Reducing the burden of severe malaria in Nchelenge, Zambia using artesunate rectal capsules
Daisy Musambachime had a vision fifteen years ago that she wanted to help people in society by becoming a community health worker (CHW). Today she serves 2,500 people in the 3km radius Mulumba district.
“The biggest challenge I’ve encountered in my career as a CHW is that people in our society lack an understanding of the importance of making the journey to a hospital to receive care.” Daisy says.
In Daisy’s role as a CHW, she can diagnose and treat most children—those who have the symptoms of uncomplicated malaria. In some cases, though, children are severely ill and need to make the journey to a higher-level healthcare facility.
The district's web of dirt roads is eroded from the seasonal rains, making access to hospitals challenging. Daisy suggests to the families of severe malaria patients that they make the trip to St Paul’s Hospital by bicycle taxi—usually, the parent holding their sick child on a makeshift seat above the back wheel as they navigate the eroded roads. This is the best value for money transport in the area. Most consider the risk of an accident justified by the short timeframe to treat severe malaria.
Daisy has had to deal with every complication under the sun from their understocked and understaffed community clinic. Yet she rates reducing the travel time to the hospital as the most critical element in treating malaria, as so often valuable hours have been lost due to transport delays.
This is why Daisy is very excited about an innovation that is shortening the bridge between community clinics and hospitals, making the transfer to adequate health care less deadly. Artesunate rectal capsules temporarily calm the infection and buy valuable hours to make the journey from a rural setting to the hospital where the patient can receive further treatment. Patients that have received the intervention arrive at the hospital in better condition, reducing the risk of complications and increasing the probability of survival.
Today Daisy is a prominent figure in her community. It is clear by the way people respond to her as she walks the dusty streets with her medical bag over her shoulder. She receives looks of appreciation from passers-by in Mulumba district.