CHAKWINDIMA, Malawi — In this rural village west of the capital Lilongwe, the Jackson family enjoys a relatively privileged life. The father runs a private school for AIDS orphans. The mother is in charge of preparing two meals a day for the students. They earn two salaries in a place where most people have none and live off what they grow in the fields.

But malaria spares no one here, including the Jacksons.

During the rainy season from November to April, people in this village contract malaria up to four times each, residents say. The initial signs are distressingly familiar—headaches, chills, sweats, fatigue. And yet even with those recognizable warnings, this village is full of stories of people who have died from malaria. Some didn’t have the money to get tested and buy drugs, putting off receiving medical help until it was too late. Others contracted an often-fatal type of malaria that attacks the brain.

A major public-health problem in this landlocked, eastern African nation of 13 million people, malaria is a leading cause of illness and death, particularly among children under the age of five. Pregnant women are also especially vulnerable to the disease, which the 2004 Malawi Demographic and Health Survey estimated to be responsible for 40 percent of all outpatient visits to health facilities in the country.

During the 2007–2008 rainy season, the five-member Jackson family came down with malaria a combined 14 times. Four-year-old Daniel contracted it four times. He fell into a debilitating routine: He would get sick, take the drug Fansidar, get better, and a month later would get sick again.

"We sleep under bed nets every night," said Jacques Jackson, 36, the father. "But we also spend some time in the early evening outside," a time thick with mosquitoes, which transmit the disease-causing parasite to humans when they bite them.

Mary Jackson, the mother, "prepares food for us and cooks outside. The children like to be close to their mother, and so they are outside with her. And maybe they even are bitten when they sleep under the nets, because they often roll right up against the nets, where the mosquitoes can get them."

In March, Mary Jackson, 32, suddenly fell ill late one morning. She began to vomit, stumbled into her bedroom and collapsed on her bed. Her oldest child, Jackisha, 10, followed her into the room and talked in soothing tones to her mother, who barely responded.

"I was really worried," the girl remembered. "I prayed for her."

At that moment, Jacques Jackson was running errands in Lilongwe, a 45-minute drive away. When he returned in the early afternoon, his family and friends led him directly to his wife. She was shivering violently. He placed two blankets atop her, but soon realized he had to get her to the hospital, a half-hour drive away.

Mary Jackson couldn’t move her legs. He picked her up and carried her to his truck. Through the village, word spread quickly of her illness; everyone knew it had to be malaria, which was confirmed by hospital tests. People prayed all that day and night and into the next morning for her.

That morning, after receiving doses of anti-malarial medicine the night before, Mary Jackson felt much better. Three days later, the hospital released her.

She still remembers the episode vividly. "I was worried that I had cerebral malariaV—the type that attacks the brain—she said. “I didn’t, but even ordinary malaria can be so dangerous."

The Jacksons know this intimately. The couple’s second child, Junior, died of malaria in 2000 at the age of eight months.

After dealing with malaria his whole life, and after hearing stories from his grandparents and village elders about how the illness had felled so many, Jacques Jackson has begun to look at the problem as something unconquerable.

"We don’t think it can go away," he said. "We don’t have much hope. We really wished we had some hope—that would change our lives so much."


John Donnelly has covered global health issues as a journalist for more than 15 years, most recently for The Boston Globe. He now is a free-lance writer and works for Burness Communications.

18 Sep 2008
By John Donnelly, Vice President and Senior Editor, Burness Communications