient are etched in her memory.
Today, more than 53 million people in Ethiopia are still at risk for malaria. Despite the technological advances made against the disease, it continues to be an elusive killer. At the center of this fight between people, parasites, and mosquitoes are the heroic health workers of Ethiopia. These workers, like Tigist, brave the scorching sun most of the year and the heavy rainy season across tough terrains to deliver lifesaving medicines, tests, and mosquito nets. Others spend countless hours examining blood samples to find out about malaria’s evolutionary survival.
Dodota, a town of 96,000 inhabitants, lies in the Great Rift Valley in the western part of Ethiopia. The town’s entire population is at risk of getting sick or dying from malaria. In recent years, community health workers have taken matters into their own hands. With help from the USAID-led U.S. President’s Malaria Initiative (PMI), the town of Dodota is waging war on one of the world’s oldest and deadliest diseases.
Thanks to a PMI-supported training, part of Tigist’s job is to track the source of the malaria infection once a case is reported. With the help of community health workers and members of the community, she knocks on every door within a 70-meter radius to see if other people have symptoms of malaria infection. Like a skilled hunter, she searches for any standing water or holes that can serve as breeding grounds for malaria-carrying mosquitos.
Tigist lets out a long sigh as she explains how hard it was to go door to door and do house visits during the early days of the pandemic. She says that the first case of COVID-19 in the country was identified in her small town. This put additional pressure on her to make sure the local residents with a fever were tested and, based on their results, treated for malaria or followed COVID-19 safety protocols such as isolation.
“As a health worker, as scared as I was to hear about COVID-19, the only choice I had was to fight it head on,” she said.
Armed with her hand sanitizer and mask, she continued to test people who had a fever for both COVID-19 and malaria and educated them about safety practices like washing their hands frequently and maintaining social distance. She credits the hands-on training and weekly mentorship she receives from PMI to accelerating the decline in malaria cases in her town.
Despite challenges, Tigist explains how a strong sense of commitment to eliminating malaria is the most powerful unifying force to do the work every day consistently and tirelessly. Health workers like Tigist are a lifeline to remote villages and towns like Dodota, which has two health centers and where the nearest hospital is many hours drive away. Local health workers are a key component of the strong network of hospitals, health centers, health posts, health workers, and community that exists in Ethiopia, each element working in harmony, like a symphony.
Health workers also train members of the community called Women Development Armies, networks of women who are well-respected and influential in their communities. These women work with community health workers to identify sick patients, encourage community members to visit the nearest health center when they have symptoms of malaria, and promote sleeping under mosquito nets.
One of the key roles that members of the Women’s Development Armies play is encouraging pregnant women to seek prenatal care in a malaria-endemic area like Dodota. Pregnant women and children under 5 are most vulnerable to getting sick or dying from malaria. The World Health Organization estimates that almost 80 percent of deaths occur in children under the age of 5, especially in sub-Saharan Africa. Health workers in Dodota, as in other parts of Ethiopia, screen women and children for fevers and signs of malaria.
For Tigist, being a health worker is more than a job. She says that growing up she used to hear stories about how many of her family members died from malaria. That motivates her to keep going and to make sure that those stories stay in the past.
“Knowing that I am contributing to cutting back deaths and illness from malaria in my community gives me joy,” she said.
Today, thanks to the meticulous follow-up and dedication of health workers like Tigist, the number of reported malaria cases each year in Dodota has decreased from more than 1,000 in 2014 to less than 100 in 2021. According to a malaria expert, Jemal Mohammed, lead trainer for the health workers, death due to malaria is becoming a thing of the past in this small town. What used to be one of the most malaria-infested towns is leading the march towards elimination, setting an example for the rest of the country.
About the Author
Ayida Abate is a Communications Advisor with the U.S. President’s Malaria Initiative (PMI) which is led by USAID and co-implemented by the U.S. Centers of Disease Control and Prevention. Each year, 700 million people across 27 partner country programs benefit from PMI’s collaboration and work.
