Mariatu Sesay, a mother of seven and grandmother of four, has lived in the Kroobay slum for her entire life. She has one word to characterize her residential area: a dumpsite.
Kroobay is near the Atlantic Ocean and it is the last station for all the garbage rushing down with the heavy rains from the hills around Freetown.
With trash clogging the rivers and drainages, puddles of stagnant water form especially around slum communities, and malaria-carrying mosquitoes love stagnant water where they breed and multiply uncontrollably.
Living in a mosquito-infested area, Mariatu visits the hospital almost every month with a sick child. “Each time I take my children to hospital following a fever, they will be diagnosed with Malaria.”
And while malaria care for children under the age of 5 is free, Mariatu sometimes ends up buying Malaria drugs from the pharmacy, because the hospitals runs out of Malaria medication.
The connection between poor sanitation and Malaria
Kroobay community is not the only one considered to be a dumpsite by its residents.
Lack of a national policy on waste management has turned low-lying communities around Freetown into dumping grounds for all the trash washing down from the hills during the rainy season.
Dr. Alhaji Sanyi Turay, Deputy Manager of the National Malaria Control Program at the Ministry of Health and Sanitation (MOHS), said that there is a very close connection between the unclean environment and Malaria disease. Mosquitos breed –or multiply—in stagnant water, such as the clogged rivers, uncovered mining pits filled with water, the swamp areas, and stagnant water near highly populated communities.
President Bio’s government began a monthly national cleaning exercise in May 2018 to tackle the overwhelming amounts of trash. But because of the coronavirus outbreak, the cleaning was placed on hold in March, more than eight months ago.
Sorie Alpha Kamara, Acting Environmental Officer at the Freetown City Council (FCC), said that since the cancellation, people became unenthused about clearing their trash. “They are leaving it for the Council to clean it for them,” he said.
The FCC deploys 40 Public Health Inspectors who try to ensure that community drainages and the environment are clean, and launched 80 tricycles, commonly known as Keke for 80 youth groups, to do regular garbage collection in communities and public places. But this is not enough, especially since most of the trash comes from the uphill.
Open mining pits are mosquito hotbeds
Malaria is one of the biggest killers in Sierra Leone. An estimated 2,240,000 people visit hospitals and healthcare centres to get Malaria treatment each year. Of these, 1,000,000 are children under the age of 5. According to the 2019 Demographic Health Survey, 12 out of every 100 children under the age of 5 will die before 5. Many of these deaths are Malaria related.
According to the Malaria Indicator Survey (MIS) 2016, Port Loko, Tonkolili and Koinadugu have the highest Malaria prevalence in the country.
Joseph Sapunka Turay, Assistant Director of the Environment Protection Agency Sierra Leone (EPA-SL), emphasized the degree to which open mining pits could increase the incidence of Malaria:
“Artisanal miners are not supposed to use heavy machinery to dig up deep holes, but some of them secretly use it. These are the uncovered pits that you see very close to homes and residential areas. And now, it poses health risks, like Malaria and sometimes [cause] fatalities. If we destroy our environment, we are destroying ourselves and our future generations,” Turay explained.
EPA only regulates large scale and small-scale mining companies, and not artisanal miners. The Agency has started engaging the local authorities on the safety and protective measures that artisanal miners should institute before and after mining.
“Now, we see that the impact of artisanal miners is as cumulative as the small-scale miners. If you finish mining in a particular area, cover it. Don’t leave it open. Because it will serve as a breeding ground for mosquitoes. This will make the country to record high incidence of Malaria,” Turay cautioned.
Most victims of Malaria are African Children
Malaria is a serious and deadly disease caused by the Plasmodium falciparum parasite that infects the female Anopheles mosquito. When a mosquito bites an infected person, a small amount of blood is taken by the mosquito, which contains Malaria parasites. About a week later, when the mosquito bites another person, these parasites mix with the mosquito’s saliva and are injected into that person’s blood.
People who get Malaria experience high fevers, shaking chills and flu-like illnesses. Illnesses and deaths from Malaria can usually be prevented if the people seek immediate medical care and treatment.
Globally, the World Health Organization (WHO) estimates that 228 million clinical cases of malaria occurred in 2018, and 405,000 people died of Malaria, most of them children in Africa.
Special attention to pregnant women
Malaria may also be transmitted from mothers to babies before and during delivery, which is called congenital Malaria.
In Sierra Leone, medication to prevent and treat Malaria is free for pregnant women and children under the age of five who must receive treatment every month. To help protect them from getting infected with Malaria, pregnant women visiting clinics will receive prophylaxis medication, called Sulfadoxine/pyrimethamine (SP). If a pregnant woman is already infected with the malaria causing parasite resulting to the disease, they will receive a drug called Lumefantrine and sometimes they receive Artesunate Amodiaquine, which Dr. Alhaji S. Turay says is very effective.
Mosquitos thrive in slum communities
Sierra Leone’s biggest problem in fighting Malaria is poorly managed waste, said Isha J. Kamara, Programme Manager for Women’s Network for Environmental Sustainability (WoNES). The garbage is just laying around, there are no collection and dumping sites, and a lot of trash clog up the drainages, and the rivers, and cause water to accumulate near people’s homes and become mosquito hotbeds.
“Mosquitoes thrive in areas with poor sanitation, and slum communities in bay areas in the Western Area are the most affected, because they get the largest number of pools of stagnant water,” said Isha. She said that the government must implement policies to ensure that the waste is properly managed and disposed of and called on the stakeholders to prioritize public education on the connection between sanitation and Malaria.
Aminata Kane Blade, the focal point for Speak Up Africa, a policy and advocacy action tank for sustainable development in Africa, added that people lack proper information on how to eradicate Malaria, how to avoid it, and how to get immediate treatment when they get sick. Communities should be able to share information and partners need to have an integrated and collaborative approach on tackling it.
“At a smaller scale,” she said, “having a sanitized environment means that you not only protect your environment but also your communities.”
By Stephen V. Lansana
30/11/2020. ISSUE NO: 7960