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Where the real battle is won

May 23, 2012 - 03:23 -- Ricardo Ataide

May 9th, 2012

I fly out from Sao Paulo, a true concrete jungle, for my very first trip to the Amazonian Rainforest. As I fly over it I see miles and miles and miles of untouched rainforest crossed by natural waterfilled highways, some black as the night others the color of clay. Suddenly, the Amazon River. A true inland sea slowly heading east. Even more suddenly, a city with highrises, traffic, smog... it's Manaus. I quickly leave Manaus and the infantile shock of having to conciliate my childish image of the Amazon and the reality of today's situation and head to the city of Cruzeiro do Sul, in the State of Acre.

May 10th, 2012

I arrive in Cruzeiro do Sul. After yesterday's shock, I am prepared for everything. What I find is a very pleasant town still at peace with the muddy margins of the Jurua River. Colourful wooden houses on stilts populate the right margin while a mix of wood, stilts and concrete make up the left margin and form what is the heart of the city, dominated by a german-style church, a remnant of a time when this Brazilian State was a major source of natural rubber (until Malaysia proved to be much more suitable for it). Cruzeiro do Sul is, together with 3 other municipalities the source of over 80% of Brazil's malaria cases and we are conducting studies on Malaria in Pregnancy here. We want to understand how malaria spreads in this environment, what parasites circulate, their burden on the lives of these riverine populations and how the battle against this can be fought. The following 11 days will be spent talking to several political, academic and health authorities as we try to forge new partnerships that will allow our research to continue and the students from Acre Universities to have access to better research facilities, equipment and projects.

May 21st, 2012

Back in Sao Paulo I have time to reflect on what I saw, heard and felt. As many other places situated at about the same latitude, both above and below the equator, Acre is plagued by many problems. Yes it has malaria. Yes, dengue and hepatitis plague the place. But it seems to me that the biggest problem of all is ambition. Political ambition. Maybe add to that a lack of political backbone and will. Fortunately, there are still some good examples of people that are fantastic professionals trying to improve a state where the population has to survive and make a living out of a Forest that the entire world wants to keep untouched. Funny thing is that the entire world lives outside of Acre. Acrianos were pushed into going to Acre at a certain point to develop the country and now there are no alternatives for the ones that remained. But I digress. I wanted to talk about those fantastic professionals that  can still be found in environments so adverse to actually being one! I wanted to talk about the warriors that are fighting the battle against Malaria on the ground. The Endemics control team in Cruzeiro do Sul. A fantastic group of field agents on motorbikes and 4x4 trucks, supervisors and administrative staff that with the support of the health secretary of Acre make sure that every single day every neighbourhood, no matter how far, or how muddy the roads are, receives a visit from an agent and is actively screened in search of malaria, or receives advice on malaria protection, or gets a delivery of bed-nets. These are the men and women that received us and our research with open arms for they saw in it a desire for improving what is currently being done as well as a way of acquiring knowledge in areas that are clearly in deficit. These are the men and women that have brought down the malaria cases in Acre in the last 5 years and received internacional recognition for it. 

Sitting at my desk at the University of Sao Paulo I'm giving the finals touches to a paper we wish to publish soon. I am looking at the acknowledgments, where we thank the Endemics team, feeling like someone fighting a battle on a computer screen and somehow I know that they will have little time to care for that "thank you", for they are fighting where it matters, on the ground, where the real battle can be won.

Comments

Submitted by Guest (not verified) on

Bravo, Ric.

The Endemics control team you describe display precisely the constant, unfailing, regular attention to detail referred to as 'the general procedure followed in the organisation of the control areas and the antilarval and antimosquito measures employed in our work' in my blog of two days ago entitled 'How was malaria of 100 years ago eradicated in Palestine/Israel? And without vaccine?' This is the constant vigilance and conduct that Dr Kligler stressed in the fight against malaria, and repeated that it was as important as the other antilarval measures.

The education of the Palestine population in the 1920s of the benefits to be derived from these measures by co-operation and assistance of the scientists and their support teams usually made enforcement of the ordinances and regulations by the British mandate in the 1920s unnecessary.

Kligler had no magic vaccines, he didn't rely upon bednets. His method worked, malaria was eradicated.

Bravo again for highlighting a side of the fight against malaria that is so easily dismissed or overlooked.

Anton Alexander

Ingeborg van Schayk's picture
Submitted by Ingeborg van Schayk on

Dear Ricardo, thank you for sharing this beautiful true-story with us. I very much welcome the attention that you give to 'workers in the field' who are actually doing the hard job when it comes to fighting malaria in real life. Do you think we could get their stories and views on figting malaria and post them at MalariaWorld? It would be valuable to share the stories about what does and doesn't work for them. What successes they achieve and what problems they face. What do you think? - Inga

Submitted by Ricardo Ataide on

Hi Inga,

Thanks for your comment. Yes, I believe that having their stories and posting them here would be an excelent idea. I'll see what I can do about that.

Cheers,

Ric

Ricardo Ataíde