Although Misleading, This is NOT an Article about Ebola

While Ebola hysteria has died down a bit on the international stage, I thought I’d take a minute to add to the growing amount of smug people who think they know a thing or two about tropical diseases. Ebola is scary- mainly because it conjures up a lot of Indiana-Jones-style face melting images, where people just erupt into bloody, bursting puddles. The air itself seems to spur on some unstoppable, apocalyptic plague. Hazmat suits don’t help anyone think more rationally, either- if you want to scare a suburban housewife to death, pull out a hazmat suit. Yes, all of that adds up to some intense panic. Truth be told, it is a terrible and deadly affliction for the more than 25,000 people who have been diagnosed with the disease since the start of the outbreak in West Africa (CDC, 2015), but it’s nothing quite as violent as the images we create in our minds. And, unfortunately, it takes much of the spotlight away from the diseases that kill the most people. For many countries in West Africa, the outbreak has been devastating but that damage doesn't just lie in simple disease burden. As it turns out, the deeply felt impact of the outbreaks in Sierra Leone, Liberia and Guinea can be seen in the funneling of aid from areas of greatest mortality like malaria and HIV to the more publicized Ebola. Health officials now fear increases in Malaria, Measles, and HIV rates (among many other diseases) due to the siphoning of aid money and staffing from hard fought eradication programs. For instance, in 2014, a mass malaria net distribution campaign in Liberia was suspended along with health facility closures (as a result of stigma and transferred staff) as well as the suspension of malaria diagnostic tests, due to the frenzy surrounding the deadly but far less frequent Ebola. (For a short but informative article on the subject click here.

It’s shocking, but the diseases that do the most damage are the ones that don’t catch a lot of air time on the 24 hour news cycle. Can you imagine if headlines actually reflected the more common deadly diseases around the world?

“Poop kills 2,082 children today. Our analysts call poop the everyday 9/11.” (WHO, 2013)

“Wearing condoms correctly and consistently, could have saved over 14 million people from life-threatening diseases this year, but didn't. The world shrugs and keeps having sex.”(CDC, 2015)

“Tiny pelvis: Friend or foe?”

“Washing your hands, paisley jean shorts and other great tips for the everyday fashionista”

“Cooking: Asthma’s greatest ally in the war on women”

“Corn comprised 90% of a Zambian child’s diet today. 3 white people were concerned.”

“3.2 billion people at risk of a disease everyone kind-of-thinks-maybe-might-actually-be eradicated.” (WHO, 2014)

Can you guess what that last one refers to? If you guessed the true heavy weight of tropical disease burden- malaria, then you would be correct. And, yes, that statistic is correct. 3.2 billion people- that’s billion with a “b”- are at risk of acquiring malaria each and every year. If we are just to compare raw numbers, 10,477 people have died from Ebola since the outbreak began but each year an estimated 584,000 people will die from malaria. If you want that said another way: 

malaria = Ebola x 55.

It is one of the oldest diseases in the world. It killed Genghis Khan. Think about that for a second. The Jin Dynasty couldn't kill him. Mulan couldn't kill him (and she had a dragon). It took an assassin the size of a grain of rice to take down arguably the greatest conqueror in human history.

This parasite has accompanied our species throughout history, transmitted by the tiny winged vector that has plagued every back yard dinner party since the dawn of time- the mosquito. And, not just any mosquito, the Anopheles mosquito. Why is that important, one might ask? Because that is the only type of mosquito that carries Malaria and it only feeds at night. Night, as you might realize, is a very vulnerable time for us humans. We can’t see very well in the dark and we are often sleeping during the time most of these insects are out taking their nightly meal. BUT, it also means that simple lifestyle changes such as sleeping under a mosquito net can save thousands of lives (but we’ll come back to treatment and prevention in just a bit).

The part of the world I am currently in, has the most to fear from this silent killer. 90% of malaria deaths occur, here, in Sub-Saharan Africa. Most deaths occur in children under the age of 5- to be more shocking, a child dies every 60 seconds from Malaria (that’s one baby every minute- whoa). Zambia considers it such a pervasive issue that the government has its own department devoted to handling this ancient, deadly disease. In Zambia, malaria is responsible for 45% of all hospitalizations, 40% of all under 5 deaths, and 20% of maternal mortality. If severe malaria doesn’t kill you, it can leave you in a coma or effect brain function for the rest of your life (severe cases have even been known to drop IQ points in children).

I don’t want to be responsible for another vast mischaracterization of a disease, either. While these numbers might send you screaming indoors and swearing off the Dark Continent altogether, most people, here, are not that concerned by it. It is “Africa’s common cold” as one counterpart phrased it. At every malaria talk I give, I usually start out with the question- “who here has or knows someone who has had malaria?” Without fail, nearly every hand gets raised. The problem is that most people are misdiagnosing themselves daily giving a very serious disease, a very toothless reputation. Every sneeze, every cough (both of which are not actual symptoms) are erroneously attributed to malaria, taking away much of the fear that should be associated with the disease. But, truth be told, a great many Zambians have had the disease at one time or another and lived to tell the tale. Thus, prevention becomes an afterthought in the hierarchy of things that are pressing in most people’s lives even though there is a very real chance that it will kill someone close to them.

As part of Malaria month (April) and World Malaria Day, Peace Corps Volunteers around the world take part in raising awareness about the disease. We often work in areas with the greatest burden and spread health messages to anyone who will listen. These tasks include health talks that support early diagnosis and treatment, behavioral changes like wearing long clothing, sleeping under a bug net, and eliminating standing water (Anopheles mosquitoes breed in clean, standing water). These changes often have cultural components that pose the greatest challenge to eradication such as not taking all prescribed medication, having the primary bread winner (i.e. mostly men) sleep under nets- leaving the most vulnerable (i.e. children and pregnant women) out in the open, among many others. While health talks and community campaigns are important, many volunteers also hope to raise more awareness among individuals at home who are indirectly and sometimes directly responsible for donor funding of malaria eradication campaigns around the world. The more you know… and all that. So, the next time you see an eye catching headline, take a minute to think about the ones you may not be seeing because they may actually be impacting the most people. Happy Easter and Happy Malaria Month from Zambia!

Want more facts about malaria and other underwhelming deadly diseases? Of course you do!

WHO- 10 facts about malaria

WHO- Diarrheal Diseases

HIV/AIDS in Zambia