As the first of its kind, the World Malaria Congress was a stunning success. The Congress organizing committee should be very proud. Grant you, it was not perfect, but first times seldom are. There was a certain rush in getting things done, an eagerness to bring to bed groups that should have had a coffee and a walk in the park beforehand in order to get to know each other's language and idiosyncrasies, likes and dislikes. But the reality of it is that things got done. People engaged with each other and held productive discussions on sensitive topics.
Ricardo Ataide's blog
I was asked by a friend, who is not a malaria scientist (in fact, not a scientist at all) to imagine the following situation:
You were chosen by a malaria endemic country to direct their fight against the disease. The government of the country tells you they will adopt three strategies to fight it, solely based on your recommendations. What would those be?
I was wondering if any of your friends has sent you this link and asked you why we don't want the MMS miracle to be spread around... I'm still confused, not knowing if I should laugh or cry. But I'm inclined to cry...
Pregnant woman arrives at the Maternity. She is worried because she had to leave her kids at home and the River Jurua is about to flood the area, so coming to the Maternity (which involves getting a boat lift from a neighbour and then walking 1.5 km)is a great deal. She is 31 weeks into her pregnancy. Two weeks ago she had a malaria episode, Pf, and was given Quinine and Clindamycin. Now she has diarrhea, lower abdominal pain, 9 g/dL of hemoglobin, 29% hematocrit.
Age: 24 Gestational age:: 37 wks Malaria history:
Pop-quiz: You're not an MD, you are conducting research in a malaria endemic setting and you are not part of the local health system. You overhear a doctor prescribing the wrong malaria drug treatment to a pregnant woman. What do you do?
In malaria endemic areas, researchers and basic health workers need to and often do find ways to join forces and complement each others work. Nevertheless, the prevalent idea among a few who are higher up in the health services is that researchers, like myself, are only there for the "kill". Some of the complaints are that we have a limited time-span in the area, we take joy in seeing a patient who provides us with some parasites and we ultimately take without giving in return. I think that these are usually the things we hear most (and mostly through the grapevine...).
The day had been a hard one. Starting at 6am, it had been filled with hours in front of the computer trying to finish a grant proposal, finishing the review of a paper and looking at dozens of images of placentas... I got home after an hour of public transport in Sao Paulo (why in the hell I still believe that I should not contribute to this city's smog levels is beyond me!!) and my wife was performing some weird australian version of Yoga/Pilates that I'm sure no Indian teacher has ever mastered before. The usual "how was your day" does not work for us.
Day 3 of the course started on anti-malaria drugs. We discussed who should take them and some of their effects, what they should be used for ( treatment? Prevention?) and against what (just Pf? Pf and Pv? All parasites?). The most heated debates arose when the issue of resistance came about. Someone mentioned resistance to artemisinin and immediately some voices rose to say that that is still not a given. There are indeed reported cases of treatment that had to be extended but not of treatment failure as such, which means that, real resistance is still not fixed in the parasite population.
I have just arrived (about 4 days ago) from a leadership course held at the Harvard Business School entitled Malaria: Science of Eradication. This course is a joint effort by Dr Dyann Wirth, Dr Pedro Alonso and Dr Marcel Tanner and is intended to be the first of many. The next course has already been allocated to Barcelona, home of Dr Pedro Alonso's ISGlobal.