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Bad Blood

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The Anopheles gambiae mosquito
                   
In Africa, Malaria Kills A Million Children A Year. So What's The Remedy? New Drug Cocktails? Free Bed Nets? Community Education? A Breakthrough Vaccine? A Return To DDT? Or All Of The Above?

Only three of the 20-odd beds at Mbita District Hospital are occupied. This surprises me. After all, we are in the heart of an impoverished, malaria-ravaged region, on the shores of Lake Victoria along Kenya's remote western border. When I ask a medical assistant if it's unusual for the ward to be so sparsely populated, he laughs grimly. "In two or three weeks we will have several patients to a bed, with more on the floor," he explains. "We'll be turning people away." Here's why: malaria infections can occur any day of the year, but surge outbreaks are cyclical, the disease blooming lushly in the wake of a rainy season. It's late June now, and the winter rains are just about spent. Roads, fields, and footpaths are strewn with puddles large and small, ideal breeding sites for the Anopheles gambiae mosquito, malaria's endlessly regenerating delivery system. 

Just beyond the hospital walls, battalions of Anopheles gambiae  larvae were incubating in their warm, clear, sun-drenched baths. Upon maturity each mosquito, weighing in at a strapping 2.25 millionths of a pound, would fly off in search of sugar, the metabolic fuel provided by certain plants; and then, thus fortified, the female would move on to extract her blood meal, the protein feast that primes her to reproduce. In a matter of days, new malaria patients would begin streaming into the hospital, by foot or in wheelbarrows or splayed across the backs of donkeys, but mostly cradled in their mothers' arms. The immature immune systems of babies and toddlers are particularly vulnerable to the disease, and in this region cerebral malaria -- the deadliest variant, marked by seizures and coma -- is endemic.

Silver bullet, anyone? Vaccine, larvicide, insecticide, bed net, hex? Why should this disease, eradicated in the lucky zones of the world, continue to flourish elsewhere, in unlucky places like Mbita?

David Soti, the hospital's medical director, shook my hand briskly, unsmiling. Our meeting was a brief formality to secure permission to tour the hospital. I was with Hortance Manda, an entomologist investigating plant and mosquito interactions. She works nearby at the Mbita campus of ICIPE, a research facility headquartered in the capital, Nairobi, that, among other things, pursues methods for managing insect-borne disease in environmentally neutral ways. (The name was formerly the International Center for Insect Physiology and Ecology, but it's now known as African Insect Science for Food and Health.) Recently Manda's work had involved malaria patients at the hospital. Soti nodded at her. "Very nice research: What is the mosquito? What does it eat? When? Why? Good. But I don't want to know the mosquito," he shrugged. "I want to kill it. DDT would kill it." He muttered this last point under his breath. ICIPE opposes the reintroduction of the pesticide DDT in the fight against malaria, and Kenyan law forbids its use under any circumstances. But Soti, apparently, would deploy the insecticide in a heartbeat.

He is not alone. Dichloro-diphenyl-trichloroethane has made a comeback. In Kenya, throughout Africa, in malarial regions around the globe, and perhaps most vociferously in certain pockets of the pundit-happy West, scientists, policy makers, and commentators are revisiting the merits and demerits of the iconic neurotoxin. Few would advocate a return to the strategies used in DDT's heyday in the United States, when crop dusters unloaded blizzards of the chemical--675,000 tons from the 1940s through the 1960s -- to control agricultural pests. But some argue that the judicious application of DDT is precisely what's needed to loosen malaria's death grip, particularly in sub-Saharan Africa. 

Enter Patrick Sawa, head doctor at the St. Jude's medical clinic on the ICIPE campus in Mbita, less than a mile from the district hospital. I caught up with Sawa in a supply room, the only semi-quiet spot at a facility swarming with patients and activity. Word had got out that the clinic would be waiving its usual nominal fee while a group of visiting American doctors were in place, and patients -- many with confirmed or suspected malaria--had arrived in droves.

I asked Sawa about the DDT option. "It's the wrong approach, an act of desperation," he said, gesturing toward the clinic's densely packed waiting area. "Desperate times, desperate measures?" I offered. His answer was immediate: "Not when the measures make matters worse."

There you have it. Two Kenyan doctors, working in the same grievously malarial and medically underserved outpost, each with a very different take on the role DDT might play in reducing the burden of the disease. 
Related Tags: malaria, africa, DDT, kenya, Kim Larsen
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Kim Larsen is a Brooklyn-based freelance writer. Her work has appeared in Discover, the Village Voice, and other publications.

As impossible as it may seem, given the millions of dollars spent on malaria research without any results, a humble scientist stumbled upon an effective cure for malaria about ten years ago. The ingredient for the cure is a common one, sodium chlorite, which is cheaply available throughout the world.

Jim Humble (aerospace engineer as well as inventor of the automatic garage door opener), discovered and tested the formulation while working in a malaria infested mining area in South America. He went on to verify 100% cures in thousands of cases in Africa.

Rather than collect earnings from his discovery, Jim has striven to freely publicize this cure throughout the world. His website is http://www.miraclemineral.org/ . Anyone in a malaria stricken location can easily test the remedy and verify for themselves its effectiveness. No doubt those with vested interests in continuing the flow of money into fruitless malaria research will strive to hide or ridicule this cure but its formula is now open for the whole world to benefit. Anyone with malaria (or other parasites) has nothing to lose by trying it since it's perfectly harmless to the body.

As a former Peace Corps volunteer in Central Africa, I'm glad to see that malaria is getting the attention from Western researchers that has been long overdue. I've been interested in the DDT question particularly, because it seemed, at least until I read this article, that environmentalists in the developed world were deciding what was best for people they'd never seen or lived among, and whose struggles they had no concept of. I stand corrected on the merits of DDT, but I still wonder whether the solutions proposed have as much validity as all that, given the circumstances I witnessed. For instance, the bed nets I used (and those I saw) would have been useless among most of the general population. They were suspended from poles stuck into a bed frame and tucked under the mattress. But most African homes I saw had no mattresses, no bed frames, and no bed poles. They were huts with packed dirt floors, and people slept on straw mats. Granted, much may have changed in thirty years, but unless the nets come in different designs, I'd doubt that they'd be worth much in that country. Similarly, the author of this article talks of ponds stocked with tilapia, and how wonderful they'd be, and if we only spent a fraction of the money on keeping the ponds that we spend on malaria R&D or development, we'd get somewhere. Maybe, but my Peace Corps buddies who taught African farmers to create ponds and raise tilapia in them--and whom I admired because I thought their work more important than mine, which was teaching English--told me that after they left the country, the ponds quickly fell into disuse. Finally, the author of this article speaks about the necessity of eradicating places where mosquitoes breed. That's all well and good, and my hat off to anyone who does it. But when every tire mark on a road leaves a rut where rainwater can gather, it's not so easy as that. I got a lesson in this my first year in-country when I decided I'd raise an avocado plant in an empty can on my window sill. Avocadoes were plentiful, the plants were pretty, and I liked the idea of greenery in my house. Within two days, I abandoned the project; the mosquitoes were landing and taking off from that can of water like planes at a busy airport.
I don't mean to sound defeatist; there's no choice about doing what you can. Only it's not so simple, which may explain why DDT seems like an attractive option to the people who are struggling with the alternatives.

As a Kenyan working on Malaria, I throw my weight behind DDT. The disadvantages of DDT have just been politicized and many 'quack' researchers have continued to earn fat salaries at the expense of a dead child, every 30 sec! Its the high time we face the reality. Malaria is a disease of the poor BUT the poor have not been involved in decision making when it comes to what they may support as the best measure to control malaria. While the poor may not have the most informed answers, the 'educated' has used this chance to expand their knowledge on malaria through research, with no impact to disease transmission. We have enough tools to fight the disease, but politics and influence from the west under the guise of doing 'sophisticated' research has thwarted such efforts. The poor will continue to be 'guinea pigs', and suffer more as the rich undermine the effectiveness of DDT for malaria control. I am suprised that the GoK may see ease in having nuclear waste dumped into our country much better than having DDT for mosquito control. How many people will die if we spray tons of DDT in our land? Maybe < 100/year which is statistically far much significantly less than 2/min due to malaria! Lets get serious!
kamanikiole@yahoo.com

Kick Malaria Out (HMO) 2009 West Africa
Contributing to achievement of malaria free Africa

Host: Volunteer Partnerships for West Africa

Campaign KMO outreach will run for two weeks by the combined volunteers as part of a month long KMO campaign by VPWA and it grass root partners through out the following countries: Togo, Benin, Nigeria, Ghana, Ivory Coast, & Liberia.

Campaign KMO will start in Ghana with Volunteers from all over the world, including professionals from all fields, students etc. Volunteers will receive a training, conducted by VPWA’s Executive Director, to facilitate cultural understanding and to teach Volunteers how to address each community i.e. community customs, habits, etc. Volunteers will then be divided into two groups (Volunteer Group A & Group B). A Volunteer Team Leader will be assigned for each group of volunteers.

Between 20th August 2009 and September 3rd 2009, Volunteer Group A will travel to the countries east of Ghana i.e. Togo, Benin and Nigeria. Volunteer Group B will travel to the countries West of Ghana i.e. Ivory Coast and Liberia. VPWA partner organizations in these countries, will be awaiting the arrival of VPWA volunteer groups to facilitate any community needs. Each group will:

Conduct community workshops on Malaria by disseminating people-friendly statistical information on the spread of Malaria and providing preventative measures to prevent being infected by the disease

Conduct clean-up training exercises designed to show communities how to prevent and clear water stagnation which is the breeding source of mosquitoes and caused by a) uneven floor b) clogged drains c) poor gradient of gutters and drains. e) rain accumulation f)overflows g)leakages from pipes h)roof gutters chocked with leaves or silt i)misalignment of rainwater downpipes with elbow joint, resulting in blockages. j) Collected water in discarded receptacles.

For more information please visit http://www.vpwa.org/kick-malaria-out-2009-campaign

Phone: 233243340112
Email: kmo2009@vpwa.org

We are asking every citizen of this planet to support our campaign in any ways that you can. Please contact us.