The "Malaria Coordination Meeting Between Bordering Countries of
the Eastern Mediterranean and African Regions' was held in Sanaa during
27-29 July. Organized by the Ministry of Health in cooperation with WHO,
the meeting was concluded with a number of recommendations.
Participants
from Yemen, Sudan, Djibouti, Somalia and Eritrea suggested that a comprehensive
plan should be adopted to monitor the malaria epidemic, a joint political
policy should be formulated by the governments of the countries concerned
to eradicate this disease as well as calling on the WHO to provide the
necessary funds, medicines and training facilities.
A paper Prepared and presented by Dr. Mohammed Saeed Amer, Director
of the National Malaria Control Program (NMCP) at the Ministry of Health,
indicated the following:
Malaria Situation in Yemen:
* About 60% of the total population live
in endemic malaria areas (at risk all through the year).
* 20% in areas were malaria is seasonal.
* 20% in malaria-free areas or slightly
affected by the disease.
* It is estimated that 1,500,000 malaria
cases occurred annually. Fatality rate is more than 1% of total cases,
mostly among children under the age of 5 and also pregnant women.
* More than 90% of the total malaria cases
were due to plas. Falci, the remaining 10% is divided between PL. Malaria
and PL. VIVAX 7-3% accordingly.
* The main malaria vector is A. Arabiansis
followed by A, cuilicficasis mainly in Socotra Island and the eastern part
of the country.
There is a great need for entomological studies to determine the roles
of A. Costani, A. Sergenti, A. Detheli and A. Multicular.
* Generally speaking, malaria in Yemen
is characterized as an Afro tropical type.
Status of Malaria Control:
During the past few years (1994-1997) the NMCP was plagued by many difficulties
which affected its control measures in general and the vector control in
particular. This led to an increase in malaria cases due to epidemics occurring
here and there, and now and then.
The main difficulties are:
* Lack of transportation, (only 6 old vehicles
in service for the whole country).
* Inadequate support and finance.
* Lack of administration connections between
the Sanaa HQ and the primary units at governorate levels.
* High turnover of technical and trained
personnel.
* In this year, 1998, the anti-malaria
activities were upgraded in 8 governorates as a first step to be followed
by 6 other governorates during the 4th quarter of this year.
* During the past 2 months, the NMCP received
8 new cars, drugs, spraying equipment, laboratory equipment and supplies
from WHO, and 20 tons of DDT WDP 75% gift from the Sultanate of Oman.
* 396 persons will be trained locally for
different controlling methods, such as microscopical diagnosis, entomology,
treatment of severe cases, data analysis, etc. Training will take place
in Sanaa, Aden, and Hodeida. Another 15 persons will be trained abroad.
Malaria Control Strategy in Yemen
The malaria control strategy in Yemen is planned according to the 4 technical elements of the global malaria control strategy. The recommendations of the regional malaria adviser are as follows:
* Early diagnosis and prompt treatment.
* Selective and sustainable prevention.
* Control of epidemics.
* Applied researches.
Taking into account the implementation conditions leading to success control:
* Political commitment.
* Malaria control is an integral part of
the health systems.
* Resource mobilization.
Dr. A.V Kondrachine, Chief Medical Officer, Malaria Control, Division of Control of Tropical Diseases, WHO, Geneva:
The objectives of this meeting are to exchange information between the neighboring countries, share the same philosophy of malaria control, make recommendations as to the development of their respective national malaria control plans, and to make recommendations as to how to proceed with coordination efforts.
There is one particular most important type of malaria, the so-called
Afro Tropical. Yemen and the rest of this territory is plagued by this
particular type of malaria.
WHO has assisted this country as well as other countries in terms of
support and finances to control malaria. The most important thing about
this meeting is that it was the government of Yemen who had demonstrated
very high political commitment to control malaria. This is very much appreciated.
But it is not only political commitment the government of Yemen made. It
was also a financially demonstrated support to the malaria control program,
in terms of personnel, equipment and support from other sectors.
I was very pleased during the first. It was not only the Minister of
Public Health who attended but also the Minister of Agriculture. However,
I would be more pleased to see the administrators who are responsible for
those areas as forestries, fisheries, etc. These departments are also very
important in contributing to different aspects of malaria and the implementations
of the activities of malaria control.
The attendance of the Minister of Education, for example, is particularly
important. It is the children who fall victims to malaria and they are
the best communicators to their families. They can share the information
on the causes of malaria, the appropriate methods of control, etc. I would
like this to be the concern of the government of Yemen.
We had been very pleased to see the health service staff very much aware
of malaria. They know how to treat people, so they appreciate the magnitude
of malaria. The government of Yemen has provided drugs practically to all
the areas affected by malaria epidemics.
Unfortunately there is no laboratory for diagnosis. But nevertheless
in spite of these, the health personnel are very well trained to deal with
the clinical diagnosis of malaria. Fortunately now because of this awareness,
there is no severe cases of malaria.
There is still a long way to go. It takes time and much effort. The second thing I would like to mention is that the organization of this meeting was superb. I was extremely pleased to see the honorable ministers and I must congratulate my Yemeni colleagues on organizing this meeting and of course the malaria control program. There is a long way to go, but the start is very optimistic.
Ismail Al-Ghabiry,
Yemen Times
At the
Expanded Program on Immunization (EPI) center a training course was held
from July 16 to August 4. It is meant for training some people working
in the field of health on how to use the solar-powered refrigerators to
keep vaccines in good potency. There are 12 students from different governorates.
This new cold chain system will help very much, especially in remote places.
Mr. Mohammed Ali Kulais, the director of the EPI center said
that the 20 solar-powered refrigerators will be installed in around 15
districts in different governerates in Yemen. "We really do thank the
Japanese government for providing the center with this new system. We also
thank the UNICEF and WHO for supporting our program.
This
system will help us very much in integrating hepatitis B vaccine to routine
immunization soon, which will be launched in September 26," he said.
Mr. Tawfiq Qaid Abdullah, the director of the Cold Chain Mentainence said that the new system will save a lot of money since the previous refrigerators worked by gas. This means one gas cylinder cost around YR 800 in far off regions. This system will focus on the far off and populated regions. " We have installed two refrigerators in Sanaa and two in Dhamar. And in the coming few day we will do the same in Taiz, Lahj and Abyan" he said.
Mr. Jo Gwillim, a trainer from the UK, said: "We supplied the UNICEF with this system, and a part of the contract is to come and show people how to install the fridges properly. It is necessary that people operating these equipment should be fully acquianted with them. Now we are training 12 students. The program is going very well. We are very interested and pleased to train them since they are learning very quickly. I gave such a course to students in other countries but they were not learning as quickly as these students."
By Mohammed Hatem Al-Qadhi,
Assistant Managing Editor,
Yemen Times
