January 30, 2013

A network of volunteer community health agents set up by MSF is helping tackle malaria in remote areas of Guinea.

In Guinea, Doctors Without Borders/Médecins Sans Frontières (MSF) has set up a network of community health agents as part of its strategy to tackle malaria. These volunteers are committed to working for the well-being of their communities.

André Millimouno is a builder by trade, but in September 2010 this cheerful 44-year-old gave up his job to become a community health agent in the area MSF supports. He is part of a team of 47 agents who help manage malaria in their communities in Guéckédou, in Guinea’s remote Guinée Forestière region.

This morning, André has come to the village of Kat-Kama, located 15 kilometers [nine miles] from the nearest health post. In the small central square, a crowd of villagers has gathered under a tree. They know that André has come to give them information about malaria, carry out tests, and treat those suffering from the disease. His t-shirt bears a simple message: “Community health agents are committed to fighting malaria.”

“Today I want to talk to you about mosquito nets and explain how best to use them to protect yourselves and your children against malaria,” André begins. After 20 minutes of explanations to the villagers, André asks if there are any sick people in the village.

A mother and her two children come forward, soon followed by others. Delba Mara’s two daughters are feverish. André takes their temperatures: the thermometer reads 37.8°C for one and 38.5°C for the other. He then puts on his latex gloves and takes a drop of blood from the tip of each girl’s finger, which he transfers to a small plastic slide—a rapid diagnostic test for malaria.

Some 15 minutes later the diagnosis is confirmed for the two little girls. Next, André gives their mother some ASAQ tablets, an artemisinin-based drug which is very effective against malaria. He explains how to administer the tablets and the importance of completing the full course of treatment: one tablet a day for three days.

After three hours in the village, André has diagnosed malaria and distributed drugs to eight other people, most of them children under five years old. However, André cannot treat all malaria cases. When the disease is detected in a child less than two months old, a pregnant woman, or a patient with signs of severe malaria, André refers them quickly to the nearest health post.

“Since I became a community health agent, I have had no time to work as a builder,” says André, who is also a father of eight. “The sick people in my community really need me, and that takes up a lot of my time, but it’s a personal commitment.”

Like the other community health agents in this area of Guéckédou, André is looked after by the community, who excuse him from work duties in the fields and give him a few dozen kilos of rice from each harvest. Without the involvement of the community, his work would not be possible. “When a village agrees to support and help its community agent, it is deciding to play an active part in its health, improving the likelihood that the project will continue once MSF has left,” explains Philippe Latour, MSF’s field coordinator in Guéckédou.

Innovative Strategies to Fight Malaria

“We set up this system of community health agents to treat simple malaria cases within the community,” says Jeannette Pedersen, an MSF nurse in charge of community outreach activities. “Here, not only are the villages often far from health facilities, but the roads are bad and people don’t have the means to travel.”

“Our aim is to see these strategies taken up throughout Guinea,” says Charles Gaudry, MSF’s head of mission in Guinea. “We’re optimistic that we will succeed. For example, the Minister of Health and his partners are already setting up a system of community health agents to treat simple malaria in other parts of the country, based on MSF’s experience in Guéckédou.”

In 2012, some 77,000 cases of malaria were treated in the health facilities supported by MSF in the Guéckédou region; 23,000 of them were handled by community health agents like André, each prepared to go the extra mile to keep their communities healthy.