Thursday, 6 November 2014

“The bed net saves my life”

By Ermi Ndoen - Health (Malaria/EPID) Officer

 Sumba Island, Indonesia, October 2014 - Martinus Lende Walu (48) counts himself lucky. Once he could have died from malaria, like two of his neighbours, but he survived. Since then he decided to not take a chance and to stay safe with the help of an insecticide-treated bed net (ITN).

His village Langgar Kampong is one of the many remarkable “stone-age” villages on Sumba Island, in Indonesia’s East Nusa Tenggara (NTT) province. It is home to some 200 people who live in 13 big traditional houses that surround megalithic tombs, each tomb belonging to a group of families. 

Travellers are drawn to Sumba Island for the houses, the megalithic tombs, the hand-woven ikat fabric, the pasola or traditional spears and horse competitions, as well as its scenic sandy beach.  But all these are overshadowed by the island’s high malaria incidence.

We visited Martinus’ village in early October 2014 to monitor the ITN  distribution campaign in Sumba Barat Daya District. Martinus welcomed us and talked about the mosquito nets he received about a week before. 

“I received 2 bed nets from the village chief during the distribution session.”

These were not his first bed nets. He had two already before.  

“I am using two bed nets now and these additional two bed nets I just received are for my two other beds. We received nets based on number of bed we have at home,” he said. In average one net can be used to protect two family members. 

Martinus and wife with the bed nets in front of their house.
 © UNICEF Indonesia/2014/Ermi Ndoen

Martinus told us why bed nets were important to him. 

“I got ill and was treated in a hospital for three days. I was saved but my two neighbours weren’t. They passed away due to malaria. When I came home from the hospital, I immediately bought bed nets for my family and me. We still use them to this day,” he said. 

He had to fork out  160,000 Rupiah (about US$13) for the two nets, on top of the 500,000 Rupiah he had spent on hospital costs. His family accompanied him at the hospital and lost their income during these days, which added to the total costs. 

“It is better to spent money on the nets than to pay for the hospital. It is even better now because the bed nets from the government are free,” he said, adding, “The bed net saves my life.” 

Malaria is a serious public health problem in NTT. With 4.9 million people, the province only accounts for 2 per cent of Indonesia’s population. However, in 2013 about one fifth  of all registered malaria cases in Indonesia (88,500 out of almost 418,000) took place in NTT. 

Sumba is among the islands in NTT with a high malaria incidence. Of Sumba’s 693,000 population, more than 25,000 fell ill with malaria in 2013. The annual parasite incidence in Sumba ranges from 27 to 75 per 1,000 inhabitants.  

Children in Kampong Langgar with their ITN.
 © UNICEF Indonesia/2014/Ermi Ndoen

To fight malaria in NTT, the Indonesian Ministry of Health, with support from UNICEF and the Global Fund to fight Malaria, HIV and Tuberculosis, distributed about 1.6 million ITNs. This has been one of the biggest distribution campaigns in this area ever. It was combined with efforts to combat malaria with other type of intervention such as improve early diagnostic of malaria cases and prompt treatment, as well as community engagement to get rid of mosquitoes breeding sites activities.  

The campaign was launched in all 15 districts of NTT between 15 and 22 September 2014. Despite the success of this campaign, as shown by the large crowd gathering at each distribution point, equally important is the follow-up activities by cadres, village or community leaders, and health centre staffs to make sure that recipients of the bed nets will use them. Proper use of bed nets will ensure people will be protected from malaria and that malaria transmission will decrease. 

Visiting Sumba helped me understand more about the campaign and learn how people were using the nets in respect to their culture, behaviour and local living condition.

Dr. Nafsiah Mboi, then Indonesia’s Minister of Health, emphasized this message during the pre-launch of the ITN campaign in Sikka: 

“Let’s make sure that you use the bed net. Do not use it as a fishing net. Do not use it to fence your garden. Do not sell it. But use it to protect yourself. To protect your beloved baby. To protect your beloved wife. To protect every one of you from malaria threat.”