Nathalie Muñoz Tord, ICBL-CMC
Today is World Malaria Day. Malaria is carried by mosquitoes and transmitted by parasites, a “vector-borne disease” that causes an estimated 660,000 deaths each year and about 219 million cases of sickness, according to the WHO , sometimes resulting in disability.
Recent research points to the very serious effects malaria can have for people affected by war-injuries and specifically for mine survivors. It has been highlighted as one more serious challenges that survivors face. Both malaria and landmines are hidden killers, and both affect the most vulnerable, sometimes even in combination.
In areas where there is a high incidence of Malaria, people often develop a partial immunity to it. They become infected without enduring any of the symptoms and are carriers of the disease.
About 40% of the world’s population is threatened by malaria and most people concerned live in the poorest regions. The most affected regions and countries are often also where the incidence of landmine and other war injuries are the highest. According to the estimates of the World Malaria Report, the vast majority of cases were in the African Region followed by the South-East Asia and Eastern Mediterranean Regions. In those endemic areas, malaria is a common post-injury complication.
Thus, malaria is a serious problem for patients with war injuries: nearly a third of them become afflicted with the disease. Yet another factor for mine survivors is that, due to the landmine accident, or any other time they sustain injuries that need surgical treatment, their immune system will be weakened and will cause resurgence of the symptoms of malaria (severe anaemia, respiratory distress, fever, and more) in carriers with no previous symptoms. The severity of the injury and the duration of the surgery will increase the risks of complication.
This leads to additional problems for survivors such as secondary infections of wounds, longer hospitalization times and increased psychological distress. Landmines are more often found in fields and farmlands, as are the mosquitoes that carry the disease, which means that many of the people who are affected are farmers who live in countries where malaria and war injuries are recognized causes of illness and death. They are particularly vulnerable to the increased economic burdens and the loss of income due to being unable to work and the additional cost of hospitalization.
The lack of necessary health services and adequate medical infrastructures and limited resources in regions where those landmine incidents, crossed with malaria infection, occur make it difficult for survivors to access the rehabilitation and the care they need. In some countries field ambulances or even vehicles are not available, making transportation to a care facility doubly challenging.
The great impact that malaria has in mine and ERW affected countries should not be understated. It also shows that survivors require better access to medical care for many reasons of which we may not always be aware. Awareness should be raised about this lesser known issue so that service providers can be better equipped to address survivors’ needs in the immediate and long-term, particularly in countries encountering high levels of malaria.