In sub-Saharan Africa, where malaria kills as many as 10,000 preg­nant women and 200,000 unborn chil­dren each year, World Vision is work­ing to raise aware­ness and com­bat the spread of this pre­ventable dis­ease.
June 2009
By Andrea Peer and Jessie Lester, World Vision U.S.

Esper­ance, 18, has her health mon­i­tored by Hyacinth Umhoza, a nurse at Kigeme Hos­pi­tal in Rwanda. Malaria still poses hid­den risks for this young mother and her unborn child.
Photo ©2009 Andrea Peer/World Vision

At 18 years old, Esper­ance con­tracted malaria for the first time. “It started on Tues­day,” she explains. “I had no appetite and a ter­ri­ble headache. I was also cough­ing and felt nau­seous, like I wanted to vomit. I couldn’t eat,” she says.

High risk for malaria

Esper­ance grew up in the moun­tains of Rwanda, where tem­per­a­tures were not warm enough to host the anophe­les mos­quito that car­ries the malaria par­a­site. When she mar­ried and moved to a warmer region, Esper­ance was exposed to the dis­ease for the first time. “Near my new home there is a river and bushes. A lot of mos­qui­toes come and bite us. That’s why I believe I am suf­fer­ing from malaria,” she says.

Four days after her fever began, Esper­ance slipped into a coma, and her hus­band of seven months car­ried her on foot to Rwanda’s Kigeme Hos­pi­tal, one hour away.

Because she had never con­tracted malaria, Esperance’s body had no immu­nity to the dis­ease, mak­ing her risk extremely high. And if that wasn’t fright­en­ing enough, this young woman’s bout with the ill­ness came at the worst pos­si­ble time — four months into her first pregnancy.

A mir­a­cle

Hyacinth Umhoza, a nurse at Kigeme Hos­pi­tal, acknowl­edges that the risk of malaria is much greater for women who are preg­nant. “Their immune system[s] [are] weak­ened because they are feed­ing two bod­ies, so vit­a­mins and min­er­als go to two peo­ple. Any dis­ease can attack both of them,” she explains.

At the hos­pi­tal, Esper­ance received three rounds of intra­venous ther­apy, which finally brought her out of the coma. “When you get some­one who is uncon­scious and you bring them back, it is a mir­a­cle,” says Hyacinth. “Esper­ance has recov­ered. It seems that God is behind this,” she adds.

A pre­ventable disease

Help pro­vide malaria pre­ven­tion train­ing and tools to those at great­est risk from this deadly dis­ease, like Esper­ance and her unborn child.

While Hyacinth is grate­ful that her patient recov­ered, she is also aware that young moth­ers like Esper­ance do not have to suf­fer this dis­ease at all. “Malaria is a seri­ous prob­lem, but yet it is a dis­ease that is pre­ventable,” she says.

In coun­tries like Rwanda, World Vision is work­ing to reduce the num­ber of malaria infec­tions by dis­trib­ut­ing long-lasting insecticide-treated bed nets and pro­vid­ing pre­ven­tion edu­ca­tion. For moth­ers like Esper­ance, these sim­ple mea­sures can mean the dif­fer­ence between life and death, both for them and their unborn children.

Addi­tional concerns

Though Esper­ance made it through the most crit­i­cal stage of malaria, her wor­ries were far from over. “Not only could I lose my child, but even my life was in dan­ger,” she said.

Even when a mother is not show­ing symp­toms, malaria’s hid­den activ­ity poses a huge threat. Malaria can reduce the mother’s red blood cells, lead­ing to ane­mia, and even death. Addi­tion­ally, the malaria par­a­site can spread to the pla­centa, caus­ing ane­mia and low birth weight in new­born babies. It can also lead to spon­ta­neous abortions.

Esper­ance sits in a hos­pi­tal bed recov­er­ing from malaria. Inex­pen­sive bed nets, like the ones hang­ing behind her, could have pre­vented this expec­tant mother from con­tract­ing the dis­ease.
Photo ©2009 Andrea Peer/World Vision

Esperance’s par­tic­u­larly severe bout with malaria caused great con­cern. “We are keep­ing her because we want to check the child in the womb. The higher risk is that the child could be affected because the mother lost con­scious­ness. The risk is the baby inside dying,” said Hyacinth, a few days after Esper­ance recov­ered from the coma.

Over­com­ing malaria

But when Esper­ance received an ultra­sound, her worst fears were stilled. Her baby was alive, evi­denced by a healthy heart­beat. Though the risk of low birth weight and ane­mia remain, Esper­ance is con­fi­dent that before long, she will be back in the hos­pi­tal for a much more joy­ous event — the birth of her first baby. “When I see him come out, I will praise the Lord,” she says.

Unfor­tu­nately, because pre­ven­tion and treat­ment tools are not always read­ily avail­able to those who need them most, many moth­ers in sub-Saharan Africa lose the bat­tle with malaria. In addi­tion to bed net dis­tri­b­u­tion and pre­ven­tion edu­ca­tion, World Vision is work­ing to pro­vide treat­ment for preg­nant moth­ers, anti-malarial drugs, and case man­age­ment and refer­rals for malaria patients.

World Vision is work­ing in 64 coun­tries where malaria is a threat, includ­ing 24 in sub-Saharan Africa. In 2008, we launched a major ini­tia­tive to sig­nif­i­cantly reduce the ill­ness and death caused by malaria. This involves advo­cat­ing for an increase in U.S. gov­ern­ment fund­ing that will allow a scale-up of exist­ing anti-malaria pro­grams and enhance the efforts of the global move­ment to com­bat this deadly but treat­able and pre­ventable disease.

“We can be the impe­tus for mak­ing sto­ries like those of Esper­ance a thing of the past,” says Craig Jag­gers, World Vision’s health and edu­ca­tion pol­icy adviser. “By rais­ing aware­ness of the dis­ease in our com­mu­ni­ties, donat­ing to malaria cam­paigns, and advo­cat­ing that Con­gress ful­fill its promises to pro­vide $5 bil­lion over five years for malaria pro­grams, we are lit­er­ally help­ing save lives.”