MSF Begins Malaria Program in Ebola-Ravaged Monrovia, Liberia

Armelle Loiseau/MSF

PARIS/NEW YORK—In order to address a deeply troubling but little-known consequence of the Ebola outbreak in West Africa, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) has begun distributing antimalarial medicines in Monrovia, Liberia, a crucial medical intervention in a city where the basic health care system has collapsed in recent months.

Malaria is endemic in Liberia but due to the incredible demand of the Ebola outbreak on the medical system, basic health care such as malaria treatment is now very difficult, if not impossible, to find in Monrovia. MSF’s program is designed to both prevent and treat new malaria cases, and to minimize the number of people with malaria at Ebola treatment centers.

“The first symptoms of malaria are the same as those of Ebola,” says Dr. Chibuzo Okonta, MSF’s deputy director of emergency programs. “They include fever, headache, and overwhelming fatigue. The antimalarial medicines treat and prevent the disease. The objective is also to eliminate the risk that patients with fever, suspected of having Ebola, will end up in Ebola treatment centers in contact with infected persons.”

MSF’s teams began distributing antimalarials in the western part of Liberia’s capital city on October 25, with the goal of reaching 300,000 people in all. This treatment—artesunate and amodiaquine—is intended for children over the age of six months and adults alike. The medicine is taken for several days for three months.

The distribution is taking place in the poorest neighborhoods, where population density is very high and where access to care, which was already very limited before the Ebola epidemic, barely exists any longer. It will be repeated the next two months at the same locations, with the same treatment and mosquito nets.

By October 29, 20,000 families—100,000 people—living in the New Kru neighborhood had already received one treatment.

Before the distribution, volunteers who live in the neighborhood and who are trained by MSF visit families to explain how the distribution works. They give each family a ticket indicating the number of people living in the same room, which will authorize them to obtain the drugs. A female family member comes to the distribution site to pick up a packet that contains the treatments.

Given the backdrop of Ebola, vigilance is essential. To protect both the population and health care workers against the risk of infection, the distribution takes place early in the morning, when the streets are still empty. Participants keep their distance from each other to avoid any physical contact. The operation is divided among 55 sites.

After each distribution, the MSF-trained volunteers ensure that the message has gotten through, going door-to-door to confirm that all family members have taken the drugs even if they are not ill, because the treatment both cures and prevents the illness.

*** Local Caption *** On October 25, MSF started a distribution of anti-malaria treatment in Monrovia to 300,000 persons, adults and children above 6 months. The distribution targets in Monrovia the poorest and highly densely populated areas where access to health care is very limited due to the collapse of the health system caused by the Ebola crisis. The objective is to eliminate malaria and to keep families from entering Ebola centres and becoming contaminated. Three rounds of distribution, one per month, are planned.
Armelle Loiseau/MSF