Photo credit: Kelsey Mertes, PATH Malaria Vaccine Initiative
30 Apr 2012
By John Tanka Bawa, RTS,S Project Manager and Communications Officer, Kumasi/Agogo, Ghana

I grew up in an environment where mishaps, including illnesses, were attributed to mysterious forces, supernatural beings, and local myths. The causes of the maladies would range from punishment by the gods or deities, to it being one’s predetermined destiny. 

Whenever someone had malaria in my community, people said he’d eaten too much red oil, as in my community, malaria was “caused” by red oil and sun. “Staying out under the sun causes malaria,” they’d say, or “the consumption of too much red oil causes malaria.” Pito, a locally brewed gin from millet, was a “malaria therapy,” and so on.  

Most families could not access basic health care

When children started showing signs of fever, they would be covered with layers of heavy cloth and placed near a bucket of hot water mixed with various herbal concoctions for 30 to 60 minutes as a therapy. This unfortunately aggravates the rise in a child’s temperature, and often leads to convulsions. On such occasions, women would be barred from touching the child, and in the absence of a male family member, a mother would have to run around the community looking for a male to assist her. If a man was found, he would pick up the child and rush him or her to the nearest traditional healer to administer herbal preparations and invoke the powers of the ancestors to intercede.

Bear in mind that the nearest health care facility was 25 miles away, and there was no ready transport available to go there. Often the afflicted children died, became mentally deranged, or experienced other forms of disabilities. Again, the illnesses were often attributed to a supposed disobedience to the gods or the destiny of the child. I personally witnessed three of my siblings die in this manner whilst growing up.

Ignorance of how to manage malaria and other diseases aside, the lack of basic health infrastructure, coupled with high poverty levels, meant that most families could not access basic health care. The result was high levels of morbidity and mortality among children under five years.

I have seen a gradual but steady improvement

In the past 15 years, however, I have seen a gradual but steady improvement in health care provisions; intensive public awareness efforts about the causes, treatments, and effects of malaria; distribution of bednets to vulnerable groups; spraying for mosquitoes; and the introduction of artemisinin combination therapies (ACTs) at prices that an average family can afford. The introduction of the National Health Insurance Scheme in Ghana in 2008, which replaced the fee-for-service regime, also has made health care for the masses more affordable.

Importantly, the Expanded Program on Immunization, through its community outreach and education programs and efforts to immunize all children under five against most of the killer childhood diseases has been widely embraced by the families of Ghana. It has relieved a great deal of suffering and saved a lot of lives that hither-to would have been lost.

People in my community now talk with wonder about how certain childhood diseases such as measles, yellow fever, diphtheria, neonatal tetanus, pertussis, poliomylitis, tuberculosis, and so forth, which were very common, have become a thing of the past thanks to the introduction of vaccines and improved access to health care.

It is with this same optimism that I expect my community to embrace a malaria vaccine when one becomes available. Everyone in my village has a personal story to tell about the devastating impact of malaria: heartbreaking deaths, loss of work, limited cash going for remedies at the expense of food or school fees, and life-long impairments. I can hear relief and joy replacing tears and anguish in homes across Africa on the day an effective malaria vaccine is deployed for our children.