Pan Africa Bicycle Information Network (PABIN)
Bicycle teams are key in controlling malaria outbreak in south Sudan
(Source: Medecins San Frontier, Information dated 12.12.2003)
Floods have
brought a five-fold increase in cases and the bicycle teams provide life-saving
treatment to stranded areas. Of the over 70,000 people who have been treated so
far, nearly 50,000 have been cared for by these teams.
© Laura Brav, MSF
Over the past five months,
49,262 people in the Bahr-el-Ghazal province of south Sudan have been treated
for malaria by MSF medical teams that are using bicycles to get to areas that
have been isolated by recent severe floods. A total of 71,006 people have been
treated in the area - including 800 severe cases - when figures from the fixed
facilities are included.
Heavy floods have followed two years of drought and have created ideal
conditions for the proliferation of mosquitoes - the vectors of malaria - and
have brought about an increase in malaria cases in the province. The malaria
surge has also followed a food crisis in the region.
MSF teams in Akuem, a town in Aweil East in the Bahr-el-Ghazal province, have
seen a massive increase in malaria cases since June and expect to be treating a
high number of malaria patients until the end of the year. The work with the
mobile teams will continue until the flood waters recede.
"These bicycle operated clinics are the only way to treat patients in regions
that have been cut off by the floods," explained Greg Elder, medical coordinator
for MSF. "These clinics prevent the death of children and vulnerable adults who
would otherwise remain stranded in their villages."
Already weakened from malnutrition, children under the age of 5 are even more
vulnerable this year. Over 50% of the patients treated by the mobile teams have
been children under the age of five. In each village, the teams diagnose, treat
and distribute drugs to hundreds of people. An average of 5,000 patients are
treated every week in the MSF fixed facilities and mobile clinics.
The floods have made transport by 4x4 ineffective as huge areas have become
marshlands that also prevent people from visiting the MSF facilities. Bicycles
are more easily transported through heavily flooded areas.
A total of 40 bikes were bought by MSF to equip 15 teams - each team is made up
of a minimum of one nurse and an assistant. The teams have been active since
August 1 this year. They transport with them the necessary medical equipment to
care for approximately 400 patients. Each stop lasts four or five days and there
are six mobile clinics that leave from Akuem, four from Madhol and five from Gok
Machar.
Explosion in malaria cases
"Malaria is endemic in this region, however there has been a sustained increase
in the number of cases this year in comparison to previous years", noted Elder.
"In July, the number of consultations and hospitalisations for malaria exploded
in Akuem. We have treated nearly five times as many patients than this time last
year."
This year the increase in the number of cases also occurred earlier than usual:
the peak is usually registered in August.
MSF has increased its treatment capacity and extended its activities to Aweil
North. The teams are treating patients in four fixed MSF facilities in Akuem,
Mangar Angui, Madhol (Aweil East) and Gok Machar (Aweil North). Mobile clinics
on bicycles have also been set up to treat patients in isolated areas: the
particularly heavy rains this year have transformed the entire region into
marshlands, preventing patients from reaching health facilities.
Malaria follows malnutrition
This increase in the number of cases of malaria follows a serious food crisis
that has been affecting the province since April. MSF, which had been running a
Therapeutic Feeding Centre (TFC), opened two more TFCs in Akuem hospital and
three Supplementary Feeding Centres (SFC) in Madhol and Gok Machar.
Over the past six months, 1,400 severely malnourished patients were treated in
the TFCs and a further 12,000 moderately malnourished patients were cared for in
the SFCs. The decrease in malnutrition has enabled MSF to transform these
feeding centres into malaria treatment facilities.
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