Retrieved From 2012: My Story on Fight Against Malaria in Sabang

Stamping out Malaria in Sabang
Arie Rukmantara, Contributor, Sabang, Aceh | Wed, 06/13/2012 11:44 AM

It is that time of the year again when the world’s population is reminded that we are still in for a prolonged fight to conquer malaria, a disease that still haunts millions of people in the country and in other parts of the world. 


Since the time of the Roman Empire, the Anopheles mosquito, carrier of malaria, has hunted the world’s population. And despite ever-progressing technology and health advances, we are still struggling to curb the deadly disease. 

In Indonesia alone, the Health Ministry says some 80 percent of regencies and municipalities are malaria-endemic areas, with 45 percent of populations living in those areas. Malaria-endemic sites frequently house remote villages with poor health conditions and inadequate healthcare services, places such as Papua and West Papua.

However, history has taught us a great deal not only about losses and defeats but also victories and achievements. Let’s take a moment to appreciate some of the out-of-the-box initiatives that have been taken by fellow public health advocates. 

The people of Sabang, the country’s westernmost city, have been collectively fighting malaria. The Health Ministry says the more than the 120-year-old city is on the right track to soon declare itself a “malaria free zone”. 

The city administration is upbeat that Sabang will be malaria-free by 2013.

Sabang has picked up their effort to battle malaria since 2008, including distributing insecticide-laced mosquito nets, clean-up drives at places suspected to be breeding grounds for mosquitoes, and also fogging when necessary. 

And, now, they have come out with a fresh and promising attempt at battling the Anopheles — the parasite hunt. The Sabang initiative attempts to seek out people with malaria by deploying dozens of people, locally dubbed Juru Malaria Lingkungan (JML), to carry out mass blood tests. Hundreds of health workers and JML are being deployed to get blood samples from the city population of some 30,000. 

The measure has been welcomed by both city officials and residents. 

A senior official at the city’s development and planning board, Thomas Pahlevi, said the initiative was an example of grueling collective work that did not happen overnight. 

The strategy to eliminate malaria was formulated in phases. In 2008, the city, along with, among others the Health Ministry and UNICEF, targeted an improved capacity for all health workers deployed to fight malaria.

More effective case tracking and rapid malaria detection brought about changes as people became more aware of the importance of getting their ailments detected and reported so they could get proper treatment. Thanks to more qualified human resources, the city health agency became more responsive and active in handling malaria cases. 

“The impact was immediately felt because we had spiking numbers of cases. We detected those who had malaria but had not reported their ailments,” Thomas said. 

Having seen progress, the city refused to fall into complacency as they moved forward and onward with new strategies. In 2009, it promoted a new strategy of involving more stakeholders.

The coordination was deemed important because the city administration found a missing link in its previous strategy, realizing responsibility did not only lie on the shoulders of health agency officials. Key to prevention was very much in the hands of the public as malaria’s spread was influenced by non-medical issues like hygienic water access, mosquito breeding grounds and the speed of a case being reported and treated. 

The public works agency was involved in repairing water drainage to ensure mosquitoes did not use them as breeding places. The education agency was involved in educating teachers to convey preventive measures to their students in class. 

The People’s Empowerment Body was tasked to recruit and train the JMLs. A total of 80 recruits were assigned to scour villages in their respective neighborhoods to detect and report people suspected of having malaria. 

UNICEF malaria elimination specialist Herdiana said the JML were all concerned residents. They live in neighborhoods and know each and everyone so they can get quick information if a neighbor is sick and has malaria symptoms. 

One JML, Dahlia, said she literally went door to door to make sure she got the most accurate data. 

“I go door to door every week because we never know what will happen unless we do it regularly,” said the woman who is in her 20s. 

Mass blood screening was used to analyze the type of parasite and the possible spread of malaria in the city. The result would help elimination efforts become more targeted and focused, said Herdiana.

A mother of a 3-year-old daughter, Fatimah said she had a blood sample taken last year and so did her daughter, Rifa Nazira. 

“I was actually terrified and couldn’t bear the thought of my blood being taken,” she said. 

Even so, Fatimah said she was relieved that she decided to get her and her daughter’s blood tested. 

“As a mother, I really wanted to know if my daughter was fine and not infected by malaria,” she added. 
Fatimah made her point as health experts said malaria symptoms manifested differently from one person to another. Some could feel the symptoms immediately and others showed no symptoms for long periods. 

Although it has been considered effective, blood screening is not the only arsenal that Sabang has utilized to put an end to malaria. Other measures, like distributing insecticide-laced mosquito nets to expecting mothers and toddlers, are still conducted as well as entomology workshops. 

“We still have time to meet the target. And we will do everything in our power to destroy malaria, once and for all,” proclaimed Thomas.

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