“IF YOU THINK YOU ARE TOO SMALL TO MAKE A DIFFERENCE, YOU HAVE NEVER SPENT A NIGHT WITH A MOSQUITO”, African Proverb
Every year on 25 April, people across the globe take part in a wide range of activities to mark World Malaria Day – the day dedicated to raise people awareness to keep up the fight against this killer disease. For most of people in malaria free areas; this moment give them one day in which they may think of malaria.
For the people in NTT and in other malaria endemic zones. “Every day is malaria day” as malaria keep treating their life daily, cut of one beloved child life, and separates life a loving mother or father from their beloved family.
We were blessed enough to be part of 25 fellows from NTT joining the short course on “Malaria Prevention and Treatment for Infants, Children and Pregnant women in Eastern Indonesia; 1-24 April 2016, in Melbourne University – Australia. This short course was supported by Australia Awards Indonesia and jointly hosted by Nossal Institute of Monash University, Burnet Institute of Melbourne University, Menzies University and Mahidol University. The course aimed to increase our knowledge and awareness on malaria issues, to build network and to open collaboration opportunity with the global world and prestigious universities/organizations who are working on malaria areas.
These 25 participants’ come from 11 districts of NTT with different professional backgrounds, experiences and understanding of malaria. The participants consisted of medical doctors, dentist, nurses, midwives, public health officers, laboratory staffs, and lecturers who are the front line health staffs. They participants work in general and private hospitals, public health centres, NGOs, also from districts health offices and district planning and development agencies.
It has been a great opportunity to participate in this prestigious short course. We were grateful to get a deeper understanding on the latest malaria knowledge directly from world leading malaria experts, and some of the best malaria scientists and professional facilitators through courses, presentations, field visits and group works. We also learned from each other fellow participants.
The training provided a complete information package, including malaria situation among infants, children and pregnant women globally, regional, and the comparison to Indonesia and NTT situation. We learned about malaria prevention strategy, one of the key important information provided during the course. This topic guided us to focus on district and village level prevention, community responses and good practice and local models. We have been enriched by case studies from Papua New Guinea on community malaria management and vector control strategies and mosquito population management implemented in Thailand. Needless to say that this kind of information was really important for fellows who are working in different field and with different background.
The constant malaria monitoring and surveillance systems had been highlighted as critical for malaria elimination. During the course, we also learned about surveillance system; how to generate data and information from field and turn into evidence for decision making. We realized that investing in surveillance system to practice needs a carefully design, constant monitoring, better coordination, good timing, good coverage, and deployment of malaria technologies to be able to improve efforts to achieve malaria elimination.
Diagnostic and treatment are other important and critical aspects to reduce malaria. Lots of information on the latest updated on malaria treatment regimens and drug resistance have been discussed. The Artemisinin Combination Therapies (ACTs) are currently the first line treatments against most malaria parasites, especially P. falciparum. However, there is a serious concern that malaria parasites could develop widespread resistance due to many factors including substandard malaria drugs, compliance or adherence to the drug and error in diagnostic. Thus it is very important that health workers have to provide better access to diagnostics and effective malaria treatments with a good quality of anti-malaria drugs.
Topic on malaria vivax was specifically explored due to the increasing number of P. Vivax malaria cases nowadays. It is believed that treatment failures and relapses contributed to the increase of malaria vivax. These recurrent episodes of P. vivax can cause severe anemia, repeated sickness and death associated with P vivax infection.
To achieve a better quality of malaria program, health system strengthening is also needed. It requires government commitment, especially in strengthening the quality of health service delivery including drug supplies and referral system, improving of the quality of health workers through an effective malaria policies and programs through vertical (global health initiatives) and horizontal approaches.
To achieve a better quality of malaria program, health system strengthening is also needed. It requires government commitment, especially in strengthening the quality of health service delivery including drug supplies and referral system, improving of the quality of health workers through an effective malaria policies and programs through vertical (global health initiatives) and horizontal approaches.
The visits to Burnet Institute, Walter and Elisa Hall Institute (WEHI) have given participants opportunity to meet leading malaria experts and to experience their work on malaria research including malaria vaccine development, biomolecular and drugs resistance researches. We also learned about advanced laboratory referral service system by visiting The Peter Doherty Institute for Infection and Immunity in Melbourne. This institute is a joint venture between the University of Melbourne and the Royal Melbourne Hospital, combining research, teaching, public health and reference laboratory services, diagnostic services and clinical care in infectious diseases and immunity, including malaria, TB and HIV/AIDS.
Another highlight activity was the opportunity to participate in the ”end malaria for good” symposium conducted by Burnett institute. We gained vital information about latest issues on drugs resistance, mathematical models to tackle malaria and also how to influence government and get their attention in malaria elimination program and health system strengthening.
On this training we have been assisted by experienced facilitators to develop a very comprehensive project using “SMART” – specific, measurable, achievable, reasonable and time bound criteria. In order to achieve our goals and objectives, we designed series of activities, defined means of clarification, analyzed risks and assumptions. Through these simple framework, we were be able to picture how the project will be conducted and monitored. At the end we managed to develop 8 projects: 2 projects addressing malaria diagnostic quality assurance, 4 projects on malaria prevention for children and pregnant women, 1 project on surveillance system strengthening and 1 project focused on village malaria prevention initiative.
Don’t be afraid that we were only studying hard. Apart of the course, we spoiled our self with enjoying the beauty of Melbourne City – the most livable city in the world and its people hospitality. We explored the Great Ocean Road with spectacular beach, the 12 Apostles, London Bridge, the Brighton rainbow bathing boxes beach, Melbourne Zoo and many more and more, including one extra night to explore Sydney's vibrant.
In August 2016, we continued our endeavor by participating in the post course conducted in Kuta, Bali. During the workshop we had chance to meet up with other fellows from Papua and Papua Barat.
We shared lots of stories and experiences. We were proudly presented all the results from the projects we designed during the workshop in Melbourne. There are ten excellent projects has been presented. The Papua’s group their achievement by presenting “Kebas – Keluarga Bebas Malaria” – a “Family free from malaria” project; SMS (Satgas Malaria Surveilance); Tangible Intruder for Anopheles, and the “One Enough Project”. Whilst NTT team presented “Laskar Jentik” Project in Manggarai; Malaria Surveilance Project in Sumba; Malaria Diagnostic Quality Assurance Projects in Kupang and Ende; Malaria Day in SoE General Hospital and finally the News from Egon – The Malaria Elimination Project in Egon Village of Sikka. We really hope that with our very small projects will be a first step to contribute to NTT efforts in achieving malaria elimination this beautiful area.
Finally, the “honeymoon” periods in Labuan Badjo, Melbourne and Kuta were over. We are now back to the real work. We are strongly believe this short course has achieved its explicit objectives. To a large extent all participants, presenters and facilitators have shared their experiences and knowledge. Now is the time to face future plans and challenges in implementing malaria elimination program. We have been equipped with many tools and methods to be more persistent, knowledgeable, confident, more empowered for our future learning experience and malaria endeavor.
We thank Australia Awards Indonesia for giving this opportunity to be part of global community for “Making Different with Australia Awards” as we believe that “we are not too small to make a difference, since have spent most of our night with mosquitoes”. Hopefully, East Nusa Tenggara will be able to eliminate Malaria in 2025, five years earlier than national target … a dream to be true.
Thank You Very Much for AAI.
Authors: Ermi Ndoen and Margaretha Telly (margarethateli@gmail.com)
#EndMalaria #Australiaawardsindonesia #unimelb #Bebasmalaria
