Apac has the highest rate of malaria in the entire world. But from here it gets difficult…

Unfortunately, it is true: Apac has the highest malaria infection rate on the globe. Ministry of Health officials estimate that each person on average receives 1,600 malaria infected bites every year! That is more than four infected mosquito bites every night.

The district administration keeps an eye on the frequency of malaria, by gathering data every week from health units in the 15 sub-counties of Apac district. When looking at this data, the figures seem unreal: In the dry months, January and February 2007, there were 10,920 and 11,952 registered cases, with almost half of these amongst the youngest, those aged four and below. Then the figures increase every month, peaking in August which had 47, 968 cases of malaria! Of those were 23,158 children under five years old.

Over twenty-three thousand small children suffered from malaria in August alone! And almost fifty-thousand people were ill with malaria in one month; that is roughly 10 per cent of the population. Every hour of the day in August, statistically speaking, 64 people living somewhere in Apac district were taken ill with malaria. (It is not difficult to eye an argument about a link between the economic poverty of Apac and her malaria frequency.) Those following this blog will know that August was particularly wet; the connection is that the parasite-carrying mosquitoes breed in water. An effect of the floods last year is likely to have been an increase in malaria, and in deaths from malaria.

The district’s bio-statistician, Jimmy Ogwal, says that “the majority of deaths [from malaria] take place within the communities, which are not reported”. He also says that malaria is “one of the major causes of maternal mortality within the district”. Despite the difficulties, the district did however record the passing away of nine under-five-year-olds during February, March and April alone.

The reason why there is so much malaria here in Apac is the prevalence of wetlands. A quarter of the district is papyrus swamps. We also have the river Nile at the border of the district, and Lake Kyoga and Lake Kwania. Water. Aplenty. Where mosquitoes breed. The wetlands, however, are far from a curse. They lead surplus water into rivers and lakes, thus preventing or minimising flooding. They keep the water levels in the lakes and river, and thereby the fish population and the fishing industry, healthy. And they are also important for the biodiversity of the country. If I had lost my last-born due to malaria, I could probably not care less about biodiversity, though.

So: it is certain that there are plenty of malaria parasites in the veins of people here in Apac. But now the malaria question gets much more complicated: The country, the district and a major international donor is rolling out a large-scale initiative to combat this deadly disease in Apac. The only problem is that it entails indoor spraying of all households with the controversial pesticide DDT…

Over the next weeks, the difficult debate about the use of DDT will be examined from many angles in this blog.

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